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Ontario health care ‘on the edge of the precipice’

Posted: November 8, 2023

(November 7, 2023)

By: Kyle Darbyson, Fort Frances Times

Simon Fraser University policy researcher Andrew Longhurst is calling on Premier Doug Ford’s government to scrap its expansion of the for-profit health-care sector, which he believes comes at the expense of public hospitals.

Longhurst detailed his grievances with the for-profit health-care system in a new report titled “At What Cost?: Ontario hospital privatization and the threat to public health care,” which was published by the Canadian Centre for Policy Alternatives this past Thursday.

On Monday, Longhurst discussed the results of this report at a series of press conferences in Sault Ste. Marie, Sudbury and North Bay alongside Ontario Council of Hospital Unions president Michael Hurley.

Longhurst talked about how an increased reliance on for-profit health-care delivery worsens public-sector staffing shortages and destabilizes hospitals, alongside being generally more expensive and lower quality.

Even though public information surrounding the growth of Ontario’s for-profit health sector is hard to come by, Longhurst unearthed some new data using Freedom of Information requests.

For example, Longhurst cites that public payments to for-profit facilities (including independent health facilities and private hospitals) increased by eight per cent between 2017 and 2022, while payments for surgeries increased by 45 per cent within that same period of time.

“By dollar value, for-profit medical imaging facilities receive the largest share of public funding— $458.6 million in 2021-22,” Longhurst writes in his report.

“Of these, ultrasound and diagnostic radiology (x-ray) received the largest share of public payments.”

In May of this year, the Ford government continued this policy directive by passing Bill 60 (the Your Health Act), which expanded the types of surgical and diagnostic procedures allowed outside of public hospitals.

Even though this piece of legislation was designed to cut long wait lists for care, Longhurst insists that the for-profit model leads to worse outcomes for patients.

Not only does this system leave patients more vulnerable to predatory practices like upselling, but Longhurst said that their safety is sometimes sacrificed in order to protect a bottom line for investors.

To support his claim, Longhurst cites a 2017 study from the Centre for Health and the Public Interest, which revealed that 82 for-profit hospitals in England were responsible for £250 million in extra costs to the public system over three years, since patients were transferred to public hospitals because of complications at a private facility.

Despite these less-than-favourable outcomes for patients, Longhurst said for-profit organizations are still able to offer attractive incentives for prospective health-care professionals, such as reduced workloads, less complex patients and higher pay.

Because of this, public health-care groups are forced to recruit staff from an increasingly limited pool of specialists to contend with an already overburdened health-care system.

“Increasing surgical and diagnostic capacity depends on the availability of qualified staff, which is not magically increased by the addition of profit,” Longhurst said in a Monday news release.

“Ontario has the physical space and equipment to improve wait times for surgeries and medical imaging. What is missing is the health-care workforce and funding necessary to do the work.”

According to Ontario Health Coalition executive director Natalie Mehra, the province’s increasing neglect of public health care is being felt at the Sault Area Hospital, where only four operating rooms are open on most days.

Mehra insists that the hospital could run five to six operating rooms if it was properly funded.

“We have already paid to build the Sault Area Hospital. We should use it to its capacity,” Mehra said on Monday.

“And of course, the private clinic’s extra-billed patients have serious quality problems and every staff person that they take out of the public hospital damages access to care for the majority of people.”

Longhurst ends his report by listing a series of recommendations on how the province can ensure better patient outcomes by refocusing on public health care.

These measures include: extending public operating room capacity, prioritizing the use of single-entry and team-based referral models and increasing access to seniors’ home and community care (thereby reducing hospital overcrowding).

“Ontario is on the edge of the precipice,” he writes in the concluding paragraph of his report. “Pursuing a policy direction at odds with the evidence and policy experience in Canada risks destabilizing public hospitals, increasing wait times, and entrenching a for-profit hospital industry that seeks to dismantle public health care.”

To read Longhurst’s report in its entirety, visit

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