Ontario Auditor General Shelley Spence has released her annual report, focusing heavily on the province's health care system. The report includes three audits addressing access to primary care, the training of new family doctors, and billing practices at the Ontario Health Insurance Plan (OHIP). While these topics are significant, critics argue that Spence's analysis is outdated and overlooks recent advancements made by the provincial government.

In her report, Spence highlighted that approximately two million Ontarians were without primary care as of March 2024. However, this figure does not reflect the current situation in December 2025. Earlier this year, the provincial government announced a $2.1 billion initiative aimed at ensuring every Ontarian has access to family health care by 2029. So far, the government has successfully connected 400,000 residents to primary care and plans to add another 300,000 through recent expansions.

Despite these achievements, Spence's report gives little attention to the progress made. She criticized the government's approach to recruiting family doctors, claiming it lacks coordination and equity. However, the new health teams established by the government are strategically located in underserved areas, which counters her assertion of inequity.

Spence also pointed out that the government has not adequately publicized the waiting list for individuals seeking new doctors. Critics argue that until more doctors are available, publicizing the list may not have been necessary. The government has stated that the 235,000 individuals on the list at the beginning of the year will have access to doctors by next spring.

The report also addresses the expansion of medical training, which has been a focus of Premier Doug Ford's administration. Ontario plans to add 340 undergraduate and 551 postgraduate seats in medical schools, with a significant portion dedicated to family medicine. However, Spence's report does not adequately reflect these developments.

Spence's analysis of OHIP billing practices garnered significant media attention. She suggested that some doctors may be billing for services around the clock, potentially costing taxpayers up to $1 billion annually. However, this figure is based on a consultant's estimate of potential savings from a more thorough review of billing practices, rather than confirmed waste.

Spence emphasized the need for a review of the billing system, stating, "If there is waste in the billing system — and we’re not saying there is, we’re just saying it needs to be reviewed." She estimated that reviewable physician billings could range from $400 million to $665 million per year. While she criticized the health ministry for having only eight auditors for suspicious claims, it is important to note that there are 130 staff members involved in auditing all claims before payments are made.

Overall, while Spence's report raises valid concerns about bureaucratic processes, critics argue that it fails to recognize the tangible progress made in Ontario's health care system under the current government.