TORONTO -- A leaked draft bill revealed Thursday by the New Democrats shows the Ontario government is considering creating a "super agency" to manage health-care services in the province as part of a transformation the Opposition says could open the door to privatization.

Health Minister Christine Elliott said the leaked document was an early draft, but repeatedly refused to rule out further health system privatization by the Progressive Conservative government.

"We are committed to our public health-care system," she said at a hastily called news conference.

"The way the system operates now is a mixture...but what we want to do is make sure that as we develop our transformational strategy we are looking at strengthening the public part of the system."

The "super agency," according to the draft bill, would be in charge of managing health service needs across Ontario, health system operational management and co-ordination, quality improvement, knowledge dissemination, patient relations, digital health and activities relating to tissue donation and transplants.

It would allow the government to transfer "all or part of the assets, liabilities, rights and obligations" of organizations including any local health integration network, Cancer Care Ontario, eHealth Ontario and the Trillium Gift of Life Network to the super agency.

The section that NDP Leader Andrea Horwath warned would lead to privatization says that the super agency "may designate a person or entity, or a group of persons or entities, as an integrated care delivery system" as long as they have the ability to deliver at least two types of health services, including hospital, primary care, home care or long-term care services.

"If there was any doubt that this government is committed to massive privatization in health care, that doubt vanishes with this bill," Horwath said. "If (Premier) Doug Ford plows ahead with this health-care privatization bill he has got one hell of a fight on his hands."

Elliott said Horwath's interpretation of that section was incorrect, but she would not say what it is actually intended to do.

"She got pretty much everything wrong," Elliott said. "We will have more to say about our transformational strategy in due course, but for the purposes of today it's important to remember it's not all finalized. What was seen was a draft."

The leak came as the premier's special adviser on health care released a report saying that "tough decisions" will be required to address hospital overcrowding, which sees at least 1,000 people treated in the hallways of the province's hospitals on any given day.

The report by adviser Dr. Rueben Devlin and the premier's council on improving health care touched on the current 21 health-related government agencies that support the design and delivery of health care in the province.

Ontario's health-care system can be characterized as decentralized, large and siloed, the report said. The agencies are not always well-aligned "and there is limited strategic oversight to ensure the efficient and co-ordinated use of resources," it said.

Devlin's next report is set to contain a series of recommendations, but some themes identified in the first document included a greater need for innovation and efficiency to decrease hospital overcrowding.

"Tough decisions will be required to address the challenges facing our health-care system, while we continue to champion the health-care professionals already leading great work in our communities," Devlin wrote in the report.

Eliminating hallway health care will require dealing with other areas where people get treatment, Devlin said.

"Hallway medicine is not a hospital issue, it's a systems issue," he said in an interview. "We know that we need to improve on primary care, we need to improve on access to long-term care, better home care and a real focus on mental health and addictions."

A government health-care survey found that 41 per cent of people who went to the emergency department could have been treated by their primary care doctor, and just one-third of hospital patients are admitted to an in-patient bed from the ER within the eight-hour target.

The report defines hallway beds as those in hallways, emergency department stretchers or other unconventional spaces such as alcoves that are not properly equipped to treat patients, Devlin said.

In October, almost 16 per cent of days spent in hospital were by patients waiting for care elsewhere. The largest proportion of that was people waiting to be transferred to long-term care, the report said, where the average wait time to access a bed is 146 days.

Natalie Mehra of the Ontario Health Coalition said claiming that those patients waiting for other spaces are blocking beds is a partial explanation, at best, and Ontario needs more hospital beds.

"What happens in Ontario's overcrowded hospitals is that all the beds in the wards are full because so many beds have been closed down," she said.