Provincial and territorial governments released today their long-awaited list of benchmarks for wait times for medically necessary services. The federal Liberals are relying on benchmarks to try to show they are actually doing something to strengthen health care.
- CUPE’s 2006 election campaign page
- How CUPE members can protect public services, a HOW-TO guide for the election campaign
- Federal NDP website
But if the Liberals don’t tackle the underlying issues – as Manitoba is doing by investing in more equipment, training more staff and introducing key management innovations – then private interests will continue to push for-profit clinics and private insurance as the solution to shorter wait times. And benchmarks could end up being the teethmarks of private, for-profit care.
The benchmark list focused on five main areas: cardiac care, hip and knee replacements, eyesight restoration, radiation therapy for cancer and diagnostic services (mammography and cervical screening). The list’s release today is sure to reinforce health care as the number one election issue, topping Canadians’ concerns.
But benchmarks will be dangerous if they’re really about streaming people and taxpayer dollars to privatization. Unless the federal and provincial governments commit to meeting these benchmarks within the public system, Canadians should be wary.
The evidence shows that private, for-profit health care doesn’t reduce waiting times. Quite the opposite – costs increase and average wait times increase. Those with lots of money may be able to get faster service, but wait times for most people increase because money and staff are siphoned out of the public system by more expensive private operators.
England and New Zealand, which have parallel private hospital systems, have larger waiting lists and longer waiting times in the public system than countries with a single-payer system. Studies that have compared wait lists within countries have found similar inequalities: the more for-profit health care in a given region, the longer the waits for patients in the public system. When public wait times dropped in Britain, it was because of increased public funding and numbers of front-line staff.
In Sweden, which allowed the growth of private hospitals and “internal markets”, waiting lists have grown again to the levels of the early 1990s. The number of patients on cataract waiting lists almost doubled between 1992 and 2000.
If the federal government were serious it would take action on the dramatic staffing shortages that are bottlenecking the public system – not offer up public dollars to pad private profits. For instance, there is an estimated shortage of 400 anesthetists across the country. More private care isn’t needed. More public staff are.
Wait lists should not be used as an excuse by some provinces to privatize. Instead, the federal government should be prepared to both enforce the Canada Health Act and provide positive solutions to shortening wait lists.
CUPE has proposed a comprehensive strategy to deal with wait lists by keeping solutions public, managing better and targeting resources more effectively, including:
- Government should centralize and coordinate wait list management, not leave it up to individual doctors.
- Improve and consolidate the different steps in diagnosis and treatment.
- Refer patients to shorter lists and integrate care to reduce underlying bottlenecks. Centralize booking, expand case management and improve teamwork.
- Expand and reform continuing and primary care.
Governments must also make public investments in hospitals and equipment. Despite our aging population, national levels of investment in health care infrastructure have not sufficiently recovered from their low in the late 1990s as a result of Liberal cuts. The federal government needs to fund a national health care capital investment program in partnership with the provinces.
Wait lists and benchmarks aren’t everything. We need to ensure that the care people receive is quality care, not just conveyor-belt private medicine geared to maximizing profits at the expense of the public purse, or to your credit card.
Voters should be wary about the focus on benchmarks and the false solutions that the Liberals and Conservatives offer. The NDP is the only party committed to stopping the growth of private, for-profit care in health care.