Sluggish Improvement in Health Waitlist Numbers

CALGARY, AB: Think tank SecondStreet.org released today data gathered from governments nation-wide that show more than 3.2 million Canadians are waiting for surgery, a diagnostic scan, or to see a specialist. However, as this data is incomplete, the true number is likely closer to 5.1 million patients – about one in eight Canadians. 

Since coming out of the pandemic, SecondStreet.org has been updating CanadaWaits.ca with government waiting list figures. Since that time, the total number of Canadians waiting has appeared to drop slightly (7%) when one looks at provinces that provided data both in 2022 and for this current update.

“Despite record health spending by provincial governments to reduce wait times, improvements to waiting lists have been quite sluggish,” said Harrison Fleming, Legislative and Policy Director at SecondStreet.org. “With more than three million Canadians waiting today – nearly the same number since Canada came out of the pandemic – it’s clear that throwing money at the problem isn’t the answer. Copying policies that work well in universal systems in Europe could help.”

Some key findings from the data include: 

  • Seven provinces have no data on how many patients are waiting to see specialist. Others have outdated or incomplete data on the number of patients waiting for a diagnostic scan or surgery.
  • Saskatchewan has seen some of the best results in Canada since the end of the pandemic, with a drop in both the number of patients waiting for surgery and diagnostic scans.
  • British Columbia’s surgical waitlist volume has increased 10% since the end of the pandemic. For the first time, B.C. has provided diagnostic numbers, noting that 204,737 patients are on waitlists for MRIs, CT Scans, colonoscopies, and other GI endoscopies. 
  • Alberta saw a modest increase in surgical and diagnostic waitlists, in addition to a larger increase in patients waiting to see specialists. However, the province did note that the latest data set was from a larger pool of health providers than previously provided and cautioned against comparisons with previous years.
  • Manitoba experienced a more than 16% increase in both the number of people waiting for surgery and to receive a diagnostic scan.
  • Ontario witnessed a large decrease in surgical waitlist volumes but also experienced a large increase in diagnostic waitlist volumes.
  • Quebec saw a large decrease in diagnostic waitlist volumes and a slight increase in surgical waitlist numbers.
  • Atlantic Canadian provinces saw some improvements, however data was largely incomplete for the region. For example, Nova Scotia followed the example set by New Brunswick last year, only providing surgical numbers, previously having shared data for diagnostic and specialist exams. 
  • While some provinces like Saskatchewan and Manitoba should be applauded for innovative and publicly accessible waitlist data online, it should be noted both provinces only provide a limited number of data points, with neither sharing data on wait times for specialist appointments. 

The complete data set from each province can be seen in the table below: (The percentage change since SecondStreet.org’s initial launch of CanadaWaits.ca in 2022 is seen in brackets next to each number.)

Province

Surgery

Specialist

Diagnostic

Date

British Columbia

98,042 (+10.4%)

204,737
(N/A)

March 9, 2024

Alberta

78,525 (+4.3%)

228,799 (N/A)

111,725 (+2.7%)

March 11-13, 2024

Saskatchewan (file 2)

27,846 (-22.6%)

18,352 (-11.0%)

June 30, 2024

Manitoba *

10,360 (+16.4%)

65,661 (+16.6%)

June, 2024

Ontario

185,081 (-19.3%)

608,010 (+32.1%)

June 10-12, 2024

Quebec

161,760 (+0.7%)

827,858 (+4.3%)

404,226 (-42.9%)

February 24, 2024

New Brunswick

26,646 (-2.2%)

February 29, 2024

Newfoundland

35,484 (-31.3%)

Oct-Dec, 2023

Nova Scotia **

17,447 (-33.5%)

3,079
(N/A)

82,834
(N/A)

May 24, 2024

Prince Edward Island

October 12, 2023

Yukon

November 15, 2023

Northwest Territories

872
(N/A)

9,989
(N/A)

443
(N/A)

Nov 30 – Jan 17, 2022-23

Nunavut (file 2)

825
(+30.5%)

749
(-80.1%)

68
(+126.7%)

March 13-18, 2024

TOTALS:

607,404

1,070,474

1,531,540

 

 

 

Grand Total:

3,209,418

 

* Manitoba only provides data for four types of surgeries and five types of diagnostic scans, so numbers are underreported.

** The specialist data provided by Nova Scotia only counted waitlists for a few types of specialists. As such, the numbers are likely much higher. In addition, the province has not provided new diagnostic waitlist numbers since June 2022.

“It’s amazing how many health ministers in Canada don’t know how many patients are waiting for health services, particularly when it comes to appointments with specialists,” added SecondStreet.org President Colin Craig. “Tracking the nation’s enormous waiting list backlog should be a priority. We’re doing our part to track the data, but can governments really fix this problem if they don’t even care to understand it?” ”

SecondStreet.org regularly updates CanadaWaits.ca with the latest government data on waitlists. In terms of solutions, SecondStreet.org’s new documentary – Health Reform Now – examines five policies from better-performing universal systems in Europe.

 

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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.