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Academic report warns against the privatization of hospital surgeries

Posted: November 18, 2025

(November 17, 2025) By: Maegen Kulchar, The Kingston Whig Standard

A Professor from England is warning Ontarians about the consequences for-profit clinics offering surgeries will have on the public sector.

The Ontario Health Coalition, Ontario Council of Hospital Unions-CUPE, along with a professor emerita from the University of Newcastle are urging Ontarians to vote against the privatization of hospital surgeries.

In June, the Doug Ford government announced that it would be adding more than $155 million to help fund private health-care clinics throughout the province to help increase access to care, a move that Allyson Pollock, a professor at Newcastle University, explained would be have negative effects down the road. She said increasing the role of private, for-profit corporations come at the expense of shrinking the public system.

Pollock has not only witnessed the consequences of privatizing surgeries in the United Kingdom such as cataracts, hip and knee replacements, but she along with a colleague have compiled a report analyzing the negative effects.

The report compared the health-care strategies of two countries within the United Kingdom, England and Scotland.

While Scotland decided to increase funding to its public hospitals, England went another route and chose to contract out hospital surgeries to private clinics with a goal to improve wait times.

Twenty years later, Pollock said the results are not what the government had expected. Instead of reducing wait times, her research shows not only longer wait times, but increased inequalities and a reduction in capacity in the public system.

“As you would expect, when you’ve got this rise in admissions, the waiting times fall, but what we found was that the waiting times fell less in England than in Scotland. So it was still higher at the end of the 22-year period,” explained Pollock, who said the private clinics also lead to inequality among patients. “The private sector was preferentially selecting the richer patients and not the poorer. So, there was a growing inequality for hips and knees.”

According to Pollock, the contracts allow the private sector clinics to pick and choose its patients.

“That’s because the private clinics don’t have intensive care, they don’t deal with sick patients, so they need the healthy patients. The healthy patients tend to be drawn from the richer parts of the community. They have less of the comorbidities,” said Pollock.

According to the report, between 2016 and 2024, England saw a 20- to 60-per-cent rise in for-profit clinics for hip and knee surgeries, which has led to the creation of more than 155 private clinics.

There are also 175 clinics for cataracts.

In addition, the report claims that the use of private clinics have led to an increase in readmissions due to complications.

“Around five to six per cent of patients are readmitted to hospitals within 30 days of having their elective surgery,” the report read. “Re-admissions from private for-profit clinics accounted for almost 120,000 “bed days” used or ‘lost’ in public hospitals.”

Pollock said the other issue revolves around hospital staff who have moved away from the public sector and into the private clinics. While it may be an attractive move, considering you only have to complete one particular surgery, it creates a void within the public hospital.

“Now the staff are split. More and more of the doctors are exiting into the private clinics, which is the quick and easy stuff, leaving the public sector with doctors and nurses to deal with all of the complex cases,” explained Pollock, who added the private sector also receive a lot more funding due to a tariff system.

In comparison to England, Scotland was able to achieve better results through its public system. The report found that by building capacity in its public system Scotland increased admissions, overall wait times were shorter and they have been able to invest in training its health-care professionals, which maintained expertise in the public system.

According to Natalie Mehra, the executive director of the Ontario Health Coalition, the Ontario government’s plan to invest in private clinics is a political decision that could be detrimental.

While Ontario doesn’t have any private clinics that conduct knee or hip surgeries, it does have clinics that offer cataract surgery.

“Most of the private clinics that we see that exist are selling cataract surgeries and the proportion has increased significantly, but nowhere near to where it is in England at this point,” said Mehra.

She said of 935,729 cataract surgeries done in Ontario between January 2017 and March 2022, 81.4 per cent were done in public hospitals, while 18.6 per cent were done in for-profit clinics.

They are also paid more by the province according to Mehra.

“In Ontario, the private clinics are given a facility fee to cover their overhead and costs. Public hospitals are given a quality-based procedure funding amount. In private clinics for cataract surgeries here, its over $600 for the private clinic and its $500 per surgery for the public hospital. So its 20 per cent more per surgery for the private clinic,” said Mehra, who said that adds up to millions of dollars extra that they are paying the private clinics.

According to Mehra, there are two cataract clinics in Kingston, one of which offers cataract surgeries for a cost even though the procedure is covered by OHIP.

She made a phone call to that particular clinic, which told her a rough estimate of the procedure would be around $3,500 per eye.

“We have a public health system. You are not allowed to charge a patient. It’s illegal under Ontario law. It’s unlawful under the Canada Health Act, which bans user fees and extra billing of patients. We pay through OHIP for our public health-care services,” said Mehra, who explained the extra cost is usually associated with an array of different lenses, a vision correction along with eye drops.

A Freedom of Information report gathered by the Kingston Health Coalition found that from Nov. 24, 2021, to Sept, 30, 2023, that particular clinic cost the public health-care system $2,036,779, a 56-per-cent increase over what it would have cost to perform the same services in the public hospital.

For Mehra, it’s a parallel situation to England that could get much worse if Ontario continues down the path of funding for-profit clinics.

“We’re calling on the Ford government to stop it. We’re calling on them to redirect that funding back to the public hospitals and away from the private clinics,” Mehra said.

“It’s a disaster for Ontario. It’s catastrophic,” echoed Pollock. “I would warn against it.”

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