Wednesday, October 24, 2007

Will Canada's problematic long healthcare waiting-lists ever be fixed?

Regarding the Fraser Institute’s recently released wait times report, this is a Letter to Editor from Tony Clement, published in The Toronto Sun (Oct.17, 2007):

“Wait debate, Re: "Boomers need to fix medicare," (Mindelle Jacobs, Oct. 15),

It is important to highlight the fact that the data used by the Fraser Institute is based on doctors' estimates, not hard facts. The Canadian Institute of Health Information tracks the actual number of surgeries performed in Canada on an annual basis and in priority areas identified by governments, surgeries are up 7%. Even in non-priority areas, surgery volume has increased 2%. In June 2007, the Health Council of Canada also reported that data from some jurisdictions and for some services do show wait times have declined, "in some cases dramatically." I, like all Canadians, value our publicly funded, universally accessible health care system. Our government has made historic increases in health funding -- more than $1 billion focused on wait times alone -- and this year signed Patient Wait Time Guarantees with all provinces and territories. We are well on our way to creating a stronger, better health care system of which all Canadians can be proud.”

Here is Dr. Merrilee Fullerton’s response (Toronto Sun, Oct.22, 2007) to Tony Clement:

“MD has advice for Tony Clement.

Federal Minister of Health Tony Clement comments that the Fraser Institute has used data based on doctors’ estimates and not facts for its report that indicates wait times are increasing (“Wait debate, Letters, Oct.17)

Dismissing information from front line physicians who have to tell patients suffering or in pain they cannot get the care they need in the near future would seem to me to be a tad arrogant.

It would be very helpful if at some point politicians would listen to those of us who are in the front lines trying to do the best we can for patients with limited resources. Clement’s attitude is the same kind of decision making that got Canada into problems with its human health resources in the first place – including physician resources when medical schools were told to cut back enrolment across the country in the early 1990s, supposedly based on sound information in the Barer-Stoddart report. A lot of good that did Canadians.

We hardly need this same kind of short term, politically-driven decision making when we are trying to shore up our system and provide access for patients.

The federal government has dumped billions into the wait times strategy over the past few years along with billions more in additional funding provincially in Ontario. Perhaps we could have expected significant improvement in wait times. But all Clement can say is surgery volumes have increased in priority areas by seven per cent and in non-priority areas by two per cent.

It would help if CIHI (Canadian Institute of Health Information) could measure wait times instead of number of surgeries done, but even the Health Council of Canada reports wait times are difficult to measure and assess because there is no standard method of measuring. Gee, I wonder why?

Perhaps the reality would be a hard pill for some of our politicians to swallow.
Is this an approach of “don’t measure what you can’t fix”? In this scenario we should be grateful some independent organization has taken on the task of assessing wait times even if it uses information from front line providers.

As our population continues to grow over the next 20 to25 years we can expect to see volumes of services for many medical treatments and procedures increase and the concept of a few priority areas will seem quite ridiculous.

When it is your health it is a priority area to you and your family. If you think we’ve got problems now, wait until more patients are requiring more treatments as the over 65 group continues to grow.

I’ll tell my mother, who is waiting in pain for a hip replacement and is unable to enjoy her life, Clement says we are “well on our way to creating a stronger, better health system” but I somehow doubt this will ease her discomfort.

One question for Clement: How long do you expect this process of creating a stronger, better health system to take and how will it help my mother?"

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