Alberta’s surgery backlog should prompt health-care reform in the province

Despite their label, “elective” procedures are medically-necessary treatments ranging from life-saving cancer surgeries to hip replacements. In Alberta, the health-care system resumed elective surgeries on May 4, but in the absence of reform, patients will likely continue facing long wait times for care. Even before the pandemic, Albertans waited a median 28 weeks for treatment after seeing their family doctor.

Moreover, due to the COVID outbreak, the Kenney government estimates it will take between 12 and 24 months to clear the 22,000 surgeries that have piled up. In total, an estimated 80,000 Albertans were waiting for care in early May.

Some suggest throwing more money at the problem. But pre-COVID, Canada was the second-highest spender among 28 high-income universal health-care countries (as a percentage of GDP, after adjusting for age). And yet, Canada had fewer physicians (2.8 per 1,000 people, ranking 26th of 28), fewer acute care beds (2.0 per 1,000, ranking 26th of 27), fewer MRIs (10.4 per million, ranking 21st of 26) and CT scanners (15.9 per million, ranking 21st of 27) than most other OECD countries with universal health care.

This contrasts with universal health-care countries such as Australia, which is also dealing with COVID-related elective surgery backlogs but has more doctors (4.0 per 1,000, ranking 6th of 28), MRIs (15.4 per million, ranking 11th of 26) and CT scanners (69.9 per million ranking 2nd of 27) compared to Canada.

In 2016, the latest year of comparable data, Australia also had a lower (8 per cent) proportion of patients waiting longer than four months for elective surgery than Canada (18 per cent).

So why the discrepancy in wait times?

Part of the explanation is that countries such as Australia approach health care differently by contracting out some universal services to private hospitals and allowing physicians to practise in both the public and private sectors.

Closer to home, Saskatchewan cut surgical wait times from 26.5 weeks in 2010 to 14.2 weeks in 2014 by, among other reforms, partnering with private clinics, which were contracted to deliver select publicly-funded treatments, dramatically expanding the system’s capacity and delivering care at a lower cost (on average) per procedure compared to public hospitals. Even British Columbia, where the government tried to “crack-down” on private clinics just a few years ago, recently announced plans for limited partnerships with private clinics to help clear its own COVID-related backlog.

And yet, despite this evidence, the Kenney government, faced with an extensive surgery backlog, recently postponed its plan to expand the use of private medical clinics to perform publicly-funded surgeries.