Social Policy in Ontario

Thousands of Canadian children experience unacceptably long wait times for surgical procedures, which put them at risk of developing lifelong health problems, a new report says.

In 2009, more than 17,000 children were not treated within time frames deemed acceptable by physicians, an annual report released by the Wait Time Alliance on Thursday shows. The report exposes new depths to Canada’s chronic deficiencies in managing wait times for common health procedures.

The Wait Time Alliance is made up of more than a dozen of Canada’s leading associations of physicians, including the Canadian Medical Association, Canadian Cardiovascular Society, and Canadian Association of Paediatric Surgeons. Its mandate is to hold federal and provincial governments accountable to a $5.5-billion promise to minimize lengthy wait times for five major areas of care identified by health ministers in 2004.

The scope of problems outlined in the new report comes after several regions of Canada missed a March 31 deadline to establish guaranteed maximum wait times for at least one area of care. Alberta and the three territories either failed to implement a guarantee or didn’t release enough information to indicate one was in place. Guarantees set by other provinces were often weak and in some cases set excessively long waiting periods as guaranteed times for treatment, according to the Wait Time Alliance.

The original five areas of care to be studied included hip and knee replacements, cataract surgery, radiation oncology, cardiac care and diagnostic scans. The alliance has also begun to track wait times for other areas such as chronic pain, gastroenterology, nuclear medicine, plastic surgery and obstetrics and gynecology.

This year marks the first time the alliance has included a comprehensive evaluation of wait times for pediatric procedures. Although 73 per cent of children received surgery within the benchmark established by the Canadian Paediatric Surgical Wait Times Project, which was designed to measure wait times for children, more than 17,000 children had to wait for excessive lengths of time for treatment. The biggest problems occurred in dentistry, plastic surgery and ophthalmology.

“A significant number of children wait beyond what we think is an ideal waiting time for surgery,” said James Wright, a professor of surgery at the University of Toronto and head of the Canadian Paediatric Surgical Wait Times Project. “If you exceed [the benchmarks], that potentially has a lifelong impact.”

Many children with serious dental issues must be treated in hospital and those with cancer or other illnesses have to undergo emergency dental treatment, Dr. Wright said. A number of children are also born with a cleft lip and/or palate that requires corrective plastic surgery. In addition, it’s also very common for children to require surgery for “wandering eye” or other issues with sight.

The majority of children must be treated for those problems in a timely way to minimize the chance of lifelong complications. For instance, cleft lip and/or palate surgery needs to be performed at the correct time to ensure normal brain and speech development. Serious problems can also occur if a child isn’t treated for a wandering eye.

“We know that unless that is dealt with in an appropriate time frame that can permanently affect their ability to see,” Dr. Wright said.

That’s not to say Canada hasn’t made any progress on wait times since governments across Canada pledged to tackle the issue in 2004. Many provinces treat the majority of patients within acceptable time frames in some of the five priority areas identified by the government.

Josée Bellemare, press secretary to federal Health Minister Leona Aglukkaq, said in an e-mail the report reflects important progress made by the government.

“The minister is pleased that the report shows our collaborative efforts have made a difference in the quality of health care delivery,” Ms. Bellemare wrote.

But many problems persist, and there doesn’t seem to be enough political will to fix them once and for all, said Lorne Bellan, co-chair of the Wait Time Alliance. For instance, some provinces are still getting C, D and F grades because they’re not performing joint replacements within 26 weeks or cataract surgery within 16 weeks.

“In the wait-times marathon, we’re still on the first mile,” Dr. Bellan said Thursday.

There is also scant information available on wait times for other areas of medicine outside the five priority areas, making it difficult to assess how long patients are being forced to wait or what the scope of problems may be, the report said.

The report also singled out Alberta and Newfoundland and Labrador for failing to update their wait-times data in more than six months.

Newfoundland and Labrador’s Health Minister Jerome Kennedy was not available for an interview, but said in a statement the province has seen some success in wait-time benchmarks for radiation treatment, cardiac care and cataract surgery and that it will “continue to work with the regional health authorities to improve waiting times throughout the province for hip and knee replacements.”

Howard May, spokesman for Alberta Health and Wellness, said the province hasn’t updated its wait-times data recently because it has been transitioning from nine regional health authorities to one. Officials have identified problems with reporting and collecting information and are working on improvements, he said.

“To ensure we were providing timely, accurate and useful information, we decided to revamp the reporting system and we expect the site will be relaunched soon,” Mr. May said.

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