Ontario's Vision Problem: A Ready Solution for Surgical Backlogs

TORONTO, ON – November 26, 2025 – For tens of thousands of Ontarians, the world is slowly dimming. A diagnosis of cataracts, a common and treatable condition, has become the start of a long and anxious wait for sight-restoring surgery. With provincial surgical backlogs remaining stubbornly high since the pandemic, a growing chorus of healthcare professionals is pointing to a solution they say is hiding in plain sight: a network of fully equipped community clinics ready to take on the load.

Today, a new national network of surgical facilities, ACCESS (Association of Canadian Centres of Eye Surgery and Standards), has launched a formal call for the Government of Ontario to follow the lead of other provinces and dramatically expand the use of accredited Community Surgical Facilities (CSFs) for publicly funded cataract procedures. The group argues that this move could not only clear the province's lengthy waitlists but also generate significant cost savings and free up strained hospital resources for more complex operations.

An Underutilized Resource

At the heart of the proposal lies a stark disparity. Ontario has approximately 40 accredited, purpose-built eye surgery facilities, yet only six are currently licensed to perform publicly funded cataract surgeries in partnership with hospitals. These CSFs are not pop-up clinics; they are physician-owned and operated centres that must adhere to the same stringent accreditation, regulatory, and quality frameworks as their hospital counterparts. According to ACCESS, these existing facilities have the collective capacity to perform up to 200,000 procedures annually—more than enough to handle the province's entire caseload of 180,000 yearly surgeries and eliminate the current funding shortfall for 30,000 of those procedures.

"In Quebec and New Brunswick, hospitals and local community surgical facilities are working hand-in-hand to deliver publicly funded cataract surgeries safely, efficiently, and most importantly, at no additional cost to patients," said Dr. Mark Cohen, a practicing ophthalmologist and Co-Founder of ACCESS, in a statement. "We believe Ontario has the same opportunity to build on these proven models to reduce wait times and improve patient care."

The call to action comes as data reveals the significant burden on patients. While the Canadian Institute for Health Information (CIHI) reports that national wait times have largely returned to pre-pandemic levels, with 70% of patients treated within the 112-day benchmark, the reality on the ground in Ontario varies dramatically. Some hospitals report average waits exceeding 30 weeks. This pressure has led to a troubling trend where, as ACCESS notes, about one in six patients feel compelled to pay out-of-pocket for faster care, often through fees for non-insured "upgraded" lenses or diagnostic tests that patient advocates argue should be covered.

The Economic and Operational Case

Beyond the patient benefits, advocates for the model present a compelling economic argument. By redirecting a significant volume of a high-frequency, low-complexity procedure like cataract surgery out of expensive hospital operating rooms, the system can achieve major efficiencies. ACCESS projects that shifting 100,000 cases to CSFs could save the province up to $50 million annually, as hospital-based procedures can cost up to twice as much as those performed in an outpatient setting.

This shift would also have a profound ripple effect on hospital capacity. The same 100,000 procedures would free up approximately 7,000 full days in hospital operating rooms. To put that in perspective, a hospital OR can typically perform four hip or knee replacements in a day. The freed-up time could therefore translate into an additional 28,000 joint replacements annually, tackling another critical surgical backlog without needing to build new infrastructure or hire more staff.

"At a time when hospitals are being asked to find creative solutions and efficiencies, community surgical facilities represent a practical, cost-effective way to increase capacity and free up time in hospital operating rooms," noted Dr. Cohen. The move would also ease the burden on stretched hospital teams, as the two nurses and anesthesiologist typically required for a hospital-based procedure could be redeployed to more acute cases.

Proven Partnerships and Lingering Concerns

The model is not just theoretical; successful pilot programs are already demonstrating its value within Ontario. In Kitchener-Waterloo, a partnership between the Waterloo Regional Health Network and a local CSF has been running for four years. Sarah Farwell, the network's Vice President of Strategy, Communications, and Public Affairs, praised the collaboration for expanding capacity and ensuring "timely, high-quality, and equitable care, while preserving hospital beds and staff for more complex cases."

A similar story comes from Kingston, where the Kingston Health Sciences Centre (KHSC) faced a massive surgical waitlist after pandemic-related disruptions. "Starting in 2020, KHSC entered into a partnership with a CSF in Kingston, in which funding was transferred to the CSF with hospital oversight," explained Dr. Davin Johnson, an ophthalmologist at KHSC and Assistant Professor at Queen's University. "This program has continued since, with over 2,000 cases completed annually."

However, the push for broader privatization of surgical delivery is not without its critics. Patient advocacy groups like the Ontario Health Coalition have long raised red flags about the expansion of private clinics, citing persistent issues with illegal extra-billing. They point to numerous cases where patients felt pressured into paying hundreds or thousands of dollars for services that should be covered by OHIP, creating a two-tiered system where access is tied to ability to pay. These groups argue that any expansion must come with ironclad oversight and enforcement to protect the principles of the Canada Health Act.

Navigating the Path Forward

The provincial government has already signaled its interest in this direction. In January 2023, it announced a plan to expand the role of community clinics, including new partnerships in Windsor, Kitchener-Waterloo, and Ottawa expected to add 14,000 cataract surgeries annually. ACCESS's campaign can be seen as an effort to accelerate and significantly scale up this existing, albeit slow-moving, strategy.

To that end, the new network is urging the government to take three key steps: expand licensing for all qualified CSFs, prioritize eye surgery capacity in future infrastructure investments, and ensure full transparency in wait-time reporting down to the municipal and surgeon level.

"Our healthcare system works best when we work together," said Dr. Rich Weinstein, a practicing ophthalmologist at St. Mary's General Hospital in Kitchener. As policymakers weigh the potential for massive efficiency gains against concerns over equity and oversight, the question remains whether Ontario can fully leverage the capacity that already exists within its communities to restore sight for thousands of its residents without delay.