Polling data from earlier this year is crystal clear—the majority Canadians believe their health-care system has worsened over the past decade and more money won’t fix the problem.

Who could blame them?

This year we’ve seen reports of the regular closing of emergency room services, studies finding that one in five Canadians are without access to a regular a family doctor, and that the country now boasts some of the longest waits for medically necessary surgery in 30 years.

It’s no secret that the rationing of care through long wait times has become the defining characteristic of Canadian health care. In fact, in 2023 Canadians could expect to wait a median of 27.7 weeks for treatment—nearly seven weeks longer than in 2019 and almost three times longer than the 9.3-week wait in 1993.

While bottlenecks can be found nearly everywhere throughout the system, less talked about are the increasingly lengthy waits Canadians face when trying to access timely diagnostic services.

In 2023, reported waits for an MRI were found to be a median of 12.9 weeks—two weeks longer than last year, and the longest on record in at least a decade. We see a similar thing for CT scans where the 6.6-week wait this year is a week longer than last year (and also the longest in at least a decade).

So why the lengthening delays?

One reason is that, when compared to other countries with universal coverage, Canada has some of the lowest availability of key diagnostic imaging technology in the industrialized world despite being one of the highest spenders among the same cohort.

Take CT scanners, for example. In 2019 (the latest year of available data), Canada ranked 26th (of 30 countries) for the number of scanners available. At 14.9 units per million population, this doesn’t even come close to the availability of this technology among top performers such as Japan, which reported having five-and-a-half times as many scanners. We see a similar story with MRI units, where Canada ranks 25th out of 29 countries and reports an availability of stock four times smaller than Japan’s. Canada also had middling to poor results for the volume of diagnostic examinations performed, ranking 13th of 26 for CT scans and 18th out of 26 for MRI exams per thousand population.

Ultimately, poor access to diagnostic imaging not only frustrates the timely triaging of patients, it can also potentially add onto already lengthy waits for scheduled treatment (which again are the longest in at least three decades).

Canadian patients face many challenges in seeking to access timely elective surgical care including lengthy waits for diagnostic services. Improving access to medical imaging is a first step towards improving this access.