Waiting List Deaths Spike in Ontario

Died on a waiting list

Think tank SecondStreet.org released today new Ontario Health data that shows a spike in the number of patients that died while waiting for surgery, CT scans and MRI scans in 2021-22. The freedom of information response shows that waiting list deaths for the aforementioned health services are up significantly over the past five years.

“Government rationing and mismanagement in health care are costing some patients their lives and many others their quality of life in their final years,” said SecondStreet.org President Colin Craig. “Decades of throwing more and more money at the health care system hasn’t worked. The Ontario Health data shows that waiting list deaths were a growing problem before the pandemic began.”

While many other provinces, and even hospitals within Ontario, release more information around waiting list deaths (the procedure in question, how long patients waited, etc.), Ontario Health has refused to release similar information, citing patient confidentiality as rationale. SecondStreet.org has a complaint before the Information Commissioner to try to obtain additional details. Past research suggests most patients likely died while waiting for procedures which could have improved their quality of life (e.g. hip operation) rather than saving their life (e.g. heart operation). However, data from Nova Scotia shows that 51 patients died in 2020-21 while waiting for procedures which could have potentially saved their lives.

Ontario Health data shows the following:

Number of patients who died while waiting for surgery:

 2021/22: 1,417
2020/21: 1,096
2019/20:    986
2018/19: 1,039
2017/18: 1,138
2016/17: 1,045

Number of patients who died while waiting for a CT scan:

 2021/22: 5,404
2020/21: 4,624
2019/20: 3,924
2018/19: 3,991
2017/18: 3,346
2016/17: 2,838

Number of patients who died while waiting for an MRI scan:

 2021/22: 1,993
2020/21: 1,867
2019/20: 1,610
2018/19: 1,363
2017/18: 1,171
2016/17: 1,058

“One can only hope that Ontario’s Minister of Health has seen these statistics and is probing the numbers more deeply,” added Craig. “How many of these patients died for procedures which could have potentially saved their lives? How many spent their final years waiting in chronic pain while waiting for procedures like hip operations and knee operations? How many developed depression or mental health issues due to their long wait for care? These are important answers to find out.”

SecondStreet.org will be releasing its annual Died on a Waiting List policy brief later this year.

To view the 2021-22 Ontario Health data – click here

To view the 2010-11 to 2020-21 Ontario Health data – click here

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.