A new study by a Regina-based think-tank has revealed a concerning trend in Canada’s health-care system—one that could have implications for the ways in which health care is provided to Canadians.

The study, conducted by SecondStreet.org, indicates that in 2022–23, a five-year high of 17,032 patients died while waiting for medical procedures, some of which could have saved lives. 

These findings are derived from information requests made to over 33 health departments, health regions, and hospitals throughout Canada. SecondStreet.org received responses, at least partially, from 12 of these entities, collectively covering almost 75 percent of the Canadian health-care system.

It’s worth noting that the majority of Quebec, Newfoundland and Labrador, as well as Manitoba, were not included in these statistics. Consequently, SecondStreet.org’s estimate of deaths tends to be conservative, suggesting that as many as 31,397 patients may have passed away across the country since 2018.

These patients faced wait times that varied from less than a week to nearly 11 years. 

Colin Craig, SecondStreet.org’s president, is critical of government action on this issue, stating that increased funding alone won’t solve the problem. 

“We have a problem in this country where for 30 years plus, governments have thrown more and more money at the system hoping that things would improve—spending has increased at nearly double the rate of inflation on a per capita basis over the past 30 years,” says Craig. “And yet, the system has gotten worse in terms of outcomes for patients.” 

Despite increased health-care spending, Canada has seen a 64 percent increase in annual surgical waiting-list deaths over the past five years and a 30 percent increase in the last year alone. While several provinces didn’t provide data for the study, SecondStreet.org extrapolated data from across the country to estimate that somewhere in the range of 31,397 patients may have died during the time period in question. 

“How on earth do you not know how many patients are dying because you took too long?” Craig asks. “That’s, I think, something that governments haven’t been questioned on enough, and I think they certainly owe it to Canadians to be reporting on these figures each year.” 

A recent Fraser Institute study revealed that Canadian patients are experiencing their longest-ever-recorded wait times for medical treatment, with a median wait of 27.7 weeks, significantly higher than in 2022 and nearly triple the wait time in 1993. Among provinces, Ontario has the shortest wait time (21.6 weeks), while Nova Scotia has the longest (56.7 weeks). 

“There are several factors that are contributing to this,” says Craig. “One, of course, would be a COVID hangover, but we would stress to Canadians that this was a growing problem well before COVID arrived in Canada.”

Craig notes that Canada’s aging population has resulted in greater demand for health-care services, such as hip replacements, heart-related procedures, and diagnostic scans, and that the system is ill-suited to accommodate this. 

“Our health-care system is not set up in a cost-effective or patient-focused manner,” he says. “All these problems are continuing to impact the services [patients] should receive, and sadly many are dying before it’s their turn.” 

Mackenzie Moir, who co-authored the Fraser Institute study, notes that more than 3 percent of all Canadians are on the waitlist for 1.2 million medical procedures across the country. 

“When we…compare ourselves to our peers, we actually have challenges with the availability of our resources,” he says. 

For context, Moir points out that Canada ranks 28th out of 30 peer countries with universal health-care systems when it comes to physician availability and 26th out of 30 for CT scanners. 

“This type of dearth of resources is going to obviously have an impact on the amount of care that can actually be accessed,” says Moir. 

Craig says that governments have a responsibility to provide health care for patients, especially when a private health-care option does not exist in Canada. 

Christine Van Geyn, litigation director for the Canadian Constitution Foundation, says the high number of patients dying on waitlists has potential constitutional implications when it comes to how health care is delivered in Canada. She refers to Cambie Surgeries Corp. v. British Columbia as an example of a case that raised issues around private health-care options.

Brian Day, a proponent of private health care, served as the spokesperson for a challenge to British Columbia’s Medicare Protection Act (MPA). This act prevented private practitioners, like Day’s Cambie Surgery Centre in Vancouver, from billing patients in the public health-care system. The legal argument asserted that the MPA infringed upon rights under sections 7 (“right to life”) and 15 (“equal protection”) of the Canadian Charter of Rights and Freedom.

In September 2020, following a trial that lasted just over four years, the B.C. Supreme Court rejected the claims. The B.C. Court of Appeal upheld the decision in July 2022, and the Supreme Court of Canada declined to hear an appeal.

“The court found that this prohibition combined with long government wait lists has resulted in not just harm to patient health, but it even results in death,” says Van Geyn. “However, the court found that this prohibition was consistent with the principles of fundamental justice—and the concurring judge found that the prohibition was not consistent with fundamental justice but, shockingly, that a law that resulted in death was justified under section 1 of the Charter.” (Section 1 of the Canadian Charter of Rights and Freedoms permits limitations on Charter rights if they are prescribed by law, reasonable, and demonstrably justified in a free and democratic society.) 

The Canada Health Act does not explicitly ban private health care. While it promotes a publicly funded and administered health-care system—and regulates and ensures access to medically necessary services through that system—it allows for the existence of private health-care services for non-essential medical procedures and services, such as dental care and prescription drugs. 

Van Geyn says patients should keep advocating for changes at the political level, and that provincial legislation can be changed to provide more flexibility for patient choice. 

“Provinces can push the envelope within the system if they have the political courage to try,” she says. 

In a recent episode of Hub Dialogues, Rudyard Griffiths, The Hub’s executive director, and Sean Speer, editor-at-large, got together for their annual conversation about The Hub itself, including its progress over the past year, opportunities and challenges for the year ahead, and their gratitude to The Hub community for its tremendous support. Here are three key takeaways from their discussion.

1. One-in-four know The Hub

“This year, just a month or so ago, we commissioned our pollster, who we really like, Heather Bastedo at Public Square Research, to reach out to Leger to put The Hub on one of its national internet panels. There are a couple of hundred thousand people that Leger polls online. I mentioned online because numbers are going to tell you and reflect, in a sense, the awareness of an online savvy audience. Amongst that group of Canadians, The Hub has an awareness of about one-in-four. One-in-four have said that they’ve listened to and or read The Hub. They’re aware of it. About one-in-twenty said they’re engaged and they’re regularly consuming our content.

That’s really cool for us because when we put ourselves up against other independent news outlets—I’m not going to name them because we like them all, we don’t see this as a competition—our awareness of one-in-four Canadians who are aware of The Hub as an independent media brand is about double any one of our competitors.”

2. The Hub‘s unique business model

“We are funded by individual donations from readers and listeners, and from foundations. In some ways, this is terrific because we’re insulated from the kind of cost-per-click methodology that most private news and information organizations use to fund themselves. They’ve got to create content that’s going to generate the most number of clicks because they’re selling those clicks on to advertisers. We don’t have to do that.

At the same time, Sean, what we’ve really seen this year, as our readership and engagement levels increased yet another 50 percent year-over-year, is that that growth in engagement doesn’t translate into a growth in revenue because the two are not attached as they would be in a traditional media model where for every new engaged listener or reader, you’re monetizing them on a one-by-one basis. We don’t want to do that, and we can’t do that, but it’s created some interesting conversations that we’ve had about how we grow this thing if audience growth doesn’t have a linear relationship to the resources that you can aggregate to generate more growth.”

3. Thanks to our readers, listeners, and donors 

“I would just say to readers, listeners, and donors, that you’ve given us a gift. You’ve given us this extraordinary opportunity to try to build something that can make a positive contribution to Canadian public policy discourse, and ultimately create a sustainable business model. We see it as a gift. We’re humbled by the opportunity and want to do right by those who support us.”

Listen to Rudyard Griffiths’ and Sean Speer’s episode on the audio player below or on your favourite podcast app.

If you enjoy Hub Dialogues, be sure to check out more insightful commentary on The Hub’s YouTube page: