Canada's public health care system holds answers to surgery wait times

May 8, 2007

(Ottawa) Surgical waitlists can be dramatically cut if governments develop a strategy to scale up innovations already underway in the public health care system, says a new study released today.

Why Wait? Public Solutions to Cure Surgical Waitlists looks at groundbreaking projects in BC, Alberta, Saskatchewan and Ontario that have significantly reduced wait times for procedures such as hip and knee replacements, cataract surgery and others.

The Saskatchewan Surgical Care Network, Canada’s first province-wide surgical patient registry, has used pro-active strategies to reduce wait times. “Accurate data is essential for creating management strategies and targeting resources for achieving long term success in wait list management,” says network Chair, Dr. Rob Weiler. The network doesn’t just report waitlists—regional health authorities are expected to actively manage them in partnership with surgeons.

The study also examines Alberta’s Hip and Knee Replacement Project and Ontario’s Wait Time Strategy, both successful initiatives. Five projects in British Columbia are profiled, including the Joint Replacement Access Clinic (JRAC) at Lions Gate Hospital in North Vancouver, where waits for the first surgical consult have dropped from almost a year to between two and four weeks. Without any additional resources, the project implemented common waitlits and a one-stop booking service that streamlines all aspects of patient screening and care before, during and after surgery.

The projects point to two key reforms needed in the surgical system:

  • Team-based care in specialized clinics: Surgeons moved from working mainly on their own to working in teams in specialized clinics. The shift to team-based care means patients are better prepared for surgeries, operations are less likely to be cancelled, operating rooms function more efficiently and hospital stays are shorter. These projects also make greater use of nurses and other health care workers at every stage of the process.
    Pro-active waitlist management: Shifting responsibility for managing waitlists from individual surgeons to health authorities means patients can access the first available surgeon. Health authorities in turn can make sure efficiencies and best practices from individual hospitals are applied across the system.

“Canadians don’t need superficial wait time guarantees,” says study co-author Dr. Michael Rachlis. “We need a strategy that helps provinces implement the kinds of public sector innovations featured in this study. The federal government’s wait time guarantee fails to provide that leadership, and leaves the door open to private delivery.”

“Solving the waitlists problem will require some major cultural shifts in how our surgical system functions,” says co-author Marcy Cohen. “We need more collaboration, not a competitive private model that will siphon precious health care professionals out of the public system.”

“There’s this myth out there that only the private sector can innovate, but this study shows that is false,” says Rachlis.


Why Wait? Public Solutions to Cure Surgical Waitlists was released today by the Canadian Centre for Policy Alternatives and the BC Health Coalition.

To arrange an interview, call Terra Poirier, 604-801-5121 x229 or Shannon Daub, 604-801-5121 x226 (cell 604-836-9372).

For BC Health Coalition interviews only, call Leslie Dickout at 604-681-7945.