Ontario does not have ability to measure success of its primary care plan: auditor general

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.

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Large swathes of the province, however, still do not have access to a family doctor.

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.

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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.

Among the issues flagged by the auditor general was competition between different jurisdictions to attract family doctors, an outdated tool to help people find primary care and a lack of tools from the government to measure if its plan was working.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.