Canadians are waiting longer than ever for medical
treatment. Waiting times for surgical and therapeutic services in
Canada have increased 7.3 percent over last year, according to
The Fraser Institute's 13th annual survey, Waiting Your Turn: Hospital Waiting Lists in Canada, released today.
The total waiting time for patients between referral from a
general practitioner and treatment, averaged across all 12
specialties and 10 provinces surveyed, increased this year;
rising to 17.7 weeks in 2003 (from 16.5 weeks in 2001-02).
"Canadians are waiting almost 18 weeks for essential medical
care. And these lineups have almost doubled over the past ten
years. The standard solution -- throwing more money at the
problem -- is just not working. The federal and provincial
governments are still failing to act in the face of international
evidence that increasing patient options for private care reduces
waiting times," said John R. Graham, the Institute's director of
health and pharmaceutical policy research.
"Unfortunately, if the proposed National Health Council merely
follows the harmful recommendations in the Romanow Report and
increases centralized decision making in bureaucratic and
political hands, the negative trends in waiting times will
continue," he continued.
Other conclusions from
Waiting Your Turn
- Wait times rose for access to both GPs and specialists
- Over 90 per cent of waiting times are considered beyond
clinically "reasonable" times
- Waits for magnetic resonance imaging (MRI), computed
tomography (CT), and ultrasound scans also increased
Total Waiting Time
Total waiting time refers to the wait between visiting a general
practitioner and actual treatment. This year's nationwide
increase in total average waiting time reflects increases in
seven provinces, with decreases in waiting time in British
Columbia, Saskatchewan, and Manitoba.
Among the provinces, Ontario recorded the shortest total wait
(14.3 weeks), with Manitoba (15.1 weeks) and British Columbia
(17.6 weeks) next shortest. Saskatchewan has the longest total
wait (29.9 weeks). The next longest waits were found in
Newfoundland (21.8 weeks), and New Brunswick (21.1 weeks).
The rise in waiting time is the result of both an increase in the
first component of waiting time -- the wait between visiting a
general practitioner and attending a consultation with a
specialist -- and the wait between consultation with a specialist
and actual treatment.
The First Wait: Between General Practitioner and Specialist
The waiting time between referral by a GP and consultation with a
specialist rose to 8.3 weeks, an increase of 14 percent over last
year (7.3 weeks).
The shortest waits for specialist consultations were found in
British Columbia (6.7 weeks), Manitoba (6.9 weeks), and
Saskatchewan (7 weeks). The longest waits for specialist
consultations occurred in Newfoundland (12.6 weeks), New
Brunswick (11.8 weeks), and Alberta (10 weeks).
The Second Wait: Between Specialist Consultation and
Waiting time between specialist consultation and treatment -- the
second stage of waiting -- increased for Canada as a whole
between 2001-02 and 2003, rising from 9.2 to 9.5 weeks. Decreases
in British Columbia, Saskatchewan, Manitoba, and New Brunswick
disguise increases in six other provinces.
The shortest specialist-to-treatment waits were found in Ontario
(7.1 weeks), Manitoba (8.2 weeks), and Alberta (8.5 weeks). The
longest waits between specialist consultation and treatment are
in Saskatchewan (23 weeks), Prince Edward Island (11.1 weeks),
and British Columbia (10.9 weeks).
Waiting by Specialty
Among the various specialties, the shortest total waits (between
referral by a general practitioner and treatment) existed for
medical oncology (6.1 weeks), radiation oncology (8.1 weeks), and
general surgery (10.3 weeks). In contrast, patients waited
longest between a GP visit and orthopaedic surgery (32.2 weeks),
ophthalmology treatment (30 weeks), and plastic surgery (28.6
There was a striking increase from last year in the wait for
ophthalmology (an increase of 3.4 weeks), otolaryngology (+1.8
weeks), and urology (+1.5 weeks). However, there were
improvements for patients receiving treatment in radiation
oncology (a decrease of 0.4 weeks), gynaecology (-0.3 weeks), and
elective cardiovascular surgery (-0.1 weeks).
Breaking waiting time down into its two components, there is also
variation among specialties. With regard to GP-to-specialist
waiting, the shortest waits are found in radiation oncology (2.1
weeks), cardiovascular surgery (3.4 weeks), and medical oncology
(3.5 weeks), while the longest waits are for ophthalmology (13.9
weeks), orthopaedic surgery (13.3 weeks), and neurosurgery (12.4
For specialist-to-treatment waiting, patients wait the shortest
intervals for urgent cardiovascular surgery (2.1 weeks), medical
oncology (2.6 weeks), and internal medicine and urology (5.7
weeks), and wait longest for orthopaedic surgery (18.9 weeks),
plastic surgery (17 weeks), and ophthalmology (16 weeks).
Waiting for Diagnostic and Therapeutic Technology
The growing waits to see a specialist and to receive treatment
were not the only delays facing patients in 2003. Patients also
experienced significant waiting times for computed tomography
(CT), magnetic resonance imaging (MRI), and ultrasound scans.
The median wait across Canada for a CT scan was 5.5 weeks. The
shortest wait for computed tomography was in New Brunswick, Nova
Scotia, and Newfoundland (4 weeks), while the longest wait
occurred in Prince Edward Island (8 weeks).
The median wait for an MRI across Canada was 12.7 weeks. Patients
in New Brunswick experienced the shortest wait for an MRI (8
weeks), while Newfoundland and Nova Scotia residents waited
longest (24 weeks).
The median wait for ultrasound was 3.6 weeks across Canada. Both
Saskatchewan and Ontario had the shortest wait for ultrasound (2
weeks), while Manitoba exhibited the longest ultrasound waiting
time (8 weeks).
"Reasonable" and Actual Waiting Times Compared
In addition to actual waiting times for care, specialists are
also surveyed as to what they regard as clinically "reasonable"
waiting times. In 92 percent of the 118 categories surveyed (some
comparisons were precluded by unavailable data), actual waiting
time exceeded reasonable waiting time.
Averaged across all specialties, Manitoba and New Brunswick came
closest to meeting the standard of "reasonable" waiting times.
Numbers of Procedures for Which People are Waiting
Throughout Canada, the total number of estimated procedures for
which people are waiting was 876,584 in 2003, an increase of 3
percent from the estimated 852,308 procedures in 2001-02.
The number of procedures for which people were waiting rose in
Alberta, Ontario, Quebec, Nova Scotia, Prince Edward Island and
Assuming that each person was waiting for only one procedure, 2.8
percent of Canadians were waiting for treatment in 2003, which
varied from a low of 2.1 percent in Newfoundland and Ontario to a
high of 7.7 percent in Saskatchewan.
The survey also asked physicians what percentage of their
patients received non-emergency medical treatment outside of
Canada. The highest percentage of patients seeking treatment
outside of Canada were those in need of neurosurgery (2.1
percent). For all specialties, 1.4 percent of patients left the
country to receive treatment.
New This Edition -- National Psychiatry Waiting List
In response to public demand, this year's edition of
Waiting Your Turn
measures Canadians' waiting times for psychiatric services such
as psychotherapy, marital therapy, and prescription drugs for
mental health. Although these measurements will be refined in
future editions, the first year's results indicate that these
waiting times are also unreasonably long.
Overall, the waiting time to see a psychiatrist on an urgent
basis was 2 weeks, both for Canada as a whole and in most
provinces. The waiting time for referrals on an elective basis
was 8.5 weeks. The longest waiting times for elective referrals
was in New Brunswick (20 weeks), followed by Saskatchewan (12
weeks), and Newfoundland (10 weeks). The shortest wait for an
elective referral was in Manitoba (6 weeks).
Waiting Your Turn -- Methodology
The Fraser Institute's annual
Waiting Your Turn
survey presents the only comprehensive measure of hospital
waiting times 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. Information for the survey was provided by 2,817
specialists nation-wide in early 2003. An additional 663
psychiatrists responded to the new psychiatric survey.
The number of procedures for which patients are waiting reported
in earlier editions of
Waiting Your Turn
have been restated for ease of comparison due to updates in the
methodology used in these calculations.