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Canada lags behind international community in strategies to reduce wait times


Despite Ottawa’s $3.8 billion wait time reduction fund, Canada’s prognosis falls short in providing fast and easy healthcare access to those who need it most, compared to other Commonwealth countries with universal healthcare insurance.

New findings from a joint study involving participants from the Institute for Clinical Evaluative Sciences (ICES) in Ontario and funded by the Commonwealth Fund from New York City, confirms access to healthcare around the world is a challenge, but some countries do better than others.

Dr. Jack Tu, ICES senior scientist and Canada Research Chair in Health Services Research (supported by Sunnybrook Health Sciences Centre and the University of Toronto) explains “considerable progress has been made in Canada, however, wait time strategies have been less successful because Canada has established nonenforceable national ‘benchmarks’ that aren’t as strong as the firm targets that have been implemented in England.”

The report titled, “Measuring and reducing waiting times: a cross-national comparison of strategies”, compares five countries: Australia, England, New Zealand, Wales, and Canada. The study examines government commitments on waiting times, and the broad strategies used to manage waiting times and their results, by analyzing key literature and government reports between 2000 and 2005 in the five countries, each having universal health insurance.

England comes out on top in reducing the wait for services linked to major funding boosts, progressively ambitious wait time targets, and an aggressive performance management system. By December 2008, England has a maximum wait time target of 18 weeks for the combined wait from general physician referral to treatment. Other countries have not had anywhere near the size and scope of England’s reductions.

The study goes on to say that Canada, England, and New Zealand have shown a stronger commitment to addressing the problem than Australia and Wales in past five years. However, whatever strengths Canada has are limited by the existence of sizeable geographic variation and different approaches to waiting times reductions across the 10 provinces as compared to a consistent national approach used in England.

“There are important lessons to be learned from other countries regarding the best policy approaches for reducing waiting times,” says Dr. Tu. “We hope that policymakers in Canada will build upon recent achievements by adopting some of the approaches used in other countries. For example:

  • Develop national standards for measuring and reporting on waiting times on a common web site, such as that available in England and New Zealand.
  • Expand the measurement of waiting times to the total patient wait from family physician’s referral, to specialist consultation, to treatment as is done in England, New Zealand and Wales.
  • Develop increasingly aggressive national targets for meeting waiting time benchmarks in Canada across a broad range of surgical and medical conditions, such as that done in England.”

The study, “Measuring and reducing waiting times: a cross-national comparison of strategies”, is in the July/August 2007 issue of Health Affairs.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. 


  • Julie Dowdie
  • Media Relations Officer, ICES
  • (416) 480-4780 or cell (416) 432-8143


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