Still No Debbie’s Law Directive?

Debbie photo

A little over a year ago, the Fewster family in Manitoba tragically lost their mother while she waited for the government to provide heart surgery.

One year later, the government has indicated nothing has been done to make sure other patients don’t suffer the same consequence.

To recap, Debbie was told she needed surgery within three weeks.

She died after waiting more than two months.

Debbie’s children told us that if they had known at the start that their mother’s life was in jeopardy – sitting on a government waiting list – they would have paid for her to receive surgery outside the province. This prompted our organization to draft, in consultation with Debbie’s family, a policy brief putting forward the idea of Debbie’s Law.

Such a law would require health providers to notify patients – who are waiting for life-saving treatment – of two things right at the start:

1) How long of a wait time they face

2) The maximum recommended wait time for their situation

This would allow patients to know if the government was putting their lives at risk or not. 

For example: If a patient was told they needed surgery within a month, but were looking at a two-month wait, then they could consider private options outside the province.

After going public in March 2025 about Debbie’s story, the government floated a draft directive in April. The directive would be sent from the Minister to the Cardiac Sciences Program and would require patients to be informed with the two pieces of information we called for.

Such a directive included no consequences for failing to comply, and it was limited to cardiac care, but it was a step in the right direction and our organization and Debbie’s family applauded the move. We also applauded a bill put forward by the opposition health critic Kathleen Cook. Cook’s bill was more comprehensive as it covered not just heart procedures, but all potential lifesaving treatments (e.g. cancer treatment). It too did not include consequences (private members bills have limitations) but it too was a step in the right direction.

More than anything, it was encouraging to see both parties try to address the tragedy.

Unfortunately, the government responded to our recent Freedom of Information request for a copy of the final directive issued by the Minister by noting on September 22 that the directive was still being drafted. (We had thought it had been sent)

It was a staggering admission.

How is it that a year after Debbie’s passing, nothing has been done? 

How long does it take to send what is essentially a memo?

To be blunt, this is not rocket science. If a patient needs lifesaving heart surgery, you tell them the best estimate for their wait time and the maximum recommended wait time for their situation. Those two pieces of information should be readily available.

This issue really boils down to human decency. It’s one thing for the public system to fail families like Debbie’s. It’s another for the system to gamble with patients’ lives and keep them in the dark.

Transparency could help save lives and that’s not an ideological solution. 

So why haven’t we seen action?

Hopefully something has been finalized since we received that note in September that nothing had been done. We’re going to follow up – but I’m not holding my breath.

Colin Craig is the president of SecondStreet.org

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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.