Lars Hagberg/The Canadian Press A photo taken outside Kingston General Hospital in November 2018 shows the outer exterior of the health-care facility.

TORONTO — Ineffective fertility tests, repetitive pre-operative assessments and medically unnecessary ear-wax removal procedures are among the services that will be scrapped in Ontario this fall in an effort to cut health-care costs, moves the government estimates will save $83 million a year. The changes announced Thursday stem from the first phase of recommendations by a group that looked into restricting inappropriate or overused physician services. The committee, made up of members from the government and the Ontario Medical Association (OMA), was created following an arbitration decision that resulted in a new physician contract. It was tasked with recommending changes that could result in $460 million in savings. “What started out as a dispute has actually grown into a collaborative process where we have worked together to increase the quality of our health care system,” said Dr. Paul Tenenbein, co-chair of the group. Among the other recommendations put forward and accepted by the province were the use of more accurate sinus testing and technology updates to some cardiac monitoring devices.

The group also recommended more stringent rules surrounding the type of patients who qualify for house calls, which will now be restricted to frail elderly and housebound patients. And it suggested that knee arthroscopies, a surgical technique used to diagnose and treat problems in the knee joint, no longer be conducted for patients with degenerative knee disease. Tenenbein, who represents the OMA, said the recommendations are based on evidence, best practices, consultations with experts as well as a scan of the guidelines from other jurisdictions. Dr. Joshua Tepper, who represents the Ministry of Health on the committee, said the changes that will go into effect Oct. 1 reflect the constant challenge of modernizing the medical system. The process will “formalize and embed” changes that in many cases were already happening, he added. “Medical knowledge is changing constantly,” he said. “There are 40,000 doctors in the province covering thousands of medical diagnosis and problems. The medical knowledge underlying that is literally changing everyday.” Watch: Ontario Premier Doug Ford spoke at a meeting of municipalities earlier this week. Story continues below.