Despite promises of improvement from successive provincial governments, recent data suggest that health-care wait times for medically necessary care in Nova Scotia remain among the highest in Canada.
In 2022, the latest year of available data based on a survey of physicians across Canada, the median wait time in the province for a medically necessary procedure was 58.2 weeks—this includes both the time patients wait between seeing a general practitioner (GP) and seeing a specialist (37.3 weeks), and the time between that specialist appointment to receipt of treatment (21.0 weeks). In other words, Nova Scotians who require a medically necessary procedure (hip replacement, cataract surgery, etc.) must now wait more than one year (the second-longest wait in Canada behind only Prince Edward Island). And at 58.2 weeks, Nova Scotia’s median wait time is more than double the national average (27.4 weeks).
Of course, this is not merely abstract data but rather a representation of human and economic cost. Long wait times may result in increased suffering for patients, decreased quality of life, and can lead to disability or even death.
Obviously, COVID—and the decisions by government to cancel and postpone certain surgeries—contributed to surgical backlogs in the province. And while Nova Scotia has a 14 per cent response rate to the survey (higher than the national average), the low absolute number of responses in certain specialties warrants interpreting the results with caution. However, even in 2019, before the pandemic, patients had to endure a wait of 33.3 weeks between referral from a GP to a treatment (based on a 29 per cent response rate). Clearly, the pandemic has exacerbated, not created, long wait times in the province.
So what’s to be done? First, it’s important to understand that long wait times are not an inevitable price to pay in exchange for universal coverage. International data reveal how other universal health-care countries have relatively shorter wait times while often spending less than Canada. A much smaller percentage of patients in the Netherlands (87 per cent), Germany (99 per cent) and Australia (72 per cent) report waiting less than four months for elective surgical care compared to Canada (62 per cent). A 2022 report also showed Canada was largely outperformed by these countries for the availability of health-care resources such as physicians, nurses and beds.
These countries depart from Canada’s approach in a number of ways. For example, they embrace the private sector as either a partner or an alternative to the public system. While certainly not a solve-all, the contracting of private clinics by provincial governments, through programs such as the Saskatchewan Surgical Initiative (SSI), have successfully lowered wait times in the past (as long as the program was running). Indeed, thanks in large part to the SSI, Saskatchewan went from having one of the longest waits outside of Atlantic Canada in 2010 (at 26.5 weeks) to the second-shortest in the country in 2014 (at 14.2 weeks). On this front, Nova Scotia’s move toward increasing publicly funded surgeries delivered by private-sector clinics is a good start.
While health-care wait times are an issue across the country, the data suggest that Nova Scotia’s waits are among the longest in Canada. The many Nova Scotians suffering from these long and unnecessary waits for necessary care deserve health-care reform now.
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Nova Scotia’s health-care wait times remain among longest in Canada
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Despite promises of improvement from successive provincial governments, recent data suggest that health-care wait times for medically necessary care in Nova Scotia remain among the highest in Canada.
In 2022, the latest year of available data based on a survey of physicians across Canada, the median wait time in the province for a medically necessary procedure was 58.2 weeks—this includes both the time patients wait between seeing a general practitioner (GP) and seeing a specialist (37.3 weeks), and the time between that specialist appointment to receipt of treatment (21.0 weeks). In other words, Nova Scotians who require a medically necessary procedure (hip replacement, cataract surgery, etc.) must now wait more than one year (the second-longest wait in Canada behind only Prince Edward Island). And at 58.2 weeks, Nova Scotia’s median wait time is more than double the national average (27.4 weeks).
Of course, this is not merely abstract data but rather a representation of human and economic cost. Long wait times may result in increased suffering for patients, decreased quality of life, and can lead to disability or even death.
Obviously, COVID—and the decisions by government to cancel and postpone certain surgeries—contributed to surgical backlogs in the province. And while Nova Scotia has a 14 per cent response rate to the survey (higher than the national average), the low absolute number of responses in certain specialties warrants interpreting the results with caution. However, even in 2019, before the pandemic, patients had to endure a wait of 33.3 weeks between referral from a GP to a treatment (based on a 29 per cent response rate). Clearly, the pandemic has exacerbated, not created, long wait times in the province.
So what’s to be done? First, it’s important to understand that long wait times are not an inevitable price to pay in exchange for universal coverage. International data reveal how other universal health-care countries have relatively shorter wait times while often spending less than Canada. A much smaller percentage of patients in the Netherlands (87 per cent), Germany (99 per cent) and Australia (72 per cent) report waiting less than four months for elective surgical care compared to Canada (62 per cent). A 2022 report also showed Canada was largely outperformed by these countries for the availability of health-care resources such as physicians, nurses and beds.
These countries depart from Canada’s approach in a number of ways. For example, they embrace the private sector as either a partner or an alternative to the public system. While certainly not a solve-all, the contracting of private clinics by provincial governments, through programs such as the Saskatchewan Surgical Initiative (SSI), have successfully lowered wait times in the past (as long as the program was running). Indeed, thanks in large part to the SSI, Saskatchewan went from having one of the longest waits outside of Atlantic Canada in 2010 (at 26.5 weeks) to the second-shortest in the country in 2014 (at 14.2 weeks). On this front, Nova Scotia’s move toward increasing publicly funded surgeries delivered by private-sector clinics is a good start.
While health-care wait times are an issue across the country, the data suggest that Nova Scotia’s waits are among the longest in Canada. The many Nova Scotians suffering from these long and unnecessary waits for necessary care deserve health-care reform now.
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Alex Whalen
Mackenzie Moir
Senior Policy Analyst, Fraser Institute
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