Canada has made “no progress” on making wait times for psychiatric care public, according to a new report on health care wait times in this country.
In its latest report, entitled “The Gap: Report Card on Wait Times in Canada,” the Wait Time Alliance (WTA) says that although “objective measures of access to psychiatric care exist in a few regions across Canada,” more must be done to take that data and develop an accurate picture of how long Canadians are waiting for access to psychiatric services.
Back in 2007, the WTA and the Canadian Psychiatric Association, which represents Canada’s 4,500 psychiatrists, teamed up to develop benchmarks for access to psychiatric care.
“The 2014 WTA report highlights that, for the sixth consecutive year, provincial governments have made no progress in publicly releasing wait times for psychiatric care,” the report says. “The CPA finds this unacceptable given the priority that has been placed on access to mental health services.”
A clear picture of how long Canadians are waiting for psychiatric care “would facilitate a ‘race to the top,’” the report says, “where jurisdictions could learn from one another and measure their success through a framework of directly comparable measurements.”
While health care is a provincial responsibility, the report notes that the federal government could help in this area by working with the Mental Health Commission of Canada and the Canadian Institute of Health Information “to develop a common approach to measuring access to psychiatric care.”
The federal government could also create a Mental Health Innovation Fund, the report says, which would fund innovations designed to improve access to care at the local level.
Mark Henick of the Canadian Mental Health Association said measuring wait times for access to psychiatric care “is one step in the right direction.
“Specialists in any field are able to identify what the medical needs of that client are,” Henick told CTV News.
‘Worrisome’ trends
The WTA was established ten years ago to monitor the progress made in meeting the objectives of the 2004 Health Accord, which called for, among other things, the establishment of benchmarks for medically acceptable wait times for care in five areas:
- cancer treatment
- heart procedures
- diagnostic imaging procedures
- joint replacements
- sight restoration
For the past two years, the WTA has found “a worrisome trend of little to no progress in reducing waits for a range of necessary medical care in Canada,” the report notes.
However, some provinces are beginning to make “substantive and sustained progress” to reduce wait times for some care, particularly in Ontario, Newfoundland and Labrador, and Saskatchewan.
Other provinces are struggling to make any improvements in wait times, the report says, and there remains “significant variation” in wait times within provinces and even with in communities.
However, 67 per cent of grades were either “A” or “A+” compared with 58 per cent in the previous report card.
Overall, most provincial governments are also doing a better job of reporting wait-time data via their websites, the report says.
Looking at that dreaded time sucker, the emergency department, the report says Canadians “wait longer in the hospital emergency department than citizens of other leading countries.”
For example, 27 per cent of Canadians report having waited for more than four hours in an emergency room, compared with only one per cent of citizens in the Netherlands and five per cent in the U.K.
Overall, five challenges remain in improving access to care, the WTA says:
- Ensuring Canadians’ wait times for care compare to wait times in other industrialized countries. Currently, they lag behind wait times in the United Kingdom, the Netherlands, Sweden and France.
- Establishing wait-time reporting for the full spectrum of care.
- Addressing “key structural factors” that increase wait times, such as improving collaborative care for patients with complex health problems and ensuring the efficient use of resources, such as operating rooms and community health centres.
- Increasing an understanding among health-care providers of the usefulness of collecting wait time data and how it can help improve care.
- Providing adequate resources for the collection and use of wait time data.
The report makes five recommendations, or a “course of action,” for the next decade:
- That provinces implement a charter of rights and responsibilities with “enforceable” maximum wait time guarantees, such as exist in England and Scotland.
- Develop a pan-Canadian strategy for care for senior citizens, where dementia and other chronic conditions call for complex care options.
- Make better use of surgical infrastructure. “A frequent contributing factor to wait times is not so much the lack of operating room infrastructure but how the existing infrastructure is used,” the report says.
- Develop a national strategy to improve wait-time data collection and ways in which that data can be used to reduce wait times and improve care.
- That the federal government be “an active partner” in improving timely access to care.
“The WTA believes it is entirely feasible to ensure timely access to care for all Canadians that is comparable to that which is available to citizens in other countries,” the report says. “Waits would be measured in days and weeks rather than months and years.”
Dr. Chris Simpson, chief of cardiology at Queen’s University and medical director of the cardiac program at Kingston General, says the “single biggest impediment” to reducing wait times in the emergency department is that as many as 15 per cent of hospital beds are occupied by patients who have chronic illness and would be better served in another facility, such as a long-term care home.
“A significant reason hospital surgeries are cancelled is because the hospital is full,” Simpson told CTV News. “There are no beds for people to go after surgery.”
A maximum wait-time guarantee, such as what is in place in Scotland, would cover wait times from when a patient first complains of symptoms to a family doctor right through to diagnostic testing and treatment.
“I think it is realistic, and Scotland has proven it,” Simpson said. “They had wait times that were as bad as ours and they are among the best in the world.”
They key to following through on such a pledge, he said, is not more money. Rather, it’s about ensuring resources are deployed when and where they are needed “and how we hold ourselves accountable.”
A patient charter of rights is one way to do that, he says.
“Something that says in writing that we as a society and governments and care deliverers are to committed to delivering quality, timely care.”
With files from CTV’s medical specialist Avis Favaro and senior producer Elizabeth St. Philip
