As the Ford government pushes ahead with a four-year plan to connect everyone in the province to primary care, the auditor general has found it does not have a co-ordinated framework for the policy or the ability to measure whether primary care is actually accessible to patients.
In a scathing annual report, Auditor General Shelley Spence concluded Ontario’s plan to expand access does “not consistently have processes in place to plan and oversee programs and initiatives to improve patients’ access to primary care.”
The plan was announced on the eve of an early election call in January and, after winning the snap poll, the Progressive Conservatives put it into law through the Primary Care Act in June.
The new plan revolves around creating family health teams, rather than family doctors, who will offer primary care to people. The system aims to attach people to care based on their postal code.
The aim, the government said at the time, is for the process to be as smooth as when a child enrolls at a local elementary school to begin their education.
Large swathes of the province, however, still do not have access to a family doctor.
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According to the auditor general, an internal analysis completed by the government in February 2025 showed that in 70 per cent of Ontario Health Teams, at least one in 10 people did not have primary care.
Three areas in the north of the province had an even higher rate of people without a doctor, along with two in Toronto.
The province has told each family health team to come up with a plan to ensure everyone in the area has access to primary care by 2029.
A spokesperson for the Minister of Health said the auditor general’s report did not include the government’s full $2.1 billion primary care action plan, or expansion of medical school places.
“To be clear, the Auditor General’s report does not account for our $2.1 billion Primary Care Action Plan (PCAT), the expansion of medical school seats, a 47 per cent increase in residency positions with half reserved for family medicine, and our historic Primary Care Act – making Ontario the first Canadian jurisdiction to establish a framework for its publicly funded primary care system,” the government said.
Among the problems found by the auditor general was the fact that Ontario’s only centralized tool designed to help people find a family doctor “has not fully met the needs” of patients.
Back in 2009, the government launched an online tool called the Health Care Connect program. Then in 2021, it was supplemented by a contracted service called Health 811.
The idea was that people would sign up and then be connected with a family doctor or primary care operator near them. Between 2009 and 2025, more than 941,000 people opted to use the service.
The service, however, does not have a target wait time, the auditor general found. Over the past five years, roughly half of those who signed up were referred within 21 days, but 15 per cent waited longer than 260 days.
Some waited more than 520 days.
In November 2024, several Ontario Health Teams told the government the online tool was “no longer fit for purpose.”
Elsewhere, the auditor general found competition between different jurisdictions to attract family doctors was a problem, while the government is failing to measure whether its plan was working.
In particular, when the government created its plan in January, it laid out five performance indicators which would assess whether or not it was succeeding in its goal of delivering primary care to everyone.
At the time of her audit, Spence was told the government had not yet “established timelines to collect data” to measure how the plan was progressing.
The Ministry of Health accepted all of Spence’s recommendations.
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