Thank you very much.
Good morning, everyone.
I'm an ophthalmologist from Winnipeg, and Dr. Urbain is a nuclear medicine physician from London, Ontario. We are pleased to be here today on behalf of the members of the Wait Time Alliance.
Our presentation today will cover three areas: the WTA's overall assessment of the implementation of the 10-year plan to strengthen health care; key barriers to making further progress in reducing wait times in these five areas and beyond; and, finally, moving ahead, the next steps government should take to ensure Canadians have timely access to quality health care.
The most recent national grades for wait times are listed in table 1 of the WTA's 2008 report card and include: in joint replacement, a B for hips and a C for knees; in radiation oncology, an A; in cataract surgery, a B; and for bypass surgery, an A.
Overall, national grades are just part of the picture in terms of assessing wait times. Therefore, the WTA has provided performance trends in the five priority areas. In some instances, where wait times are not decreasing, resources are being increased that should either lead to future wait time reductions or handle surging demand to prevent further increases in wait times.
While progress is being made to reduce wait times in the five priority areas, more can and should be done. The 10-year plan makes a number of commitments regarding wait times, including the development of access indicators, benchmarks, multi-year targets, and reporting on progress. In these areas, commitments have only been partially met, at best.
While provincial and territorial governments did adopt benchmarks in December 2005, they did not include benchmarks for diagnostic imaging nor did they honour their commitment to cardiac care. The current benchmark for bypass surgery fails to recognize the continuum of care for cardiac patients. Because of this, wait times are not being meaningfully addressed in cardiac care.
The current benchmark of four weeks for radiation therapy from “ready for treatment” until the start of treatment differs significantly from the WTA recommendation of two weeks. The benchmark also does not reflect the research evidence that found wait times for beginning radiotherapy for treatment of all types of cancers should be as short as possible.
Also, some provinces have still not indicated goals for meeting their wait time benchmarks. While most provinces are making progress, it is not equal progress across the spectrum of care, and we are concerned that some provinces may not have the necessary funding, structures, and processes in place to ensure that the reductions can be maintained.
Moving to our second area, the WTA has identified three key barriers that continue to undermine the progress being made and our ability to accurately record that progress: one, clarifying and standardizing wait time definitions and criteria among provinces; two, improving the collection and dissemination of wait time information to the public; three, lack of progress in addressing health care workforce and infrastructure capacity issues.
Governments continue to use different starting points to measure when wait times actually start. There is also huge variation in the quality of reporting by governments on wait times, and governments have not adequately addressed the most significant barriers to timely access, that being the shortage of providers and system capacity.
Dr. Urbain.