Ontario's Auditor General has issued a critical report regarding Premier Doug Ford's government and its handling of health care services. The report highlights significant shortcomings in connecting Ontarians with family doctors, ensuring timely medical appointments, and overseeing billing practices under the Ontario Health Insurance Plan (OHIP).

Auditor General Shelley Spence's annual report, presented to the legislature, reveals a lack of action to address an estimated $1 billion in potential overcharges by physicians. This includes instances where 59 doctors billed for more than 24 hours of services in a single day. Spence noted that there is “limited oversight” leading to patients paying out-of-pocket for services that should be covered by OHIP, particularly in cataract clinics. “The ministry (of health) has not done enough work to prevent these practices,” Spence stated in the 483-page report released on Tuesday.

Despite the government's claims of creating two new medical schools to alleviate the doctor shortage, the report indicates that a lack of training sites, such as primary care teaching clinics, has resulted in 44 percent fewer family physicians graduating than anticipated. The report criticizes the Health Ministry, led by Sylvia Jones, for not planning adequately for the development of additional training sites in a timely manner.

This report comes in the wake of the government's promise during the February 27 election campaign to ensure every Ontarian has access to a family doctor within four years. This commitment was a key factor in Ford's re-election to a rare third majority. However, the audit found that the ministry, along with Ontario Health, lacked consistent processes to plan and oversee initiatives aimed at improving access to primary care. Furthermore, it noted that the ministry does not have effective methods to measure and report on primary care accessibility, nor does it have a timeline for collecting this data.

The government has appointed former federal Liberal health minister Dr. Jane Philpott to help connect residents with family doctors by 2029 based on postal codes. However, the report indicates that the province is not adequately promoting its “health care connect” service, which could help more Ontarians register for a family doctor. A 2023 study cited in the report revealed that only 35 percent of residents with a family doctor can secure same-day or next-day appointments, prompting many to seek care at walk-in clinics or emergency departments.

On the issue of overbilling, Spence attributed the problem to outdated technology that fails to flag suspicious billing patterns. The report states, “We conclude the ministry does not have effective systems and procedures in place to identify, review and prevent inappropriate physician billings.” Currently, the ministry employs only eight auditors to review questionable billings, a number that has remained unchanged since 2017. In 2024, the Health Ministry is projected to pay doctors $19.5 billion through OHIP, a significant increase from $11.9 billion nine years ago.

The report also highlighted alarming billing practices, including one unidentified physician who billed for more than 24 hours of services on 98 separate days, with one day showing a staggering 114 hours billed. The ministry has identified $1.4 million in overpayments and is seeking reimbursement, with a hearing scheduled for next May. Another physician has agreed to repay $105,000 for inappropriate charges.

Additionally, the auditor found that many patients are unaware of what services can be charged by physicians, leading to unexpected out-of-pocket expenses. Ford and Jones have emphasized that patients should use their OHIP cards for payments, not credit cards, as the province expands medical services to private clinics within the public system. The report specifically noted cases where physicians charged patients directly for optional or unnecessary add-ons during cataract surgeries without informing them of their right to choose a basic, fully funded procedure.

In response to complaints from opposition parties, Jones has encouraged individuals to contact the ministry. However, the report underscores the need for more proactive measures by the ministry and increased consumer awareness regarding health care services.