Wait times increased for some surgeries outsourced to for-profit clinics in Ontario: report

Wait times for surgeries and medical imaging in Ontario have increased since the provincial government began outsourcing these procedures to private for-profit clinics, according to a new report.

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The research, published on Monday by the Canadian Centre for Policy Alternatives (CCPA), analyzed publicly available Canadian Institute for Health Information (CIHI) data and Freedom of Information requests and found that between 2017 and 2025, median wait times for eight of 12 priority procedures increased in Ontario.

For MRI scans, for example, the research found that median wait times increased from 35 days in 2017 to 47 days in 2025, an increase of 34 per cent. In the same time period, increased median wait times for cancer surgeries included bladder (eight per cent), breast (33 per cent), colorectal (five per cent), lung (25 per cent), and prostate (18 per cent).

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National Post spoke to Andrew Longhurst, a research associate with CCPA and the author of the new study, who said the findings regarding cancer surgeries in particular are “concerning.”

“The movement of resources and funding to the private sector for lower complexity procedures often results in increased wait times for those more complex procedures like cancer surgeries, where they’re only performed in public hospitals,” he said. “Staff in (for-profit) facilities are performing lower complexity procedures at the expense of those more complex procedures. So that is a concerning finding regarding wait times.”

Elsewhere, other procedures saw smaller increases in wait times or little change. Median wait times for cataract surgeries, one of the key procedures subject to privatization, according to the study, increased from 67 days in 2017 to 68 days in 2025. Wait times for hip fracture repair also increased by one day, from 23 days in 2017 to 24 days in 2025.

For CT scans, median waits remained unchanged, at six days between 2017 and 2025. Coronary artery bypass graft (CABG) surgery wait times also stayed the same, at eight days.

In other areas, wait times improved, including for hip replacements, which declined from 82 days in 2017 to 76 days in 2025, and knee replacements, which decreased from 92 days to 81.

Meanwhile, Lily Barnes, a spokesperson for Ontario Health Minister Sylvia Jones, said in a statement to National Post that the findings of the study don’t reflect “the reality of Ontario’s health-care system.”

“Ontario is proud to lead the country with the lowest wait times for joint surgeries, like hips and knees, and we are continuing to make record investments to keep times down, including $101 billion in our health-care system this year alone,” she said, adding that the figure represents a 64 per cent increase from 2018.

“This historic funding has directly supported hospitals in reducing surgical backlogs, including $1 billion to increase surgical capacity across the health-care system. We have also shortened waits for diagnostic imaging by adding 50 new MRI and CT machines in hospitals and increasing publicly funded imaging capacity by 450,000 annual hours since 2018. Last year, we performed a record of nearly three million MRI and CT scans, a seven per cent increase from the previous year. As a result, Ontario now has some of the shortest wait times in the country for MRI and CT scans.”

According to publicly available CIHI data, no benchmark has been established for MRI and CT wait times. For hip and knee replacements, 84 per cent and 82 per cent of patients met the wait time benchmark respectively in Ontario in 2025. This compares to 69 per cent across Canada for hip replacements and 63 per cent for knee replacements.

For-profit surgical and medical imaging is big business, the study says, and it’s growing. It argues that the provincial government is “aggressively promoting greater for-profit involvement in health-care delivery,” with the most pronounced shift in this policy direction following the passing of Bill 60, Your Health Act, in 2023, which allows more private clinics to offer certain publicly funded surgeries and procedures.

It says there are now 918 licensed integrated community health services centres (ICHSCs, previously called independent health facilities) in Ontario, up from about 902 in 2023. Between 2017-18 and 2024-25, the volume of surgeries performed in ICHSCs increased by 117 per cent.

Of these ICHSCs, 21 have transfer payment agreements with the Ministry of Health to perform plastic surgeries (eight facilities), eye surgeries (six facilities), and CT and MRI scans (seven facilities). The remaining 897 bill the Ontario Health Insurance Plan (OHIP) on a fee-for-service basis.

Meanwhile, in 2024-25, for-profit surgical and medical imaging was a $674 million industry in Ontario, up from $457 million in 2017-18 (an increase of 48 per cent).

As a share of the total public payments to for-profit facilities, medical imaging facilities received the largest share, at 92 per cent ($621.8 million) in 2024-25, while those performing surgeries received 7.7 per cent ($52.1 million).

Bill 60 formed part of the government’s efforts to decrease wait times and reduce a backlog of surgeries, but the study’s findings challenge the rationale that greater outsourcing of surgeries reduces wait times.

It adds that this finding is consistent “with the international evidence, and from other provinces, which finds outsourcing is not an effective strategy to reduce public wait times.”

Longhurst explained that this is because increased surgical and medical imaging outsourcing creates “fragmentation in the health-care system,” which results in longer wait times.

“Hospital-based (delivery) tends to be more integrated and centralized, and it allows resources to be focused,” he said. “When you increase surgical and medical imaging outsourcing, you tend to create fragmentation within the health-care system, and with that comes the shifting of health-care professionals, including medical imaging technologists, surgeons, anesthetists and, importantly, operating room nurses. So it has the effect of spreading those staffing resources thin.”

With this in mind, the research makes three recommendations to the provincial government: stop privatizing surgeries and medical imaging; immediately increase public hospital funding and service capacity; and commit to evidence-based public system improvement strategies.

“When we look at the international research coming from a number of different studies, that evidence tells us that increasing public sector capacity in a more integrated, coordinated manner actually has the best evidence to support reducing wait times over the long run,” said Longhurst. He adds that the provincial government needs to recognize that the current approach is not working, and commit to a plan that implements strategies that are proven to reduce wait times, such as centralized wait lists.

“The research has shown that we could have all Ontarians getting their orthopedic surgeries within the recommended benchmark if the provincial government adopts this as the standard operating procedure, province-wide,” said Longhurst.

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