Provinces Catch Up on Cancelled Surgeries, but Long Waits Persist

Provinces Catch Up on Cancelled Surgeries, but Long Waits Persist
A health-care worker at a COVID-19 unit that used to be an orthopedic surgery unit at the Health Sciences Centre in Winnipeg on Dec. 8, 2020. (The Canadian Press/Mikaela MacKenzie)
Lee Harding

Many surgeries cancelled by lockdowns last spring have since taken place, but experts say even the best-performing provinces still struggle with chronically long wait times.

In British Columbia, about 30,000 procedures were cancelled or never scheduled during the two-month shutdown last spring. The province recently reported that as of Nov. 12, 2020, surgeries had been completed for 90 percent of patients whose operations had been postponed. Although a wait list of 88,401 still remained, it was 4 percent less than the same period in 2019.

“Surgical capacity continues to increase across health authorities as a result of extending weekday and weekend operating room hours to improve operating room efficiency and contracting private surgical centres,” the health ministry’s progress report stated.

Bacchus Barua, who co-authored the Fraser Institute’s 2020 wait times report, told The Epoch Times that B.C.’s efforts are “incredibly commendable” but wait times remain a big concern.

“What’s unfortunate is that just in order to get through that backlog ... we have to run our health-care system on overdrive, which really makes us foster concern with regards to what would it actually take to get wait times down.”

According to the report, the wait time from referral by a general practitioner (GP) to treatment by a specialist averaged 9.3 weeks in 1993, 20.9 weeks in 2019, and a record 22.6 weeks in 2020.

“COVID has definitely challenged the system,” Barua said. “However, the situation didn’t look very different in terms of the average wait times for elective surgeries just a year before.”

Saskatchewan caught up on its wait list cancellations by the end of November. Barua said the province went from having the highest wait times to having the lowest wait times three years ago.

“[Saskatchewan] created partnerships with third-party private clinics to deliver a certain set of surgeries, and in doing so could dramatically expand capacity. And, interestingly, those clinics were actually delivering services at a lower cost per procedure than the public clinics as well,” he explained.

“The second thing it did was that it started a pooled resource [where patients were] matched with the physician with the shortest wait times.”

Nova Scotia, where GP-to-treatment wait times jumped to 43.8 weeks in 2020, had caught up on nearly three-quarters (72 percent) of postponed surgeries as of Oct. 19. Of that wait time, 30.1 weeks accounted for the wait time between consultation with the specialist and ultimate treatment by that specialist.

A study published in the Canadian Medical Association Journal in November 2020 estimated that the surgery backlog in Ontario between mid-March and mid-June was 148,364 and that it would take 84 weeks to clear. The Epoch Times requested an update from the Ontario Ministry of Health but none was received before publication.

A report by the University Health Network, which encompasses several Toronto hospitals, estimated that 30 to 35 patients may have died while waiting for cardiac surgery between March 15 and the end of May 2020.

The problem is not new., a group that works to explore how government policies impact Canadians, conducted a study which found that 1,480 patients in Canada died while waiting for surgery during the 2018–19 fiscal year. According to its policy brief, that figure is incomplete because it’s from health facilities that serve approximately 14.6 million Canadians, or less than half the country

SecondStreet President Colin Craig told The Epoch Times that wait times can cause suffering.

“We’ve talked to patients who have described basically getting depression because they’ve had to take a year of their life and sit on the sidelines and struggle with pain, struggle with mobility, struggle with other health ramifications from waiting so long. So there’s just a lot of pretty sad stories out there.”

SecondStreet’s investigation found that many jurisdictions don’t seem to know how many people are dying while on wait lists in their health-care systems. The policy brief recommended that health authorities report such numbers annually and that governments allow private health-care options in order to increase patient choice.

“We have fewer doctors per capita than other countries that have both public and private systems; we have fewer hospital beds ... so the government rations the amount of health care that people receive,” Craig said.

“You hear people saying, oh well, in Canada the system is free. But it’s like the Soviet bread line joke: The bread is free, you just have to wait all day in line to get it.”

According to Barua, Switzerland, Sweden, France, Australia, the Netherlands, and Germany have universal health care and spend similar amounts as Canada. “They all have more resources, they all have remarkably shorter wait times, and they tend to do three things differently.”

The differences, he says, are that these countries view private care positively as a partner in health-care delivery, they require patients in most circumstances to share some of the cost of services, and they fund hospitals based on the services they deliver—not based on global budgets where every patient becomes a drain on the budget.

“One of the positive things about the current pandemic is this is giving us a little bit more of a global outlook,” Barua said. “My hope is that we also learn about what are the other things that these countries do ... [and] work towards a better normal, rather than returning to the old normal.”