For almost two years now, the COVID-19 pandemic has disrupted public health, the economy and the well-being of Quebecers like never before in modern history. In the shadow of the suffering inflicted by the disease on the families concerned, a side effect is becoming increasingly widespread: the cancellation or postponement of thousands of surgeries. According to data from the Ministry of Health and Social Services, some 19,000 patients have been waiting for an operation for more than a year in Quebec1.
In 2021, the average wait time between a family doctor’s appointment and required medical treatment was over 29 weeks in the province, well beyond what doctors consider clinically reasonable . This is what emerges from the Fraser Institute’s most recent annual survey of Canadian physicians.2.
While these delays concern so-called “non-emergency” interventions, they are all medically required and include treatments ranging from cataract extraction to coronary bypass surgery, including oncological operations.
In addition to the significant economic consequences, prolonged waiting times can increase patient stress and pain, lead to a deterioration in their health and, in the worst case, lead to preventable death.
The pandemic has certainly worsened waiting times for surgery, due to load shedding measures imposed in the network. Our health professionals, exceptional in the way they face this crisis on a daily basis, had to be mobilized to give priority treatment to patients suffering from COVID-19. But let’s not forget that before the pandemic there were major problems in accessing surgical services in Quebec. Many things can be blamed for the pandemic, but it alone cannot explain nearly three decades of increased wait times!
Drawing inspiration from foreign experience
The current situation is obviously not unique to Quebec. However, the situation in many developed countries was less unfavorable than ours at the dawn of the pandemic. In 2020, the Commonwealth Fund ranked Canada last out of 11 international health systems assessed for speed of access to care.
Just over a third of Quebecers (35%) reported having to wait four months or more for elective surgery, much more than patients in the Netherlands (13%), France (10%), Switzerland (6%) and Germany (1%)3.
To solve this problem of chronic waiting in the aftermath of COVID, we will also need to draw inspiration from the most efficient systems in Europe, which offer universal health care like us, but in a much more opportune time. In these countries, institutions are funded on the basis of services rendered rather than as a fixed budget as here. Patients can freely choose the facility where they wish to receive their treatment, using their treating physician and performance indicators available online. Hospitals are financially rewarded when they receive more patients and therefore have every interest in improving the speed of access and the quality of care.
It is inconceivable that a rich and advanced country like ours is to “hang” its citizens on waiting lists for so long. Let’s stop comparing ourselves to our neighbor to the south and try instead to imitate the socio-democratic countries of Europe, which have historically managed to reduce waiting times by taking advantage of healthy collaboration between their public and private sectors, without however undermine the principles of universality and equity in access to care.