Ontario Auditor General Tables 2025 Annual Report

TORONTO, Dec. 2, 2025 /CNW/ - The Auditor General of Ontario today released her 2025 Annual Report. It details the results of her performance audits focused on oversight of access to primary care, oversight of medical education in family medicine, oversight of physician billing, Supply Ontario: personal protective equipment (PPE), the Resource Productivity and Recovery Authority, and the operation of the Environmental Bill of Rights, 1993. The Report also includes yearly sections on review of government advertising, the Public Accounts of the Province of Ontario, the Office's operations report, and a report on the standing committee on the public accounts.

"These reports focus on government operations that affect the lives of Ontarians. Access and availability of a family physician, how they are paid, keeping waste out of landfill, or spending on PPE are government services that are worth examining," said Auditor General of Ontario Shelley Spence. 

The Commissioner of the Environment, Dr. Tyler Schulz, added with relation to the Environmental Bill of Rights, "When decisions that could significantly affect Ontario's environment are made without meaningful public consultation, it reduces government accountability, and can undermine the public's confidence in government decision-making about environmental matters."

Here follows a summary of some of the key takeaways from each audit in the 2025 Annual Report, which is available in full at this link.

Oversight of Access to Primary Care

Millions of Ontarians still cannot find or access a family doctor, and efforts to fix the issue are fragmented, and overdue

The audit observed that the Ministry of Health and Ontario Health did not consistently have processes in place to plan or oversee programs and initiatives to improve patients' access to primary care providers. As of 2024, an estimated 2 million Ontarians did not have a primary care provider. This represents about 12 per cent of Ontario's population.

The audit found that Ontario Health Teams and local primary care networks lack the authority to require local providers to collaborate on system planning. The Province's only centralized matching program, Health Care Connect, has not met demand. More than 108,000 Ontarians have been waiting over a year to be matched to a doctor, and the number of Ontarians on the wait list as of January 2025 represented only 11 per cent of the estimated number of Ontarians needing a family doctor. Failure to co-ordinate physician recruitment at the Provincial level has resulted in a fragmented and competitive approach to recruitment across the Province.

Oversight of Medical Education in Family Medicine

The Province expanded medical school seats without first ensuring there were enough training sites or a clear framework to measure outcomes

The audit found that the Ministries of Health, and Colleges, Universities, Research Excellence and Security did not analyze how many seats were needed or whether schools had capacity. Two new medical schools were approved without assessing whether existing schools could have been expanded instead. While the government announced plans to add 340 undergraduate and 551 postgraduate seats between 2022 and 2024, the audit found that by the end of the 2025/26 academic year, medical schools had rolled out 44 per cent fewer family medicine seats than planned due to a lack of training clinics.

INSPIRE-Primary Health Care and the Ministry of Health indicated that about 2 million Ontarians were not attached to primary care in 2024, which is a higher estimate than what the Ministry had used in its forecast model to support the medical seat expansion. Based on our own analysis, about 2,000 family physicians would be necessary to meet this need in 2024.

Oversight of Physician Billing

The Ministry of Health lacks a modernized payment system and is not using data analysis to detect potentially inappropriate physician billings

The Ministry paid $19.5 billion to about 35,000 physicians in 2024/25 and relies primarily on tips and complaints to trigger post-payment audits. The Ontario Health Insurance Plan (OHIP) system cannot automatically flag unusual or high-risk billings, such as physicians claiming over 24 hours of work in a day. A system modernization initiative announced in 2023 has been delayed awaiting approval by the government. Eight staff currently conduct post-payment audits, the same number as in 2017 and post-payment audits could take more than a year to complete.

In a 2024 analysis, the Ministry noted that 3-5 per cent of fee-for-service (FFS) claims reviewed had potential anomalies. Based on the $13.3 billion in FFS payments in 2024/25, this translated to approximately $400 to $665 million in payments that would require additional review.

Supply Ontario: Management of Personal Protective Equipment

Supply Ontario lacks an integrated inventory management system, relying instead on inefficient manual processes to track and manage the quantities and costs of PPE

Supply Ontario now manages Ontario's Provincial personal protective equipment (PPE) stockpile.

The audit found that hospitals and other clients are not utilizing the stockpile. Hospitals received only 2–3 per cent of distributed PPE, and many clients reported unclear program objectives, quality concerns and limited communication from Supply Ontario.

Over 1 billion PPE items, valued at about $1.4 billion, were written off between 2021/22 and 2024/25, and more stock is projected to expire in the coming years. Further, Supply Ontario does not track full order-to-delivery times or use a modern, integrated inventory system, limiting its ability to plan, monitor performance, and respond to demand.

Resource Productivity and Recovery Authority (RPRA)

RPRA could do more to ensure that Ontario's recycling framework is working as intended, including to reduce its backlog of cases of potentially unregistered producers, escalate enforcement against non-compliant producers, and require the auditing of producers' data for its programs

Landfilling waste, such as tires, batteries, lighting, electronic e-waste and hazardous materials, has various impacts, including creating a risk of harmful chemicals leaking into soil or water, and wasting resources that could otherwise be reused. The Resource Recovery and Circular Economy Act, 2016 requires producers of these materials to collect and recycle or reuse the waste that results from their products after consumers have disposed of them.

The Auditor General found that RPRA rarely escalated enforcement against producers that failed to report their supply and waste recovery data as required. RPRA has issued compliance orders to only 4 per cent of such violators, most of which remain unresolved.

RPRA has not finalized audit procedures for producers of most programs, increasing the risk of inaccurate resource recovery data being reported. Also, RPRA did not have formal processes to proactively analyze and bring forward systemic compliance challenges to the Ministry of the Environment, Conservation and Parks (MECP) to resolve them. The audit also found that MECP made regulatory changes without addressing RPRA's concerns or providing RPRA time to make operational updates.

Operation of the Environmental Bill of Rights, 1993 (EBR)

When ministries follow requirements, the EBR can lead to transparent, accountable and informed decision-making. However, the Province continues to disregard Ontarians' public participation rights by exempting major projects with potential environmentally significant impacts from, and passing laws without, full public consultation under the EBR

The Auditor General's annual audit of the operation of Ontario's Environmental Bill of Rights, 1993 (EBR) found continued examples of a disregard for the public's rights under the EBR legislation.

During the audit, the Province passed Bill 17, the Protect Ontario by Building Faster and Smarter Act, before consultation under the EBR was complete and without consulting at all on an amendment to the Building Code Act intended to end the practice of municipalities enforcing their own green building standards. The Province also exempted approvals for two major projects, Highway 413 and the Ontario Place redevelopment, from EBR consultation altogether.

The report concludes that government actions are eroding public participation rights and transparency in environmental decision-making.

Review of Government Advertising

Government advertising spending hit a record high of $111.9 in fiscal 2024/25, of which 38 per cent would not have passed our Office's review under the old act.

The Public Accounts of the Province of Ontario

The Auditor General issued a clean audit opinion on the Province's Consolidated Financial Statements for 2024/2025.

SOURCE Office of the Auditor General of Ontario