Ontario’s efforts to connect residents with primary care remain weak, according to the latest annual report from Auditor General Shelley Spence. The 483-page review, released Tuesday at Queen’s Park, highlights failures in primary care planning, OHIP billing oversight, medical school expansion, and the province’s PPE inventory system.
Spence found serious issues in how the Ministry of Health and Ontario Health manage programs meant to link residents to family doctors. She reported that the Health Care Connect system does not meet current needs. As of June 2025, more than 178,000 people waited for a referral to a family doctor. Over 108,000 waited longer than a year. About 5,000 had complex health needs.
Wait times varied widely. Of the 197,000 people connected to a doctor since the 2020 to 2021 fiscal year, 47 percent waited less than 21 days. Fifteen percent waited more than 260 days. Twelve family health teams have already told the ministry that the tool created in 2009 no longer works for them.
Spence also flagged low public awareness. Only about 235,000 people without a doctor are registered on Health Care Connect. That represents about 11 percent of Ontarians without a primary care provider. She noted that the government has not updated its communication plan for the program since 2015.
The report found alarming examples of high-risk billing patterns that the province failed to review. Spence identified physicians who billed for more than 24 hours of work in a single day or claimed to work every day of the year. One ophthalmologist billed 6.7 million dollars in 2023 to 2024, more than double the next highest earner. A diagnostic radiologist billed 3 million dollars in 2023 to 2024 while reporting work on at least 364 days each year since 2021.
She said the ministry relies too heavily on complaints instead of proactive data monitoring. A joint working group in 2019 estimated that limiting medically unnecessary services would save about 480 million dollars each year, but the province has realized only 87 million dollars in reductions.
Ontario plans to add 340 undergraduate and 551 postgraduate medical school seats by 2028 to 2029, with most directed to family medicine. Spence said the government offered no clear analysis to justify these numbers or its decision to create two new medical schools. Schools also delivered 89 fewer family medicine seats than expected due to a shortage of training sites.
The report found that Supply Ontario has yet to implement a complete system that tracks PPE quantities and costs. Spence said manual tracking and delays in documentation continue to slow audits. She noted that a new logistics contract is in progress but not yet fully integrated.
The government accepted all 11 recommendations related to primary care.
