Patients in Atlantic Canada are waiting longer than anywhere else in the country to receive specialist treatment, according to new data from the Fraser Institute, with waits on P.E.I. approaching a full year. A national survey of more than 1,500 specialist physicians by the think tank shows the median wait between a family doctor referral and treatment sits at 28.6 weeks, the second-longest delay recorded. That’s slightly down from 30 weeks in 2024. But the Atlantic provinces continue to report the longest waits nationally: New Brunswick at nearly 61 weeks, P.E.I. close to 50, Nova Scotia at 49, and Newfoundland and Labrador at roughly 43. “The data is depressing,” says Nadeem Esmail, director of health policy studies at the Fraser Institute. “We know Canada has some of the longest waiting lists for health care in the developed world, in spite of the fact that we have some of the highest expenditures for universal access health care in the developed world.” Esmail says the East Coast has historically reported the longest delays. Part of the current bottleneck can be traced back to decisions made in the 1990s, Esmail says, when governments — fearing an oversupply of physicians — restricted medical school seats and residency positions. “We’re now living the consequence of those policies,” he says. He adds that a “complex gauntlet” of acceptance, retraining and recertification for internationally trained doctors has further constrained supply. The result: overwhelming demand, insufficient staffing and growing backlogs. Herb Dickieson, former president of the Medical Society of P.E.I., says the Island’s wait times reflect a system stretched at every point — from hospitals to long-term care. He notes that when patients who should be discharged cannot access long-term care beds, hospitals back up, and emergency departments, do too. “Right now, we’re in a bottleneck,” Dickieson says. “Until we recruit more physicians and other health staff, wait times won’t come down because the backlog keeps growing.” Health P.E.I.’s latest strategic plan sets a goal of hiring 60 physicians in 2025. As of October, 28 had been recruited, following 41 hires in 2024. The province is also adding training seats and clinical placements through an expanded partnership with Dalhousie University. UPEI’s new medical school is also expected to bolster the local workforce. Esmail argues that while recruitment helps, deeper policy reform is needed to bring waits down to levels seen in high-performing countries. He supports a mix of public and private tools, including cost-sharing or user-fee models, plus private alternatives alongside public options. “We’re not talking about a health-care system that abandons universality,” he says. “It’s about striking the right balance.” However, Dickieson says creating a private parallel creates a two-tier system. “It tends to pull needed personnel away from the public system,” he says, citing studies that suggest it may cost the province more. “That might help some people initially, but in the long run, for the whole population, it will hold us back.” Esmail says there are a number of policies that could be implemented within the bounds of the Canada Health Act to improve wait times. One of those, he says, is paying hospitals for each patient they treat. Right now, he says, hospitals are primarily funded on a budgetary basis. “With every patient being a source of revenue for hospitals, it makes sense to open the doors longer. It makes sense to turn them over faster. It makes sense to ensure hospital beds are used efficiently.” Both experts agree on one point: without more staff and more capacity throughout the system, the long waits captured in this year’s survey won’t come down anytime soon.
