June 3, 2014
Canadians wait longer in hospital emergency departments than people in other countries with publicly funded health-care systems, according to a new report.
The Wait Times Alliance’s annual report card, called "Time to close the gap," said 27 per cent of Canadians reported waiting more than four hours in the emergency department compared with one per cent in the Netherlands and five per cent in the United Kingdom.
"It is not right to force Canadians to wait two or three times longer for necessary medical care than citizens of other countries that also have universal publicly funded health systems," the report’s authors said.
"Furthermore, as seen in many other countries with universal health systems, it is indeed possible to have timely access to medical care — long waits are not an unavoidable price to pay nor are they tolerated by their citizenry."
The alliance called for a patients’ charter of rights and responsibilities that includes wait-time guarantees, such as to access a member of their primary-care team, like a family doctor or nurse practitioner, within 48 hours. England and Scotland have wait time charters, while Finland and Denmark have enforceable patient wait-time guarantees.
Overcrowded ER myth
The human costs to patients and their families are significant, since health suffers and deteriorates while economic costs to individuals and society from lost productivity and lost tax revenue mount.
The health-care system also ends up with more costs, such as on drugs to manage pain or tests to monitor patients while they wait, a time when complications can occur.
The main contributing factor is the high number of patients such as seniors, the majority of whom have dementia and other chronic health conditions, who are in hospital beds while they wait for a place in residential facility.
Dr. Chris Simpson, chair of the alliance, suggested that instead of spending old money for old problems, what's badly needed is new thinking. Neglect of the aging population means all Canadians will pay with longer wait times, he said.
The number of beds may not be enough or may be blocked for budget reasons. Community care is also limited.
"Contrary to public opinion, ED overcrowding is not caused by inappropriate use of EDs," said the group, which includes the Canadian Medical Association and national organizations that represent specialists.
In other countries that have succeeded in reducing wait times, governments made it a priority to achieve benchmarks and health-care providers are strongly engaged.
About 4.4 million Canadians don’t have a family physician, but provinces such as British Columbia and Manitoba have taken the lead, the alliance noted.
Overall, they said, Ontario continues to lead. Newfoundland and Labrador and Saskatchewan have or are starting to make real progress to reduce wait times in the original areas that provinces and the federal government agreed to focus on in 2004, namely:
Diagnostic imaging — MRI/CT.
Hip and knee joint replacements.
Cancer radiation therapy.
Coronary artery bypass surgery.
In terms of progress on the original priority areas, 67 per cent of all provincial grades were either "A" or "A+" compared with 58 per cent last year.
But provinces have continued to struggle to make sustained improvements. The volume of procedures has also increased.
"The WTA continues to find significant variation in wait times around the country, within provinces and within communities," Simpson told reporters. "How long you wait for treatment has a lot to do with your postal code. Don't Canadians deserve the same quality of care no matter where they live?"
As well, no province reports wait times for pain management or psychiatry.
The Canadian Psychiatric Association said almost a third of Canadians who seek mental health care report that their needs are unmet or only partially met, and the rates are higher for children and youth.