Ontario Minister of Finance Peter Bethlenfalvy released 2026 Ontario Budget: A Plan to Protect Ontario on March 26. The budget allocates a record $101.2 billion for healthcare, which is a considerable increase from $91.3 billion allocated in the previous budget. Major investments include more than $1.1 billion for hospitals, more than $9 billion for long-term care, and $64 billion toward a 10-year health infrastructure plan.

The budget focuses on expanding primary care and mental health services, while projecting historically low average annual health spending growth (0.7%). But this level is significantly less than the estimated 4% average annual growth needed to maintain 2024-2025 service levels, according to the Financial Accountability Office of Ontario. It indicates a potential funding shortfall of $6.4 billion in 2026-2027 and $9.6 billion by 2027-2028.

Difficulties facing primary care and home care, including workforce shortages and low primary care attachment, are contributing to increased strain on hospitals. In a statement, Anthony Dale, president and CEO of the Ontario Hospital Association, thanked the Ontario government for its continued investment in hospitals. Nevertheless, the $1.1 billion allocated for hospitals is less than the $2.8 billion that the association has said the province’s hospital sector needs.

Primary, Home, and Community Care

In December 2024, Ontario established the Primary Care Action Team led by Jane Philpott, MD, family physician and former minister of health for Canada. In January 2025, the government launched the Primary Care Action Plan with the goal of attaching everyone in Ontario to a publicly funded primary care clinician or team by 2029. The 2026 Ontario budget invests an additional $325 million in expanding primary care to achieve this goal. When combined with ongoing funding, this amount brings the 2025-2029 investment in the Primary Care Action Plan to $3.4 billion.

The government also will spend $1.1 billion over 3 years to extend home care services and the Home First program to thousands more patients annually. This measure is intended to lessen the burden on hospitals and free beds for patients who need them most.

The Registered Nurses’ Association of Ontario (RNAO) welcomed the government’s measures in support of community care, which they said should be part of a primary care framework. “I’m very excited about the investments being made in primary care because we’re seeing results in attaching patients to primary care providers,” Sue LeBeau, RN, MScN, MBA, president-elect of the RNAO, told Medscape News Canada. “I’m also pleased to see that recognition of the importance of primary care extends to nurse practitioners and interdisciplinary teams. Patients want care at home and in the community, and receiving regular primary care and the screening that comes with it will decrease the burden on hospitals in the long term.”

Organizations and the government must work to ensure that wages are competitive and encourage the recruitment and retention of staff in primary care and home care, LeBeau added.

In addition, the Ontario Autism Program will receive as much as $189 million in additional funding with the goal of reducing the wait list for support, which currently stands at 5 or more years in some cases.

Primary Care Medical Record System

As part of its Primary Care Action Plan, Ontario is advancing a new provincewide Primary Care Medical Record system that is intended to integrate patient records and reduce paperwork for doctors. The goal is to streamline patient care. While approximately 90% of Ontario family physicians use electronic medical records, the current system is fragmented, disconnected, and unable to support effective information sharing.

“The Ontario Medical Association supports the province’s investment in a provincewide integrated Primary Care Medical Record Program, which will help alleviate the administrative workload for family physicians, attract more physicians to family medicine, and attach more patients to family doctors. We also welcome investments that strengthen hospital capacity and home care, which help ensure that patients receive timely care and reduce pressure across the broader system,” Zainab Abdurrahman, MD, president of the Ontario Medical Association, said in a statement.

But there is a discrepancy between Canada’s investment in healthcare and the quality of care being delivered, according to Nadeem Esmail, director of health policy studies at the Fraser Institute in Toronto. “Canada is at the top of the list of developed countries in terms of healthcare spending, but at the bottom of the list in healthcare access and delivery. The solution lies in healthcare policy reform, not in the level of investment.”

The countries doing the best job at delivering universal healthcare are Switzerland, Germany, Australia, Sweden, and Netherlands, Esmail told Medscape News Canada. “They share policy approaches that include user fees or cost sharing for access to medically necessary services, competition, and a parallel private option for healthcare. Those policies are absent from Ontario’s healthcare system.”

A system that offers patients other options when the public system is unwilling or unable to meet their needs would be desirable, Esmail continued. “Ontarians can seek healthcare in Quebec, the United States, or western Canada, but they don’t have the opportunity to purchase private care within Canada. This leads to a poor experience. A competitive alternative to the public system is disallowed in Canada because the public system protects Medicare. Yet we have some of the worst access to healthcare in the developed world,” he said.

LeBeau, Abdurrahman, and Esmail reported having no relevant financial relationships.

Evra Taylor is a widely published freelance medical writer and reporter with 20 years’ experience covering a broad range of therapeutic sectors, including family health, cardiology, psychiatry, ophthalmology, and dermatology.