Canada: Waiting-times failure a worry

Federal Health Minister Tony Clement says the fact that patients at nearly half of Canada's cancer treatment centres are not getting critical radiation treatments within the target period of four weeks bolsters his argument for guaranteed waiting times. A study by the Canadian Association of Radiation Oncologists found that only 50 to 60 per cent of the centres are able to provide radiation treatment within the four-week period. Prostate cancer patients were among the least well served: 70 per cent of Canadian hospitals could not deliver the radiation treatment within four weeks. And breast cancer numbers were also disturbing, with only 53 per cent of hospitals meeting the target.

Mr. Clement said the waiting-time figures, which were obtained by The Globe and Mail, are a worry. But they prove the need for provinces to promise to pay to send patients elsewhere for treatment when it can't be delivered locally in a timely manner, he told a news conference. "Benchmarks and targets without recourse is an empty promise," said Mr. Clement, whose government has made reduced waiting times the centrepiece of its health-care strategy. "That is why we have sought to engage the provinces and territories, not just to create benchmarks, but to take the next logical step, which is to have the recourse which creates the guarantee."

Clinically acceptable standards for radiation and four other priority treatments were agreed upon in December of 2005 at a meeting between provincial health ministers and Ujjal Dosanjh, who was then the Liberal minister of health.

The Conservatives were elected a month later on a promise that they would get the provinces to set targets to meet those standards by next month -- and they said they would work with the provinces to bring in the proposed guarantees. But the provinces have been less-than-willing partners in the push for guarantees because the federal government is offering them no extra money for the initiative. Mr. Clement will meet with his provincial and territorial counterparts at a meeting in Moncton in two weeks and the discussion around guaranteed waiting times promises to be heated.

Les Vertesi, a councillor with the Health Council of Canada, a federal-provincial-territorial body that monitors the revamping of the health-care system, said yesterday the radiation oncologists' study confirms that "we had a problem all along." But he stressed that all the provinces are taking the issue of waiting times very seriously. Canada's waiting-list problem -- not just for cancer services but for all priority areas -- is "bigger than people anticipated and it's going to take a lot longer to clean up than people have thought."

Bill Hryniuk, past chairman of the board for the Cancer Advocacy Coalition of Canada, said he didn't understand why the federal government would select a waiting time of four weeks -- double what the radiation oncologists recommended. "Everybody who has to wait with cancer suffers mentally and that has to be a No. 1 consideration," Dr. Hryniuk, a medical oncologist, said yesterday. "It's frustrating for patients," Dianna Schreuer, past president of the Canadian Breast Cancer Network, said in a telephone interview from Halifax. "It doesn't meet the standards and it's frustrating for the oncologists delivering the service." She called the figures from the Canadian Association of Radiation Oncologists a "call to arms," describing it as a problem that's going to take some time to fix.

Opposition members in the House of Commons, meanwhile, have taken up the attack. Ruby Dhalla, the Liberal health critic, said the waiting times for radiation outlined in The Globe were indicative of the Conservative government's failure on the file. The report shows that cancer patients "are taking out loans, racking up financial debt and worrying about financial ruin, all in an effort to pay for their treatment that they so desperately need," Ms. Dhalla told the House of Commons. "The Conservatives promised to reduce wait times for cancer patients but, instead, the patients are waiting longer than ever."

Mr. Clement countered, saying that, under the Liberals, the average waiting time from specialist consultation to treatment doubled from 9.3 weeks in 1993 to 17.8 weeks in 2003.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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