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September 29, 2008
The Waiting Is The Hardest Part
Aaron Derfel, Montreal Gazette, September 27, 2008
When Anne Duquette was 11 years old, she underwent surgery on her right hip to correct a bone malformation. Only two days passed from her first doctor's appointment till the moment she lay on the operating table.
Nearly 40 years later, Duquette had to undergo surgery again on the same hip. This time, however, she was forced to wait nearly two years.
"There were days when I couldn't go down the stairs because I was in too much pain," the 50-year-old Ahuntsic resident recalled.
Duquette was put on a waiting list at the Montreal General Hospital in the first week of September 2006. She finally got her hip replacement on Aug. 21 this year, but only after filing complaints with the hospital and the provincial ombudsman.
"It's unacceptable that patients have to be treated like this," Duquette said. "It's scandalous."
Cutting surgical wait times was a major theme in the last federal election two years ago. All the parties made promises on the issue, and today, Stephen Harper's Conservatives proudly point out on their website that their minority government signed "wait-time guarantee agreements" with all the provinces.
Yet thousands of Canadians like Duquette continue to wait months for surgery. And despite the problems that are still afflicting Canada's medicare system, health care has been attracting far less attention on the campaign circuit this time around, political observers say.
That has upset the Canadian Medical Association, which has noted that total health-care spending has soared to about $150 billion a year and is outpacing the rate of inflation and population growth.
"It would be reasonable to expect that health care would be a major campaign issue," the CMA said in an article on its website last week, "yet the five political parties ... have been remarkably silent."
(The exception has been the listeriosis outbreak that has killed 19 people. Both the Liberals and the New Democrats have accused the Conservatives of undermining public health safeguards, but the tainted-meat crisis has not been about the fundamentals of the health-care system.)
Antonia Maioni, director of the McGill Institute for the Study of Canada, agreed that health care has taken a back seat to crime and the environment, but she said it could still prove to be the deciding factor for many voters on Oct. 14.
"Health care is what we would call a salient issue - that is to say that voters still take that issue into account when choosing among different political parties," Maioni said. "It's probably even more salient than something like environment, even though we hear a lot about the environment."
In the 2004 election, Paul Martin's Liberals won a minority government, in part by accusing Harper of a secret agenda to privatize health care. Martin went on to sign a 10-year, $41.3-billion deal with the provinces to shore up public health care.
Ironically, after defeating the Liberals two years later, the Conservatives chose not to abandon that deal. In fact, they allude to it as a shining example of the "Conservative record."
"Curiously enough, it's the Conservative government that is the steward, if you will, of this huge multi-billion plan that they have not scaled back, but are just going forward with it," Maioni said.
Observers have suggested that by sticking with the original deal - and hugging the political centre - the Conservatives have deflected concerns that they might want to dismantle Canada's cherished public health-care system.
Yet despite the injection of billions of dollars, wait times persist, thousands of Canadians are in need of a family doctor and more private clinics have opened across the country.
In Quebec, the private Rockland Surgical Centre has signed an agreement with Sacré Coeur Hospital to perform some of its surgeries. A private clinic is expected to open in Calgary on Monday offering unlimited care to clients for a fee of $3,900 in the first year.
However, neither the Conservatives nor Stéphane Dion's Liberals have been willing to engage in the debate over private care. NDP leader Jack Layton has expressed concern about "for-profit" clinics, but he has focused more on promises to phase in universal prescription drug coverage and create more training places for doctors and nurses.
As for wait times, Duquette's orthopedic surgeon said the numbers have not gone down despite the promises of the last election. William Fisher noted that he has a list of more than 200 patients for joint surgery.
"I do not know of any patient I have treated recently who has not been waiting at least a year - apart from those requiring urgent surgery," he said. "In the last month, (operations) have been cancelled on two occasions due to a lack of beds and a shortage of nurses."
Yet, unlike in 2006, the parties have been been unwilling to talk about wait times, much less make promises.
Where there has been a substantive debate is on addressing the severe shortage of physicians and nurses. A report last week by the Manitoba-based Frontier Centre for Public Policy warned that access to general practitioners remains a huge problem.
The report found that more than 15 per cent of Canadians don't have a family doctor. In Quebec, access was judged the worst, with one in four Quebecers without a regular doctor.
The Conservatives, Liberals and the NDP have all weighed in on the shortage and, thus far, the latter two have unveiled detailed proposals to tackle it.
A month after her operation, Duquette is still in recovery, undergoing physiotherapy at a north-end rehabilitation hospital. She's getting better, but is convinced that she didn't have to wait as long as she did.
As politicians spar and skirt important health issues, her message was simple: there must be more accountability by those in power.
"At one point," she said, "people have to assume their responsibilities."
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