Ontario Auditor General’s 2025 Report: Health Highlights
The Auditor General (AG) released her annual report earlier this week, which included scrutiny of multiple health files, with physician billing generating the strongest media traction and political attention. Other reports examined primary care expansion, medical school expansion for family medicine, and Supply Ontario’s personal protective equipment (PPE) management post-pandemic.
Key findings include:
- Physician Billing: Persistent failures to detect or act on suspicious claims (e.g. billing for 365 days in a year, one case of 114 hours billed in one day); outdated Ontario Health Insurance Plan (OHIP) technology; missed investigations that were also flagged in 2016.
- Primary Care Access: Health Care Connect remains ineffective (e.g. 260-day waits in 15% of cases); inconsistent patient-attachment processes; flaws in the first round of the 2024–25 primary care expansion.
- Medical School Expansion: Ontario is falling short on family medicine seat expansions due to insufficient training sites and preceptor capacity; missing projected targets for graduates due to delays in opening the medical schools.
- PPE Stockpile: $1.4B in expired PPE written off; expired PPE is burned through waste-to-energy conversion; weak inventory controls; long-term contracts mismatched to need; slow order fulfilment averaging 9 days versus other large medical supplier distributors being able to deliver in two to four days.
What It Means:
The AG reports confirm what health providers have experienced: good policy intentions undermined by weak operational planning. For the government, the pressure has been immediate, but likely short-lived.
The Ministry of Health, the Ministry of Colleges, Universities, Research Excellence and Security, and Supply Ontario have agreed to all the recommendations on improvements. They will all look to accelerate short-term fixes—particularly on billing oversight, OHIP modernization, and Health Care Connect improvements —to show responsiveness, while the hard work will take longer to see.
If the Auditor General doesn’t see progress, she will put these files under the microscope again in a few years as part of follow-ups. She can connect to her original report and gauge progress made on recommendations.
What To Expect:
- Increased audits into physician billing, especially as new physician compensation models (e.g., time-based billing) launch.
- More two-way communications and consultation between Supply Ontario and its PPE vendors aimed at overall supply chain and procurement improvements.
- More collaboration between Supply Ontario and vendors on finding solutions to address administrative burden, data integrity, and operational visibility within the agency and the future of health procurement in general.
- More focus on standardization, metrics and data collection and two-way communications in primary care team expansion.
- Opportunity to shape the primary care modernization agenda— improvements to patient experience with respect to the Health Care Connect waitlist, clearer proposal processes for primary care teams, and stronger Primary Care Network governance.
OINP Consultations on New Priority Health Stream
In case you missed it, the Ministry of Labour, Immigration, Training, and Skills Development has posted regulations to overhaul the Ontario Immigrant Nominee Program (OINP), consolidating eight streams into four as part of a first phase. There will also be a second phase that proposes three new pathways, which includes a priority health care stream, an entrepreneur stream, and an exceptional talent stream.
The new priority health care stream would:
- Provide a pathway to permanent residency for applicants with valid professional registration without a job offer.
- Potentially include recent graduates finalizing registration.
- Target high-need regulated health professions across Ontario.
Public comments are due by January 1, 2026.
What It Means:
Minister of Labour, Immigration, Training and Skills Development, Hon. David Piccini shared this overhaul during an Empire Club event on December 3. The goal of the reorganization is to increase efficiency, especially in light of the federal government’s cap on immigration, which has resulted in a smaller number of nominee slots allocated to Ontario. This is a significant opportunity for health providers experiencing chronic workforce shortages, including labs, home care providers, long-term care organizations, and hospitals. A dedicated stream would reduce friction, accelerate recruitment, and allow more predictable multi-year planning.
However, priority health care stream design remains high-level, and the selection criteria, quotas, and geographic prioritization have not been specified. These are crucial pieces of input for the new stream. Larger health professions could dominate the consultation unless smaller professions proactively shape the eligibility list. The stream must also integrate with the requirements set out by Ontario’s regulatory colleges, which vary in their readiness to support international applicants – although Ontario’s recent as-of-right legislation would relieve some of the pressure for out-of-province health professionals.
Stakeholder input in the next four weeks will matter. Organizations should prepare evidence-based submissions highlighting vacancy rates, regulatory timelines, and geographic need, and advocate for explicit inclusion of their professions’ National Occupational Classification (NOC) codes.
In Case You Missed It
- A new Ontario Medical Association survey released earlier this week shows more than half of Ontario doctors are planning to retire or considering that option in the next five years. 42% of medical students surveyed want to go into family medicine, but only half want to stay in the specialty area for the long term.
- The Minister’s Patient and Family Advisory Council 2024-2025 annual report was quietly released earlier this fall. The report supports the government’s direction on digital health, expanded scope of practice for certain health professions, and more two-way communications between Ontario Health Teams and patients.
- Ontario passed its Emergency Management Modernization Act, 2025 this week. The act changes the reporting structure to the new Minister of Emergency Preparedness and Response as the decision-maker, establishes a permanent Ontario Corps, and requires municipal and provincial bodies to submit up-to-date emergency-management plans to the Minister for review.
- In B.C., Health Minister Josie Osborne announced this week that the government has completed the “first steps” of its review of the province’s health authorities. Launched in March, this review is intended to identify administrative savings within the Ministry of Health and its provincial health authorities that can be redirected to frontline care. To date, the Minister reports that health authorities have “eliminated, closed or left vacant” approximately 1,100 positions, resulting in $60 million in annual savings. Read our full memo here.
Need advice on your OINP submission? Not sure what the Auditor General’s report means for medical supplies in Ontario? Reach out to one of our experts:
Clare Michaels – clare.michaels@santishealth.ca
Nabiha Paracha – nabiha.paracha@santishealth.ca
Dylan Brenneman – dylan.brenneman@santishealth.