Maintaining healthcare services has been a pillar of the Alberta NDP’s election campaign, but wait times for key surgeries went up while the party was in power, the United Conservatives say.
Using data from Alberta Health Services, the UCP’s official Twitter account, @UniteAlberta, said wait times for open-heart surgery increased 50 per cent from 2014 to 2018; cataract and hip-replacement surgery waits went up 30 per cent; and knee-replacement surgery waits climbed 23 per cent.
They said “NDP mismanagement” is to blame.
What are the facts?
The UCP’s figures are correct. According to Alberta Health Services’ 2017-2018 annual report and performance measures, wait times for some procedures have gone up since 2014 (page 136):
For a coronary artery bypass, the wait was 14.9 weeks in 2014-15 and 22.2 weeks in 2017-18.
For cataract surgery, the wait was 29.9 weeks in 2014-15 and 38.4 weeks in 2017-18.
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For hip replacement surgery, the wait was 28.7 weeks in 2014-15, and 36.7 weeks in 2017-18.
For knee replacement surgery, the wait was 33 weeks in 2014-15, and 40.7 weeks in 2017-18.
The report shows wait times for several operations and treatments also went down.
While waits for radiation therapy dropped from 3.1 weeks in 2014-15 to 2.7 weeks in 2017-18, the time to see a radiation oncologist went up, from 4.9 weeks in 2014-15 to 5.3 weeks in 2017-18.
Between 2016 and 2018, the wait time for breast-cancer surgery dropped 66 per cent in Calgary — from 22.2 days to 7.5 days — and 34 per cent in Edmonton — from 14.1 days to 9.3 days.
The percentage of patients receiving urgent hip fracture repair within 48 hours improved from 86 per cent in 2014 to nearly 93 per cent in 2018.
Under the NDP’s Alberta Referral Pathways initiative, the wait time to see a gastrointestinal specialist in Calgary went down 98 per cent.
The Canadian Institute of Health Information (CIHI) released new wait time data on March 28, which also shows patients in Alberta waited longer for hip and knee replacements and cataract surgery in 2018 than two years earlier.
Just 49 per cent of Albertans received cataract surgery within the recommended wait time of 16 weeks in 2018. In all of Canada, it was 70 per cent.
Public policy think-tank Fraser Institute also released a study on Thursday, which found long waits for surgery and medical treatment cost Canadians $2.1 billion in lost wages last year. The study found the average value of time lost during the work week in 2018 for Alberta patients waiting for treatment was $2,538.
The Fraser Institute says factors like aging and growing populations are contributing to the problem across Canada.
What do the experts say?
Wait times are a problem across Canada, according to Ron Kneebone, the scientific director of the social and health policy research program at the University of Calgary’s School of Public Policy.
“Wait times are basically the result of a number of factors: how much money you throw at the system, how much time you allow operating rooms to be available. It might surprise you to know that operating rooms do not operate 24 hours a day because they’re expensive to run. A government will sometimes only allow operating rooms to be running for eight or 12 hours a day.
“It’s not an easy solution. It’s not just a matter of: ‘Let’s hire more doctors,’ because then you don’t have enough ORs. It’s not enough to just build more ORs because now you have to have the staff to run them.”
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The Alberta government budgeted $22.7 billion for health for 2019-2020. That’s up from $19.6 billion in 2015.
And, according to Kneebone, spending more doesn’t seem to reduce wait times.
“Throwing more money at it does not guarantee a solution,” he said.
“What you need to understand is where are the bottlenecks? What can we do to reduce those bottlenecks? It’s not necessarily money that will solve it. It might just be a better process for recording patients’ records. It might be a better process for getting a patient from one doctor to another so you don’t have to wait for weeks at a time to get a consult.
“They may not cost you any money; it’s just efficiencies and I think that’s what governments need to be looking at… There’s a lot of push back on those sorts of efforts.”
“One of the solutions that a lot of people are pushing now is that health should be more broadly defined. Rather than just thinking about fixing things, we should be investing more money in keeping people healthy so they don’t break in the first place.”
Kneebone says it’s not just the current government that has contributed to this problem.
“Alberta has been under PC governments, too. They’ve been pushing a lot of money towards health care but wait times are not coming down. I’m not sure I’d be blaming the NDs for this. I’m looking at all governments for allowing this to happen. Let there be no mistake: this is not an easy problem to solve.”
Using data from AHS’ 2013-14 annual report, wait times for heart, cataract, hip and knee replacement surgeries went down between 2010 and 2014.
“I know Canadians and Albertans don’t like to think about two-tier health care but do you not think there is two-tier health care with those sorts of wait times?,” Kneebone asked. “I’m not going to wait six months to get a surgery I need. If I can afford to do it, I will go to another province where I can get it done more quickly or I might even have to leave the country.
“These sorts of wait times, when they get that long, it just encourages the evolution of two-tier health care and it’s something governments really need to take seriously and start to address.”
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What are the parties’ positions?
NDP Leader Rachel Notley has promised to spend another $90 million a year to further reduce surgery wait times if the party is re-elected April 16. Notley says the money would also go toward getting patients quicker care in emergency wards.
With that injection of cash, almost 40,000 Albertans would get faster cancer, open-heart and cataract surgeries over the next three years, she said.
The party also pointed to the $40 million its government invested in wait time reductions in the last budget, which UCP members voted against.
United Conservative Leader Jason Kenney has said he wouldn’t cut health budgets, but would work to reduce bureaucratic bloat in health care and explore private delivery options. Private delivery for minor procedures has improved wait times in other jurisdictions, he said.
Kenney said a UCP government would launch a third-party review of Alberta Health Services to target redundancies and inefficiencies in its 4,000 management positions. The review would include talks with front-line staff and would help determine ways to improve health-care delivery, he said.
A UCP government would mirror Saskatchewan’s surgical model that Kenney said reduced surgical wait times there by 76 per cent by, in part, inviting third-party surgical clinics to bid into the publicly-insured system.
“We will seek to replicate the phenomenal success of the Saskatchewan surgical initiative to meet our goal of a four-month maximum wait time for surgeries.”
Alberta Party Leader Stephen Mandel said, if elected, his party would decentralize a lot of the decision-making in health care and give that power back to communities.
“It’s allowing communities to make decisions about the priorities they have,” he said. “We would like to see more integration regionally. So for example, Red Deer Hospital needs to be expanded but Red Deer wants to have a catheter program and they should be able to put one in if they can show, within their budget or process, that they can do it. And that goes in other areas.”
The Alberta Party would also invest more money in the specific surgeries that are falling behind and “put the operating time together, so that surgeries can move forward quicker.”
Mandel said he would maintain front-line staff and evaluate the current processes and supports.
“Our health-care system is spectacular. We’re not going to privatize it. There’s a lot of things that could be done to make it more efficient, which we will do.
“Nobody should have to wait the kind of times we’re having in the province of Alberta right now, especially with the money we’re spending on health care. So we need to get to the bottom of that because, it’s not that we’re not putting enough money into the system.”
Alberta Liberal Leader David Khan said, if elected, his party would review how public dollars are spent.
“We would institute full-value-for-money audits across the health system to figure out where we can spend money more wisely and how we can get those wait times down by spending money on the surgeries and less on the bureaucracy.
“One thing we’ve got to look at is: are we using our operating rooms to the most efficient way possible? I know some operating rooms in some hospitals in Alberta are being left unused for large periods of time.”
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Watch below: Sarah Kraus looks at the issue of wait times in Alberta’s health-care system.