The Fraser Institute

The Fraser Institute

October 18, 2005 06:00 ET

The Fraser Institute: Waiting Times are the Second Longest Canadians Have Experienced; Little Relief in Spite of Increased Health Care Spending

VANCOUVER, BRITISH COLUMBIA--(CCNMatthews - Oct. 18, 2005) - Waiting times for medical treatment have stalled at their peak levels of about 18 weeks, according to The Fraser Institute's 15th 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, fell slightly this year; decreasing to 17.7 weeks in 2005 (from 17.9 weeks in 2004).

"Canadians should not be fooled into thinking that this small reduction in overall waiting is a good-news story. It is important to remember that these waiting times are the second-longest that Canadians have ever experienced and that they exist despite record levels of health spending and in spite of numerous commitments made by provincial and federal governments," said Nadeem Esmail, senior health policy analyst at The Fraser Institute and co-author of the survey.

"Canadians should also not expect any dramatic improvement in waiting times resulting from 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," he continued.

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 being used to control health care expenses.

Total Waiting Time

This year's modest nationwide decrease in total average waiting time (the wait between visiting a general practitioner and receiving treatment) reflects increases in five provinces, with decreases in waiting time in British Columbia, Alberta, Saskatchewan, Quebec, and Prince Edward Island.

Among the provinces, Ontario achieved the shortest total wait (16.3 weeks), with Manitoba (16.6 weeks) and Alberta (16.8 weeks) next shortest.

Saskatchewan, despite a dramatic 7.8 week reduction in the total waiting time, has the longest total wait in 2005 (25.5 weeks). The next longest waits were found in New Brunswick (24.5 weeks) and Newfoundland (22.3 weeks).

The First Wait: Between General Practitioner and Specialist Consultation

The waiting time between referral by a GP and consultation with a specialist fell from 8.4 weeks in 2004 back to the 8.3 weeks last seen in 2003.

The shortest waits for specialist consultations were found in Prince Edward Island (6.2 weeks), Manitoba (7.0 weeks), and British Columbia and Saskatchewan (7.2 weeks).

The longest waits for specialist consultations occurred in Newfoundland (13.0 weeks), New Brunswick (12.9 weeks), and Nova Scotia (10.4 weeks).

The Second Wait: Between Specialist Consultation and Treatment

The waiting time between specialist consultation and treatment-the second stage of waiting-fell to 9.4 weeks in 2005, from 9.5 weeks in 2004. Decreases in British Columbia, Saskatchewan, Quebec, and Prince Edward Island were offset by increases in the six other provinces.

The shortest specialist-to-treatment waits were found in Quebec (8.4 weeks), Alberta (8.6 weeks), and Ontario (8.7 weeks). The longest waits between specialist consultation and treatment were in Saskatchewan (18.3 weeks), New Brunswick (11.6 weeks), and British Columbia (11.2 weeks).

Waiting by Specialty

Among the various specialties, the shortest total waits (between referral by a general practitioner and treatment) existed for medical oncology (5.5 weeks), radiation oncology (5.7 weeks), and elective cardiovascular surgery (8.3 weeks). In contrast, patients waited longest between a GP referral and orthopaedic surgery (40.0 weeks), plastic surgery (36.2 weeks), and ophthalmology treatment (27.4 weeks).

There was a large increase from last year in the wait for orthopaedic surgery (an increase of 2.1 weeks), while wait times for general surgery (+0.5 weeks) and plastic surgery (+0.4 weeks) increased slightly.

However, there were improvements for patients receiving treatment in neurosurgery (-3.9 weeks), elective cardiovascular surgery (-2.8 weeks), radiation oncology (-2.1 weeks), otolaryngology (-1.5 weeks), ophthalmology and urology (-1.3 weeks), internal medicine (-0.6 weeks), and medical oncology (-0.1 weeks).

Waiting for Diagnostic and Therapeutic Technology

Patients also experienced significant waiting times for computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound scans.

The median wait across Canada for a CT scan was 5.5 weeks. The shortest wait for computed tomography was in New Brunswick, Nova Scotia, and Prince Edward Island (4 weeks), while the longest wait occurred in Saskatchewan (8 weeks).

The median wait for an MRI across Canada was 12.3 weeks. Patients in Prince Edward Island experienced the shortest wait for an MRI (5 weeks), while Newfoundland residents waited longest (36 weeks).

The median wait for ultrasound was 3.4 weeks across Canada. Both Alberta and Ontario had the shortest wait for ultrasound (2 weeks), while Newfoundland exhibited the longest ultrasound waiting time (9 weeks).

"Reasonable" and Actual Waiting Times Compared

Specialists are also surveyed as to what they regard as clinically "reasonable" waiting times. In 85 percent of the 123 categories surveyed (some comparisons were precluded by unavailable data), actual waiting time exceeded reasonable waiting time.

"The provinces' efforts to create benchmark waiting times by the end of this year are ultimately a waste of resources, even if one were to assume that they are actually able to do something about the wait time problem. The information on the reasonableness of queues is available right here from the minds of physicians across Canada. Those physicians have been telling Canadians for years that the wait times for most types of medically necessary treatment are much longer than is clinically reasonable," said Esmail.

Numbers of Procedures for Which People are Waiting

Throughout Canada, the total number of estimated procedures for which people are waiting was 782,936 in 2005. Assuming that each person was waiting for only one procedure, 2.5 percent of Canadians were waiting for treatment in 2005, which varied from a low of 1.9 percent in Prince Edward Island, to a high of 5.3 percent in Saskatchewan.

National Psychiatry Waiting List Survey, 3rd Edition

Waiting Your Turn also measures Canadians' waiting times for psychiatric services such as psychotherapy.

The waiting time for referrals on an elective basis in 2005 was 7.8 weeks, a slight increase from 2004 (7.6 weeks). The longest waiting times for elective referrals was in New Brunswick (20 weeks), while the shortest wait for an elective referral was in Nova Scotia (6 weeks).

Waiting time between specialist consultation and treatment--the second waiting time--fell slightly in 2005 (10.3 weeks) from the 10.5 weeks experienced in 2004. The shortest specialist-to-treatment wait was found in Quebec (7.5 weeks), while patients waited longest in New Brunswick (17.5 weeks).

Waiting for Change

Waiting times are the legacy of a medical system offering low expectations cloaked in lofty rhetoric. Solving the waiting time problem will require emulating the success of those nations that provide universal access to health services without significant waiting times: Austria, Belgium, France, Germany, Japan, Luxembourg, and Switzerland.

"Canada must look at incorporating health care policies that have been proven to work in other countries' universal-access health care programs," concluded Esmail. "A dramatic reduction in waiting times is not possible with the Medicare programs we have today, no matter how many billions of dollars are spent on provincial initiatives to measure and manage queues for medically necessary care."

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

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