Your Health Matters
June Tavenor-Brake, BN RN
Mr. Smith, a 58 year-old Newfoundlander, had to wait 4 months for an angioplasty to diagnose coronary artery disease. At the time of the angioplasty, he was told to give up work and do nothing -- he was going to need heart surgery urgently. “Urgently” turned out to mean an additional 5-month wait, for a total wait of 9 months to correct the problem. Mrs. Jones, a 78 year-old Ontarian, fell from her chair to the floor and sustained a hip fracture. After waiting 6 hours on an ER stretcher, she was admitted. She waited 3 more days for surgery to repair her hip. Ms. White, a 54 year-old nurse, waited 12 months for the same hip replacement surgery after years of degeneration in her hip.
Waiting times: a very common theme in hospitals and clinics across this country. But how long are Canadians waiting? And for which procedures are we waiting the longest? Throughout this column, I will be exploring various health-related issues, and since waiting times is a common and frequent concern for most Canadians, I will, no doubt return to this issue. For now, I want to provide an overview of waiting times in various parts of the country by exploring two common but very different procedures: cardiac surgeries (excluding heart transplant surgery) and hip replacement surgery.
In Ontario, the average waiting time for cardiac bypass surgery is 19 days, with 90% of cases being completed within 42 days. To have a hip replaced in Ontario, the average waiting time is 150 days, with 90% of cases being completed in 341 days.
In British Columbia, the average waiting time for cardiac bypass surgery is 70 days. At Vancouver General, which has the longest list of patients waiting for hip replacement surgery in the province, the average wait time is 33.99 weeks.
In Nova Scotia, Cardiovascular surgery is only offered at Queen Elizabeth II Health Science Centre in Halifax. The average waiting time, depending on the urgency of the case, ranges from 3 days for a priority one case, to 119 days for a priority four case. (A priority one case means the patient cannot be discharged prior to receiving the surgery. Priorities two and three have underlying disease and are at risk for heart attacks. Priority four patients are stable with medication but may not be able to work.) Hip replacements are available at various sites throughout Nova Scotia, with an average of 77% of cases being completed in 360 days.
What does this mean for Canadians? Consider the five principles of health care in Canada: portability, public administration, universality, accessibility, and comprehensiveness. Do the above figures agree with these principles?
Portability means that health services can be accessed in any province. It also means that a province without a service can borrow that service from another province for its own citizens. Mr. Smith, from my example, was able to place himself on the waitlist in Nova Scotia as well as in Newfoundland, although this would have cost him and his family in accommodations.
Public administration is exactly how it sounds, in that no private company can be involved with the funds generated through taxes to run the health care system. I stand to be corrected, but to the best of my knowledge this principle does stand.
Universality means that everyone is covered, contradicting two-tiered systems in which some people would not be covered for all services.
Accessibility is tricky. It means that every Canadian citizen should have access to services. In the above statistics, it is obvious that accessibility varies from province to province. Instead of having the same caliber hospitals across the country, let’s make access to the state-of-the-art centres easier. For example, let’s make sure that Mr. Smith and his family will not have to worry about travel and accommodations if they have to travel out of province. Let’s make sure these facilities are staffed with enough doctors, nurses, and space to perform more surgeries so Ms. White does not have to be off work for 12 months.
Comprehensiveness means that those services which are deemed essential be covered by the Canadian Health Act. I recently learned that eye exams were once covered by Ontario Health Care. Interesting, because the fact that this procedure is covered in only one province disagrees with the pillars of portability, universality, and comprehensiveness.
It is not all negative. In the first ministers meeting on health care, a ten-year $41 billion plan was announced to help with wait times and the overall well-being of health care. The plan is specific to several key areas and mentions deadlines for achieving goals. It is realistic in terms of time frames and goals for meeting these time frames. What is potentially not realistic is whether or not these goals will remain the same, especially with a new government in power. It will be up to us to ensure everything is being done as promised if we expect publicly funded not-for-profit health care to survive.
With the recent change in government, it is important for Canadians to make it clear that we value our health care system the way it is currently delivered. Politicians need to know how we feel. They need to know that we do not find it acceptable that people in one province have to wait longer for care than people in another province.
But in the meantime, consider this: why are we waiting? What are we waiting for? It’s great that we have a new plan to help with waiting times, but let’s not forget how we get on those lists. Consider preventative action -- the key to lowering wait times. In my next installment of this column, I will discuss preventative health care in further detail. We cannot forget about the people who are already on lists, but let’s take care of ourselves and each other and not get ourselves on the lists!
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