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The emergency room entrance is shown at the Northumberland Hills Hospital in Cobourg, Ontario on Sept. 21, 2021.Doug Ives/The Canadian Press

Ontario’s financial watchdog says the provincial government spent $1.7-billion less than planned on health care in 2022-23, even as rural and small-town hospitals struggled with staff shortages that forced some emergency rooms to close.

The report, from the province’s independent Financial Accountability Office (FAO), sparked renewed accusations from opposition politicians that the Progressive Conservative government is sitting on money it could have spent to alleviate the crisis in its health care system. But a spokesman for the government dismissed the FAO report, which is based on numbers from the province’s own accounting system, as “opinions.”

The FAO’s expenditure monitor report for the fourth quarter of 2022-23, which ended March 31, was released Wednesday. It shows that overall, while the government had planned to spend more than $194.29-billion on all programs, it fell short by $7.2-billion, or 3.7 per cent, rolling out a total of $187.1-billion.

The government often spends slightly less than planned. In 2019-20, it spent $3.2-billion less than it had intended. In 2020-21, in the heat of the pandemic, it undershot spending by $8.6-billion.

In health care, where the FAO says actual spending hit $73.64-billion in 2022-23, the government had aimed to spend $75.33-billion, meaning it was off by 2.2 per cent. Among the largest shortfalls in health was the amount earmarked for the response to COVID-19, which was $341-million behind planned spending, with the virus’s impact waning. But the amount spent on hospital operations was also off by $279-million.

When compared with actual health spending from the year before, 2021-22, when COVID-19 spending was much higher, the amount Ontario dedicated to health was lower by just $37-million. And across all government departments, Ontario’s total spending in 2022-23 was still higher than the amount actually spent the year before, by 3.7 per cent.

As the FAO has said previously, the province’s projected $2.2-billion deficit for 2022-23 has evaporated. The FAO now expects a $37-million surplus, down from the $500-million in black ink the agency had expected in June. The FAO’s numbers are based on unaudited figures from the province’s accounting system as of April 24. The province’s final official numbers for 2022-23 are not due until September.

NDP Opposition Leader Marit Stiles said the figures illustrate the government’s refusal to help struggling hospitals that are forced to close ERs, or to ease the burden of Ontarians facing a financial squeeze from inflation.

“The Premier of this province, rather than investing in public services at a time when people are so desperate for support, is sitting on billions of dollars of unspent money,” Ms. Stiles said. “For what? A rainy day? Well, it’s raining right now. People are drenched.”

Christopher Martin-Chan, a spokesman for Ontario Treasury Board President Prabmeet Sarkaria, dismissed the FAO report, saying that all actual spending will be captured when the government tables the public accounts in September.

“As we’ve said all along, FAO opinions are not representative of actual government spending,” Mr. Martin-Chan said in an e-mailed statement. “The FAO’s snapshot in time simply isn’t reflective of the realities of our government’s investments in delivering better services for Ontarians.”

Toronto Liberal MPP Stephanie Bowman, her party’s finance critic, said the FAO report shows how the government has been “fiscally irresponsible” for holding back funds it had pledged for health care and other areas.

“It’s a deliberate plan to not spend what they said they were going to spend,” Ms. Bowman said.

The Ontario government will also finish the year, the FAO says, with $1.8-billion unspent in its contingency fund, despite the $5-billion it allocated for its share of the proposed $10-billion settlement agreement with the federal government and 21 First Nations over unpaid annuities from the 1850 Robinson Huron Treaty.

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