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Wait times

Further progress on wait times needed, physicians say

OTTAWA – A Wait Time Alliance (WTA) report card released in June shows some spotty progress in cutting wait times in the five clinical areas deemed priorities by governments. However, far too much of the wait-times picture for patients remains shrouded in mystery.

“People can go online and track the progress of a package they shipped from one end of the country to another, yet in many parts of Canada patients still cannot find out how long they can expect to wait for critical medical treatments and procedures,” said WTA co-chair Dr. Lorne Bellan. “We need to do a better job of tracking and reporting on the full wait that patients experience to access necessary medical care.”

The WTA’s fourth annual report card – entitled Unfinished Business to highlight the fact that much more work remains to be done to cut wait times – grades the progress of provincial governments in reducing waits compared to last year.

This year’s WTA Report Card shows slight improvement over the previous year in wait times for the five priority areas.

New this year, the WTA Report Card includes data on the total wait for an expanded range of specialty services. This includes waits for more procedures under the initial five priority specialty areas, as well as for procedures in new specialties, specifically: psychiatry, obstetrics/gynecology, gastroenterology, plastic surgery, anesthesiology and emergency care.

Unfinished Business also examines wait times from the time a patient is referred by a family physician to the time treatment by the specialist is provided.

“In England, the maximum allowable target time set by the National Health Service for referral by family doctor to the day of treatment is 18 weeks,” said Dr. Bellan. “Our study shows that for many medical specialties in Canada that we examined, we don’t even come close to that.”

For provincial “Trends” in reducing wait times, the 2009 Report Card again shows that some progress has been made over the last year with only a few regressions in some areas. The failure of governments to apply wait-time targets to a broader array of clinical services remains a glaring example of the work that still needs to be completed.

“Five years ago, governments agreed to targets for coronary artery bypass grafting, just one, narrow part of cardiac care,” said WTA co-chair Dr. Lorne Bellan. “Since then, there has been no progress in expanding benchmarks, even though the Canadian Cardiovascular Society developed a full set of evidence-based care in 2005.”

“While some progress is being made, it only represents a small step toward improving access to timely care for our patients-there remains much unfinished business,” added Dr. Bellan.

Dr. Robert Ouellet, president of the Canadian Medical Association, listed solutions from Europe that Canada could draw on. For example, about six years ago, England started funding hospitals based on the number and type of patients they see instead of lump funding. The result was waiting times “melted like snow in the sun,” he said.

In Denmark, patients waiting more than a month are automatically referred to private clinics, said Dr. Ouellet, a radiologist by training who owns and operates medical imaging clinics in Quebec.

Likewise in France, wait times are kept in check by referring 60 per cent of non-urgent surgeries to private clinics. The surgeries are paid for under the public system.

Dr. Ouellet stressed he’s not pushing for U.S.-style private medicine, which he called a poor performer in terms of life expectancy, infant mortality and spending per capita. About 46 million Americans under the age of 65 lack health insurance.

For more information on the 2009 Report Card and background materials, see