Waiting for treatment has become a defining characteristic of Canadian health care. In order to document the queues for visits to specialists and for diagnostic and surgical procedures in the country, the Fraser Institute has—for almost three decades—surveyed specialist physicians across 12 specialties and 10 provinces.

This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have increased since last year. Specialist physicians surveyed report a median waiting time of 25.6 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 22.6 weeks reported in 2020. This year’s wait time is the longest wait time recorded in this survey’s history and is 175% longer than in 1993, when it was just 9.3 weeks.

There is a great deal of variation in the total waiting time faced by patients across the provinces. Ontario reports the shortest total wait—18.5 weeks—while Nova Scotia reports the longest—53.2 weeks. There is also a great deal of variation among specialties. Patients wait longest between a GP referral and neurosurgical procedures (49.2 weeks), while those waiting for radiation treatments begin treatment in 3.7 weeks.

The total wait time that patients face can be examined in two consecutive segments.

From referral by a general practitioner to consultation with a specialist. The waiting time in this segment increased from 10.5 weeks in 2020 to 11.1 weeks in 2021. This wait time is 201% longer than in 1993, when it was 3.7 weeks. The shortest waits for specialist consultations are in Ontario (8.2 weeks) while the longest occur in Prince Edward Island (24.1 weeks).

From the consultation with a specialist to the point at which the patient receives treatment. The waiting time in this segment increased from 12.1 weeks in 2020 to 14.5 weeks this year. This wait time is 159% longer than in 1993 when it was 5.6 weeks, and 6.1 weeks longer than what physicians consider to be clinically “reasonable” (8.3 weeks). The shortest specialist-to-treatment waits are found in Ontario (10.3 weeks), while the longest are in Nova Scotia (34.1 weeks).

It is estimated that, across the 10 provinces, the total number of procedures for which people are waiting in 2021 is 1,425,517. This means that, assuming that each person waits for only one procedure, 3.7% of Canadians are waiting for treatment in 2021. The proportion of the population waiting for treatment varies from a low of 2.96% in Ontario to a high of 10.76% in Nova Scotia. It is important to note that physicians report that only about 14.4% of their patients are on a waiting list because they requested a delay or postponement.

Patients also experience significant waiting times for various diagnostic technologies across the provinces. This year, Canadians could expect to wait 5.2 weeks for a computed tomography (CT) scan, 10.2 weeks for a magnetic resonance imaging (MRI) scan, and 3.6 weeks for an ultrasound.

Data were collected between January 15, 2021 and July 27, 2021, longer than the period of collection in years preceding 2020 when provincial governments began implementing hospital closures and surgical postponements in response to COVID-19. Despite this extension, this year’s response rate was 9% (a lower response rate than in previous years). As a result, the findings in this report should be interpreted with caution.

Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.

The results of this year’s survey indicate that despite provincial strategies to reduce wait times and high levels of health expenditure, it is clear that patients in Canada continue to wait too long to receive medically necessary treatment.