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Canada’s health-care wait times hit 27.7 weeks in 2023—longest ever recorded

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From the Fraser Institute

By Mackenzie Moir and Bacchus Barua

Canadian patients waited longer than ever this year for medical treatment, finds a new study released by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

The study, an annual survey of physicians across Canada, reports a median wait time of 27.7 weeks—the longest ever recorded, longer than the wait of 27.4 weeks reported in 2022—and 198 per cent higher than the 9.3 weeks Canadians waited in 1993, when the Fraser Institute began tracking wait times.

“COVID-19 and related hospital closures have exacerbated, but are not the cause, of Canada’s historic wait times challenges,” said Bacchus Barua, director of the Fraser Institute’s Centre for Health Policy Studies and co-author of Waiting Your Turn: Wait Times for Health Care in Canada, 2023.

“Previous results revealed that patients waited an estimated 20.9 weeks for medically necessary elective care in 2019—long before the pandemic started.”

The study examines the total wait time faced by patients across 12 medical specialties from referral by a general practitioner (i.e. family doctor) to consultation with a specialist, to when the patient ultimately receives treatment.

More than 1,200 responses were received across the 12 specialties and 10 provinces. Among the provinces, Ontario recorded the shortest wait time at 21.6 weeks—still up from 20.3 weeks in 2022. Nova Scotia recorded the longest wait time in Canada at 56.7 weeks.

Among the various specialties, national wait times were longest between a referral by a GP and plastic (52.4 weeks), orthopedic (44.3) neurosurgery (43.5). Wait times were shortest for radiation (4.4 weeks) and medical oncology treatments (4.8 weeks). Patients also experience significant waiting times for various diagnostic technologies. This year, Canadians could expect to wait 6.6 weeks for a computed tomography (CT) scan, 12.9 weeks for a magnetic resonance imaging (MRI) scan, and 5.3 weeks for an ultrasound.

Crucially, physicians report that their patients are waiting over four and a half weeks longer for treatment (after seeing a specialist) than what they consider to be clinically reasonable.

“Excessively long wait times remain a defining characteristic of Canada’s health-care system” said Mackenzie Moir, Fraser Institute policy analyst and co-author of the report. “And they aren’t simply minor inconveniences, they can result in increased suffering for patients, lost productivity at work, a decreased quality of life, and in the worst cases, disability or death.”

Median wait times by province (in weeks)

PROVINCE                        2022      2023

British Columbia                            25.8           27.7

Alberta                                               33.3            33.5

Saskatchewan                                 30.1            31.0

Manitoba                                           41.3            29.1

Ontario                                              20.3            21.6

Quebec                                               29.4            27.6

New Brunswick                              43.3            52.6

Nova Scotia                                      58.2            56.7

P.E.I.                                                   64.7            55.2

Newfoundland and Labrador    32.1            33.3


Each year, the Fraser Institute surveys physicians across twelve specialties and the ten provinces in order to document the queues for visits to specialists and for diagnostic and surgical procedures in Canada. Waiting Your Turn: Wait Times for Health Care in Canada, 2023 Report reports the results of this year’s survey.

In 2023, physicians report a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment. This represents the longest delay in the survey’s history and is 198% longer than the 9.3 weeks Canadian patients could expect to wait in 1993.

Overall, Ontario reports the shortest wait across Canada (21.6 weeks) while Nova Scotia had the longest (56.7 weeks).

The 27.7 week total wait time that patients face can be examined in two consecutive segments:

  • referral by a general practitioner to consultation with a specialist: 14.6 weeks;
  • consultation with a specialist to receipt of treatment: 13.1 weeks.

After seeing a specialist, Canadian patients were waiting 4.6 weeks longer than what physicians consider clinically reasonable (8.5 weeks).

Across the ten provinces, the study also estimates that there were 1,209,194 procedures for which patients—3% of the Canadian population—were waiting in 2023.

Patients also face considerable delays for diagnostic technology. This year, Canadians could expect to wait 6.6 weeks for a CT scan, 12.9 for an MRI scan, and 5.3 weeks for an ultrasound.

Survey results suggest that, despite provincial strategies to reduce wait times, Canadian patients continue to wait too long for medically necessary treatment.

Data were collected from the week of January 16 to July 1, 2023, longer than the period of collection in years before the COVID19 pandemic. A total of 1,269 responses were received across the 12 specialties surveyed. However, this year’s response rate was 10.3% (lower than in some 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.

Waiting Your Turn: Wait Times for Health Care in Canada, 2023 Report

By Mackenzie Moir and Bacchus Barua, with Hani Wannamaker

www.fraserinstitute.org

Click here to read the full report

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Alberta

Early Success: 33 Nurse Practitioners already working independently across Alberta

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Nurse practitioners expand primary care access

The Alberta government’s Nurse Practitioner Primary Care program is showing early signs of success, with 33 nurse practitioners already practising independently in communities across the province.

Alberta’s government is committed to strengthening Alberta’s primary health care system, recognizing that innovative approaches are essential to improving access. To further this commitment, the Nurse Practitioner Primary Care Program was launched in April, allowing nurse practitioners to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.

Since being announced, the program has garnered a promising response. A total of 67 applications have been submitted, with 56 approved. Of those, 33 nurse practitioners are now practising autonomously in communities throughout Alberta, including in rural locations such as Beaverlodge, Coaldale, Cold Lake, Consort, Morley, Picture Butte, Three Hills, Two Hills, Vegreville and Vermilion.

“I am thrilled about the interest in this program, as nurse practitioners are a key part of the solution to provide Albertans with greater access to the primary health care services they need.”

Adriana LaGrange, Minister of Health

To participate in the program, nurse practitioners are required to commit to providing a set number of hours of medically necessary primary care services, maintain a panel size of at least 900 patients, offer after-hours access on weekends, evenings or holidays, and accept walk-in appointments until a panel size reaches 900 patients.

With 33 nurse practitioners practising independently, about 30,000 more Albertans will have access to the primary health care they need. Once the remaining 23 approved applicants begin practising, primary health care access will expand to almost 21,000 more Albertans.

“Enabling nurse practitioners to practise independently is great news for rural Alberta. This is one more way our government is ensuring communities will have access to the care they need, closer to home.”

Martin Long, parliamentary secretary for rural health

“Nurse practitioners are highly skilled health care professionals and an invaluable part of our health care system. The Nurse Practitioner Primary Care Program is the right step to ensuring all Albertans can receive care where and when they need it.”

Chelsae Petrovic, parliamentary secretary for health workforce engagement

“The NPAA wishes to thank the Alberta government for recognizing the vital role NPs play in the health care system. Nurse practitioners have long advocated to operate their own practices and are ready to meet the growing health care needs of Albertans. This initiative will ensure that more people receive the timely and comprehensive care they deserve.”

Jennifer Mador, president, Nurse Practitioner Association of Alberta

The Nurse Practitioner Primary Care program not only expands access to primary care services across the province but also enables nurse practitioners to practise to their full scope, providing another vital access point for Albertans to receive timely, high-quality care when and where they need it most.

Quick facts

  • Through the Nurse Practitioner Primary Care Program, nurse practitioners receive about 80 per cent of the compensation that fee-for-service family physicians earn for providing comprehensive primary care.
    • Compensation for nurse practitioners is determined based on panel size (the number of patients under their care) and the number of patient care hours provided.
  • Nurse practitioners have completed graduate studies and are regulated by the College of Registered Nurses of Alberta.
  • For the second consecutive year, a record number of registrants renewed their permits with the College of Registered Nurses of Alberta (CRNA) to continue practising nursing in Alberta.
    • There were more than 44,798 registrants and a 15 per cent increase in nurse practitioners.
  • Data from the Nurse Practitioner Primary Care Program show:
    • Nine applicants plan to work on First Nations reserves or Metis Settlements.
    • Parts of the province where nurse practitioners are practising: Calgary (12), Edmonton (five), central (six), north (three) and south (seven).
  • Participating nurse practitioners who practise in eligible communities for the Rural, Remote and Northern Program will be provided funding as an incentive to practise in rural or remote areas.
  • Participating nurse practitioners are also eligible for the Panel Management Support Program, which helps offset costs for physicians and nurse practitioners to provide comprehensive care as their patient panels grow.

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Alberta

Province considering new Red Deer River reservoir east of Red Deer

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Central Alberta reservoir study underway

Alberta’s government is moving forward a study to assess the feasibility of building a new reservoir on the Red Deer River to help support growing communities.

Demand for water from communities and businesses is increasing as more families, businesses and industries choose to live and work in central Alberta. The Red Deer River supplies water to hundreds of thousands of Albertans across the region and expanding water storage capacity could help reduce the risk of future droughts and meet the growing water demands.

Alberta’s government has now begun assessing the feasibility of building a potential new reservoir east of Red Deer near Ardley. A two-phase, multi-year study will explore the costs and value of constructing and operating the reservoir, and its impact on downstream communities, farmers and ranchers, and businesses.

“Central Alberta is a growing and thriving, and we are ensuring that it has the water it needs. This study will help us determine if an Ardley reservoir is effective and how it can be built and operated successfully to help us manage and maximize water storage for years to come.”

Rebecca Schulz, Minister of Environment and Protected Areas

Reservoirs play a vital role in irrigation, drought management, water security and flood protection. Budget 2024 allocated $4.5 million to explore creating a new reservoir on the Red Deer River, at a damsite about 40 kilometres east of the City of Red Deer.

Work will begin on the scoping phase of the study as soon as possible. This will include reviewing available geotechnical and hydrotechnical information and exploring conceptual dam options. The scoping phase also includes meetings with municipalities and water users in the area to hear their views. This work is expected to be completed by December 2025.

“Reliable water infrastructure is essential for Alberta’s growing communities and industries. The Ardley reservoir feasibility study is a vital step toward ensuring long-term water security for central Alberta. As we assess this project’s potential, we’re supporting the sustainability of our economic corridors, agricultural operations and rural economy.”

Devin Dreeshen, Minister of Transportation and Economic Corridors

“Water is essential to the agriculture industry and if the past few years are any indication, we need to prepare for dry conditions. A potential dam near Ardley could enhance water security and help farmers and ranchers continue to thrive in Alberta’s unpredictable conditions.”

RJ Sigurdson, Minister of Agriculture and Irrigation 

Once that is complete, the feasibility study will then shift into a second phase, looking more closely at whether an effective new dam near Ardley can be safely designed and constructed, and the impact it may have on communities and the environment. Geotechnical and hydrotechnical investigations, cost-benefit analyses and an assessment of environmental and regulatory requirements will occur. The feasibility phase will also include gathering feedback directly from Albertans through public engagement. This work is expected to be completed by March 31, 2026.

Quick facts

  • The Ardley dam scoping and feasibility study will be undertaken by Hatch Ltd., a Canadian multi-disciplinary professional services firm.
  • Once the feasibility study is complete, government will assess the results and determine whether to pursue this project and proceed with detailed engineering and design work and regulatory approvals.
  • Alberta’s government owns and operates several large reservoirs in the South Saskatchewan River Basin that help ensure sufficient water supply to meet demand from communities, irrigators and businesses, while also maintaining a healthy aquatic environment.
  • Water stored at Gleniffer Lake, the reservoir created by Dickson Dam, helps supplement low winter flows along the Red Deer River and helps ensure an adequate water supply for Red Deer and Drumheller.

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