Fraser Institute says hospital waiting times longer
Contact:
Martin Zelder, Director,
Health Policy Research, The Fraser Institute
Telephone: (604) 714-4548
Email: martinz@fraserinstitute.caEmbargo Date: 12 October 2000
VANCOUVER, BC — Despite improvements in two provinces, waiting time for surgical and other therapeutic treatments in Canada continued to increase in 1999, according to The Fraser Institute's 10th annual survey, Waiting Your Turn: Hospital Waiting Lists in Canada, released today.
"Under the current healthcare system — no user fees, with access limited by waiting, and crucial medical resources priced and allocated by governments — prospects for improvement are dim. Only substantial reform of that regime is likely to alleviate the medical system's most curable disease — protracted waiting for care, and its tragic progeny," says Martin Zelder, director of health policy research at The Fraser Institute.
Total waiting time
Patients are waiting longer than ever — almost four months — between visiting a general practitioner (GP) and receiving treatment. Averaged across all 12 specialties and 10 provinces surveyed, total waiting time rose from 13.3 weeks in 1998 to 14 weeks in 1999, a 5.3 percent increase (Chart 1 and Table 1).
This nationwide deterioration reflects waiting-time increases in eight provinces, while concealing decreases in total waiting time in Manitoba and Ontario.
Among the provinces, Manitoba achieved the shortest total wait in 1999, 11.2 weeks. Ontario (11.8 weeks) and Quebec (12.4 weeks) have the next shortest waits. The longest total wait is in Saskatchewan, 34.5 weeks; the next longest waits occurred in Newfoundland (19.5 weeks), and Prince Edward Island (18.8 weeks).
But, "Providing relatively shorter waiting times, as do Manitoba, Ontario, Quebec, and Nova Scotia, is a hollow victory. The focus should be shifted away from being the best in Canada to reducing waiting times closer to the standards set in other leading developed countries," says Zelder.
Waiting times have increased a dramatic 51 percent since 1993, when the median total wait for Canadian patients to receive treatment was 9.3 weeks.
The first wait: Between general practitioner and specialist consultation
The first component of total waiting time — the time between GP referral and specialist consultation — actually decreased in Canada as whole in 1999. This component of waiting time fell from 6 weeks in 1998 to 5.6 weeks in 1999, a decrease of 6.7 percent (Chart 2).
Five provinces shortened this first segment of waiting: Manitoba, New Brunswick, Nova Scotia, Ontario, and Prince Edward Island. The shortest waits for specialist consultations were experienced in Manitoba (4 weeks), Quebec (5.3 weeks), and British Columbia (5.4 weeks). The longest waits for specialist consultations occurred in New Brunswick (7.6 weeks), Newfoundland (7.5 weeks), and Alberta (7.4 weeks).
The second wait: Between specialist consultation and treatment
Waiting time between specialist consultation and treatment — the second stage of waiting — increased for Canada as a whole between 1998 and 1999, rising from 7.3 to 8.4 weeks, a 15 percent increase (Chart 3).
The increase in this Canada-wide average reflected the fact that this second segment of waiting rose in 8 of 10 provinces between 1998 and 1999. This second segment of waiting did not diminish for any province, and remained constant in Ontario and British Columbia.
The shortest specialist-to-treatment waits were found in Ontario (6 weeks), Nova Scotia (6.8 weeks), and Quebec (7.1 weeks), while the longest such waits existed in Saskatchewan (28.9 weeks), Prince Edward Island (12.6 weeks), and Newfoundland (12 weeks).
Waiting by specialty
Among the various specialties, the shortest total waits for treatment existed for medical oncology (4.5 weeks), general surgery (7.5 weeks), and internal medicine (8.8 weeks). (Chart 4). Conversely, patients waited longest between a GP visit and treatment for orthopaedic surgery (24.6 weeks), ophthalmology (19.3 weeks), and plastic surgery (18.7 weeks).
"Should a civilized country tolerate typical waits of almost six months for orthopaedic surgery, over four months for neurosurgery, and two months for radiation treatment for cancer?" asks Zelder.
"Reasonable" and actual waiting times compared
Specialists were also surveyed as to what they regard as clinically "reasonable" waiting times (Chart 5). "The comparison of actual waits with what are considered clinically acceptable waits shows that in most specialties in most provinces, physicians believe that Canadians have to wait longer for care than is healthy," notes Zelder. Among the specialties, "reasonable" was most often met or bettered for urgent cardiovascular surgery and medical oncology.
Waiting for diagnostic and therapeutic technology
Patients also experienced significant waiting times for various diagnostic technologies across Canada, including computed tomography (CT) scans and magnetic resonance imaging (MRI). The median wait for a CT scan across Canada was 5 weeks, a 6.4 percent increase over 1998. The shortest wait for CT scans was found in New Brunswick (3 weeks), while the longest wait occurred in Prince Edward Island (8 weeks).
The median wait for an MRI across Canada was 12 weeks, a 5.3 percent increase in waiting time since 1998. Patients in Manitoba experienced the shortest wait for an MRI (8 weeks), while Alberta residents waited longest (18 weeks).
Numbers of people waiting
The numbers of people waiting for each procedure and therefore each specialty were also calculated. Throughout Canada, the total number of people waiting for treatment was 166,150 in 1999, a reduction of 22 percent between 1998 and 1999. The number of people waiting rose in Saskatchewan, Newfoundland, and Prince Edward Island. As a percentage of the population, 0.54 percent of Canadians were waiting for treatment in 1999, which varied from a low of 0.36 percent in Ontario to a high of 2.23 percent in Saskatchewan.
Spend more, wait less?
The notion that longer waiting is due to cuts in government health spending has also recently been explored in a related Fraser Institute study. This analysis revealed that provinces which spent less on health care per person during the years 1993 through 1998 had neither longer nor shorter total waiting times than provinces which spent more. In addition, provinces which spent less had no lower rates of surgical specialist services (consultations plus procedures) and actually had higher rates of procedures and major surgeries.
"Look at Saskatchewan," says Zelder. "That province had the second-highest government health spending per person in 1999 and the longest total waiting time of all the provinces." Instead, according to Zelder, lengthy waiting is a consequence of medicare's defective structure.
The Fraser Institute's annual Waiting Your Turn survey presents the only comprehensive measure of hospital waiting lists across Canada. The survey measures the extent to which queues for visits to specialists and for diagnostic and surgical procedures reflect health care rationing in the provinces from year to year. Information for the survey was provided by 2,315 specialists nation-wide during the latter part of 1999.
Established in 1974, The Fraser Institute is an independent public policy organization based in Vancouver, with offices in Calgary and Toronto.
For further information regarding Waiting Your Turn: Hospital Waiting Lists in Canada (10th edition) contact:
Suzanne Walters, Director of Communications,
The Fraser Institute, (604) 714-4582,
Email suzannew@fraserinstitute.ca
info@fraserinstitute.ca
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