How underfunding created a vicious cycle of privatization (Americanization)
$9.2B
Paid to for-profit staffing agencies over 10 years
(2013-2023)
Note: Most of this growth occurred during the Ford era (2018-2023)
Source: CCPA "Hollowed Out" Report
Real per capita spending cuts for 7 of 10 years
1% cap on raises makes health care work less attractive
Hospitals can't retain workers
Expensive private agencies fill the gaps
Public Hospital Staff
+6%
Real per capita spending growth (2013-2023)
Private Staffing Agencies
+98%
Real per capita spending growth (2013-2023)
North West
17% of staffing costs
480%
increase in agency costs
North Simcoe Muskoka
7% of staffing costs
372%
increase in agency costs
North East
11% of staffing costs
216%
increase in agency costs
Central West
9% of staffing costs
Significant
increase in agency costs
In 2022-23, private agencies accounted for:
0.4%
of frontline hours worked
6%
of total labour costs ($725M)
Private agency staff cost at least 3x more than regular employees
Underfunding has left Ontario with one of the most undercapacity hospital systems in the industrialized world
66
of 134 hospitals
had budget deficits in 2023-24
33/38
Canada's OECD ranking
Hospital beds per capita (Ontario reflects this)
Per capita hospital spending, 2022
Real per capita hospital spending decreased in 7 of 10 years (2013-2022)
63% of hospitals under $100M revenue had deficits
In Ontario, hallway medicine is the norm
Ontario has the second-fewest hospital beds per capita in Canada
The Solution
$2 billion annually
Additional funding needed to stabilize public hospitals and increase capacity
The Ford government's bed allocation decisions reveal a clear privatization (Americanization) agenda
The Pattern
New long-term care beds overwhelmingly allocated to for-profit operators
Municipal and non-profit operators have historically provided the majority of long-term care
Under Ford, new bed allocations have shifted dramatically toward for-profit operators
For-profit LTC homes have worse outcomes
Higher mortality rates, lower staffing levels, more violations
Public dollars flow to private profits
Every new for-profit bed is a permanent commitment of public funding to private operators
Capacity leaves the public system
Once built, these beds are locked into the for-profit system for decades
Some communities are hit harder than others
Fastest-growing, most-racialized communities have the lowest per capita hospital spending
Central West
Brampton, Etobicoke, Peel
Central
Markham, Vaughan, North York
Central East
Durham, Peterborough, Scarborough
Highest agency costs as share of staffing budget
Second-highest growth in agency spending
Significant reliance on private agencies
Brampton, Etobicoke, northern Peel — fastest-growing, most-racialized communities
⚠️ Lowest per capita hospital spending
Markham, Vaughan, North York — fast-growing communities
⚠️ Lowest per capita hospital spending
Durham region, Peterborough, Scarborough
⚠️ Lowest per capita hospital spending
480%
North West
increase in agency costs
372%
North Simcoe Muskoka
increase in agency costs
216%
North East
increase in agency costs
Where shortages are most severe, privatization (Americanization) costs are highest