2019 and 2020 were tough on Canadians awaiting surgery, a procedure, scan, or an appointment with a specialist. According to government data, over 10,000 patients died on the waitlist or from excessive waiting periods.
“The most unfortunate part about so many patients dying on waiting lists in our health care system is that many of these tragedies could have been prevented,” said Colin Craig, President of SecondStreet.org. “Health reform could save lives and improve the quality of life that patients experience in their final years. Australia, New Zealand, Norway, there are many other countries out there with both universal health care and better outcomes for patients.”
Between April 1, 2019 – December 31, 2020, 2,367 patients passed away while waiting for surgery during 2020, which covers eight months of the COVID-19 pandemic. Government data also shows there were at least 2,256 patient deaths while waiting for surgery and 6,202 deaths while waiting for diagnostic scans or appointments with specialists.
Despite a lack of data — as many governments did not track data on patient deaths while waiting for surgery or medical appointments — SecondStreet.org found patients passed away while waiting for procedures that could be linked with their cause of death, including cardiac surgery, and procedures which could have increased their quality of life, like cataract surgery. Patient deaths occurred after waiting less than one month to more than six years.
“Governments postponed hundreds of thousands of surgeries, procedures and appointments with specialists during the pandemic,” added Craig. “If we don’t see meaningful health reform, we should expect to see even more patient suffering in the years ahead.”
Alberta patients died while waiting up to more than five years, predominately for cardiac and cataract-related surgeries and procedures. Despite a “good” response from Alberta Health Services in reporting data, 92 percent of cases, where the government provided a benchmark, represent patients who waited longer than the recommended period when they passed away.
BC Interior Health also saw a significant increase in the number of patients who died while waiting for surgery — from 149 to 209 between fiscal 2019-20 and the 2020 calendar year. The percentage of patients who passed away after waiting longer than the recommended time period for surgery increased from 11 percent to 43 percent.
In Ontario, 1,032 patients across the province died while waiting for surgery in 2019-2020, and 1,086 patients died while waiting for surgery in calendar year 2020.
Quebec did not track data on this topic.
According to the SecondStreet.org policy brief, private health care options are outlawed by the state in my cases. For instance, in Ontario, citizens cannot pay for something as simple as an MRI scan at a non-government clinic. One exception to this is in British Columbia, where private clinics provide many diagnostic scans and elective surgical procedures. However, it should be noted that the BC government has been fighting in court for several years to prevent those clinics from offering patients a choice outside the public system.
The think tank criticized governments for their "monopolistic approach" to health care, and for taking opportunity to receive credit for the system — holding a press conference to announce construction of a new hospital, or hiring nurses — despite failing to show enthusiasm when it came to disclosing information on shortfalls in the system.
Canada is unique in the world when it comes to access to health care services. Our governments often give patients only two choices: Either sit on a government waiting list or leave the country — an ultimatum that led to far too many senseless tragedies.
Laura Hillier’s tragic case is a good example. The 18-year-old Ontario student was fighting cancer and had a bone marrow donor lined up, but passed away while waiting seven months for a bed and a surgeon to become available. The province had only rationed enough funds for five transplants per month and Laura was forced to wait. This case became famous not because of proactive government disclosure, but because the young patient’s public cry for help went viral.
Michel Houle’s story in Quebec is also tragic. The 72-year-old patient required cardiac surgery within two to three months. Nine months after he was placed on a waiting list, the government phoned to schedule his surgery. But by then, he had passed away.
More recently, SecondStreet.org brought to light Judy Anderson’s story. The retired nurse from Port Perry, Ontario has lost two daughters due to excessive waiting periods in the health care system.
Even where provinces disclosed information on adverse patient cases, their reports lack details. For example, a critical incident report from Manitoba in 2019-20 simply notes that a patient died and that there were “gaps in monitoring of results, communication to care providers, and treatment delays led to a significant decline in a patient’s medical condition.”
SecondStreet.org made several recommendations for provinces to tackle meaningful healthcare reform to reduce the number of deaths caused by dysfunction and excessive waiting periods.
First, just as governments require businesses to report on workplace injuries and accidents, governments could regularly compile and disclose “waiting list incident reports.” Such reports could include anonymous information on cases where patients die while waiting for surgery, and situations where patients suffer as well, including health complications due to excessive waiting periods, patients developing depression, and substance abuse issues.
Second, governments could maintain our public health care system, but allow non-government clinics to provide the same services and charge the public on a fee-for-service basis. This could potentially save lives and provide patients with more choice instead of suffering on waiting lists during their final years, and take pressure off the public system.
Third, governments could increase output in the health care system by implementing what is known as “activity-based funding”. In short, this would see hospitals funded based on services provided, rather than annual budgets. This approach incentivizes hospitals to complete more surgeries as they receive more funding, an approach many countries around the world adopted over the past 30 years.
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