The Fraser Institute

The Fraser Institute

October 24, 2006 06:00 ET

The Fraser Institute: Media Release; Canadians Waiting Longer for Medical Treatment in 2006 According to Annual Survey

CALGARY, ALBERTA--(CCNMatthews - Oct. 24, 2006) - The amount of time Canadians have to wait for surgical and other therapeutic treatment increased slightly in 2006 and continued to hover near the 18 week mark first reached in 2003, according to The Fraser Institute's 16th annual survey, Waiting Your Turn: Hospital Waiting Lists in Canada, released today.

The total waiting time for patients between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, increased to 17.8 weeks this year from 17.7 weeks observed in 2005. The slight increase in the average is the result of an increase in wait times in seven provinces: B.C., Saskatchewan, Manitoba, Quebec, New Brunswick, Nova Scotia, and Prince Edward Island. This masked the decreased wait times experienced in Alberta, Ontario and Newfoundland.

"These waiting times are the second-longest Canadians have ever experienced, despite record levels of health spending and numerous commitments made by provincial and federal governments," said Nadeem Esmail, Director of Health System Performance at The Fraser Institute and co-author of the survey.

"Canadians should not expect to see any dramatic improvement in waiting times as a result of the latest federal-provincial agreements regarding waiting lists. The long waiting times for medically necessary services are a symptom of a much greater problem: a poorly designed health care system."

The Fraser Institute's annual Waiting Your Turn survey documents the extent to which queues for visits to specialists and for diagnostic and surgical procedures are used to control health care expenses.

Total Waiting Time

With a total of 14.9 weeks, patients in Ontario benefited from the shortest total average wait time (the wait between visiting a general practitioner and receiving treatment). Alberta was second at 16.3 weeks followed by Manitoba at 18 weeks. Patients in New Brunswick experienced the longest wait times (31.9 weeks) followed by Saskatchewan (28.5 weeks) and Prince Edward Island (25.8 weeks).

The First Wait: Between General Practitioner and Specialist Consultation

The waiting time between referral by a GP and consultation with a specialist rose to 8.8 weeks from the 8.3 weeks recorded in 2005.

The shortest waits for specialist consultations were found in British Columbia and Ontario (7.4 weeks), Manitoba (7.7 weeks), and Saskatchewan (8.4 weeks).

The longest waits for specialist consultations occurred in New Brunswick (20.8 weeks), Newfoundland (12.4 weeks) and Prince Edward Island (11.8 weeks).

The Second Wait: Between Specialist Consultation and Treatment

The waiting time between specialist consultation and treatment-the second stage of waiting-fell to 9.0 weeks from 9.4 weeks in 2005. Increases in waiting times in B.C., Saskatchewan, Manitoba, Nova Scotia, and Prince Edward Island were offset by decreases in the five other provinces.

The shortest specialist-to-treatment waits were found in Ontario (7.5 weeks), Alberta (7.8 weeks), and Newfoundland (8.1 weeks). The longest waits between specialist consultation and treatment were in Saskatchewan (20.1 weeks), Prince Edward Island (14.0 weeks), and British Columbia (11.9 weeks).

Waiting by Specialty

Among the various specialties, the shortest total waits (between referral by a general practitioner and treatment) occurred in medical oncology (4.9 weeks), radiation oncology (5.0 weeks), and elective cardiovascular surgery (8.0 weeks). Patients waited longest between a GP referral and orthopaedic surgery (40.3 weeks), plastic surgery (35.4 weeks), and neurosurgery (31.7 weeks).

The wait for neurosurgery increased significantly (by 12.9 weeks) over 2005 levels while wait times for otolaryngology increased by 2.9 weeks, internal medicine by 0.6 weeks, and orthopaedic surgery by 0.3 weeks.

Wait times improved for patients seeking treatment in urology (decreased 1.2 weeks), plastic surgery (decreased 0.8 weeks), radiation oncology (decreased 0.7 weeks), medical oncology (decreased 0.6 weeks), gynaecology (decreased 0.5 weeks), general surgery (decreased 0.3 weeks), elective cardiovascular surgery (decreased 0.3 weeks), and ophthalmology (decreased 0.2 weeks).

Waiting for Diagnostic and Therapeutic Technology

Patients continue to experience significant waiting times for computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound scans.

The median wait across Canada for a CT scan was 4.3 weeks. The shortest waits were found in Alberta, Ontario, Quebec, and Nova Scotia (4.0 weeks), while the longest wait occurred in Prince Edward Island (9.0 weeks). The median wait for an MRI across Canada was 10.3 weeks. Patients in Ontario and Nova Scotia experienced the shortest wait for an MRI (8.0 weeks), while Newfoundland residents waited longest (28.0 weeks). The median wait for ultrasound was 3.8 weeks across Canada. Ontario had the shortest wait time for ultrasound (2.0 weeks), with patients in Prince Edward Island and Manitoba experiencing the longest wait times (8.0 weeks).

"Reasonable" and Actual Waiting Times Compared

Specialists are also surveyed as to what they regard as clinically "reasonable" waiting times. While these values by themselves do not reflect the state of actual waiting time, they can be compared with actual waits to gain an understanding of the medical consequences of waiting for care in Canada. In 77 per cent of the categories surveyed (some comparisons were precluded by missing data), actual waiting time exceeded reasonable waiting time.

Pan-Canadian Waiting Time Benchmarks

Canada's provincial, territorial, and federal governments agreed to a set of common benchmarks for medically necessary treatment on December 12, 2005. A comparison of those benchmarks and the measures used to compile Waiting Your Turn shows that Canada's physicians tend to have a lower threshold for reasonable wait times than do Canada's provincial, territorial, and federal governments. Secondly, median wait times in many provinces are already within the benchmarks set by governments in Canada. This means more than 50 per cent of patients in these provinces are already being treated in a time frame that provincial governments would consider "reasonable."

Health Expenditures and Waiting Times

With variations in waiting times across the country, it is natural to ask if shorter waiting times occur in provinces that spend more on health care. An analysis reveals that provinces spending more on health care per person have neither shorter nor longer weighted median waiting times than provinces spending less. In addition, provinces spending more have no higher rates of surgical specialist services (consultations plus procedures) and lower rates of procedures and major surgeries.

"While our provinces and federal government should be applauded for acknowledging there is a problem and attempting to do something about it, they are falling well short of the gold standard. All their actions are based on the premise that Canadians must wait for care and will always wait for care," Esmail said.

"It's time Canadians sat down and took an honest look at what works elsewhere in the developed world. We need to move beyond the politics, rhetoric, and nonsense that have plagued discussions of health care reform for years if we truly want to improve the state of health care in Canada."

Established in 1974, The Fraser Institute is an independent public policy organization with offices in Vancouver, Calgary, and Toronto.

The media release and complete publication are posted at

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