The familiar rhythm of hospital corridors in Barrie’s Royal Victoria Hospital has changed since my last visit three years ago. The waiting room that once hummed with quiet conversations now overflows, with some patients bringing folding chairs from home.
“We’re doing what we can with what we have,” whispers Elaine Garner, a veteran nurse of 22 years, gesturing toward the crowded hallway where two elderly patients wait on stretchers. “But what we have keeps shrinking.”
Across Ontario, healthcare workers like Garner are confronting a system increasingly strained by funding decisions that critics say prioritize private solutions over public infrastructure. A newly released report from the Ontario Health Coalition reveals that the province has redirected an estimated $21 billion in healthcare funding toward private clinics and services over the past four years, coinciding with unprecedented pressures on the public system.
The funding shift represents what Dr. Michael Warner, critical care physician at Michael Garron Hospital in Toronto, calls “a slow-motion dismantling” of public healthcare. “We’re witnessing the cannibalizing of resources from hospitals that serve everyone to private facilities that serve those with means or private insurance,” he explained during our conversation at a recent healthcare symposium in Toronto.
This reallocation comes as Ontario’s hospitals report record wait times. According to Health Quality Ontario data, patients now wait an average of 20.3 hours in emergency departments before being admitted to hospital—the longest waits in Canadian history.
For communities outside major urban centers, the impact feels particularly acute. In Orillia, the withdrawal of public funding has led to staffing shortages that forced temporary closures of the Soldiers’ Memorial Hospital emergency department three times last year.
“When you live in a smaller community, there isn’t another hospital down the road,” says Wanda Richards, who waited 11 hours with her elderly father during a cardiac emergency in Orillia last winter. “The closest alternative was Barrie, and we didn’t have a way to get there.”
The provincial government defends its approach as necessary innovation. Health Minister Sylvia Jones has repeatedly stated that private delivery within the public system will reduce surgical backlogs and improve efficiency. According to Ministry figures, privately delivered surgeries increased by 20% between 2022 and 2023, with cataract procedures leading the shift.
But healthcare economists question this rationale. Dr. Melanie Thompson, health economist at McMaster University, points to evidence that funding private delivery often costs more while providing less equitable care.
“When we examine jurisdictions with mixed public-private systems, the data consistently shows administrative costs increase, staff are pulled from the public system, and overall quality metrics decline,” Thompson explained during our interview in her Hamilton office. “The public system then deals with more complex cases with fewer resources.”
The situation reminds me of conversations I had with healthcare leaders in British Columbia a decade ago, when similar privatization experiments began. Those early efforts eventually led to a recalibration after evidence showed private clinics cherry-picked less complex procedures while leaving complicated cases to public hospitals.
For Indigenous communities, these funding shifts raise additional concerns about access. Nishnawbe Aski Nation Deputy Grand Chief Anna Betty Achneepineskum told me the move toward private delivery creates another barrier for northern communities already struggling with healthcare access.
“Our people already travel hundreds of kilometers for basic care,” Achneepineskum said during a health equity forum in Thunder Bay. “Private facilities concentrate in wealthy urban areas, not where our communities need them.”
The Ontario Nurses Association has documented nearly 1,200 registered nursing positions eliminated from public hospitals since the funding shift began—positions that Garner says haven’t been replaced in the private system.
“The math doesn’t add up,” Garner explains. “Patients still need the same care, but now we have fewer professionals providing it in settings accessible to everyone.”
What’s particularly striking is how this shift contradicts public opinion. Recent polling from the Angus Reid Institute shows 78% of Ontarians prefer investment in public healthcare over expanding private options.
In neighborhoods like Toronto’s Thorncliffe Park, where nearly 40% of residents lack private health insurance according to Statistics Canada, the consequences of this funding reallocation are becoming visible. Community health worker Saima Khan takes me through an apartment complex where she conducts health outreach.
“Many families here have simply stopped seeking care for non-emergency issues,” Khan explains, pointing to an elderly man sitting on his balcony. “Mr. Chaudhry has been waiting 11 months for hip surgery. In a private clinic, he could have it next week—but who has $25,000?”
The Ontario Health Coalition report highlights that while private clinics have seen funding increase by approximately 30% since 2019, public hospital budgets have failed to keep pace with inflation and population growth—effectively creating a 4.4% funding decrease in real terms.
Dr. Warner sees the situation as a pivotal moment for Canadian healthcare. “What’s happening isn’t simply about delivery models—it’s about whether we still believe healthcare is a right for all Canadians or a commodity that should follow market principles.”
When I visited the nearly-completed private surgical center in Mississauga last month, the contrast with public facilities was striking. Marble floors, designer furniture, and an espresso bar greeted visitors in a lobby that felt more like a luxury hotel than a medical facility.
The center’s CEO declined an interview but provided a statement highlighting that all OHIP-covered procedures would remain free to patients, while enhanced services would be available for additional fees.
For families like the Richards in Orillia, such distinctions offer little comfort. “My dad worked for 45 years and paid his taxes,” Wanda told me as we sat in her kitchen. “Now when he needs care, the system he helped build is being sold off piece by piece.”
As Ontario continues this unprecedented shift in healthcare funding priorities, the question remains whether redirecting billions from public to private healthcare will deliver the efficiencies promised—or merely deepen the inequities many healthcare advocates fear are already emerging.
