Published on February 25, 2019

February 16, 2017

by Graeme Frisque  Independent Free Press

A family doctor and anesthesiologist from Georgetown, Ont. is painting a rather gloomy and concerning picture of the current state of the province’s healthcare system.

Dr. Nadia Alam, who was recently elected to the Ontario Medical Association (OMA) board of directors, isn’t pulling any punches as Ontario doctors enter a fourth year without a labour contract with the province.

Alam offered a sobering evaluation, claiming wait times for specialists and surgery have gotten so out of control that some patients in need of life-saving diagnosis and treatments are dying while in the queue.

“It takes two months to diagnose cancer in a patient now, longer to get treatment and a lot of people actually die waiting for treatment. It is becoming more and more prevalent with every week. That’s the sad part, it’s snowballing. As the system reaches a breaking point, where you have too many patients and too few resources, more and more patients are falling through the cracks,” said Alam.

Minister of Health and Long-term Care, Dr. Eric Hoskins, neither confirmed nor denied this is occurring, but insisted the province has increased healthcare funding in a number of areas.

“Last year we increased health care spending by more than 2 per cent including nearly $500 million more going to our hospitals. We have reduced wait times for surgery, increased the number of Ontarians who have a primary healthcare provider, and expanded services for Ontarians at home and in their communities,” said Hoskins in an email response to Dr. Alam’s comments.

“In fact, both the Fraser Institute and Wait Time Alliance have consistently ranked Ontario as having some of the shortest wait times in Canada – a direct result of the investments we’ve made. Our investments are working to reduce the reliance on hospitals to ensure more Ontarians can receive access to care in their homes,” he added.

However, according to Dr. Alam, those numbers only tell half the story, and claims the common refrain that patients with the greatest need move to the front of line is no longer a functioning model.

“There are so many people at the front of the line, even the people who need urgent help and emergent help are waiting,” she said.

“That’s how bad things are getting out there and this government just keeps turning a blind eye to it. I mean they make great announcements, they’ve been announcing lately over the last couple of weeks about all these investments… what they don’t say is while they’re doing that, they’re taking away more general internal medicine beds. So they’re giving with one hand and taking with the other and we’re no further ahead,” said Alam.

MPP for Elgin-Middlesex-London and Progressive Conservative Critic of Health, Jeff Yurek, also took issue with Hoskins’ numbers, pointing out before last year hospitals endured a five-year budget freeze.

“I don’t think (Minister Hoskins) has a feel for what’s going in the healthcare sector which has been rationed over the last few years, and we have demoralized doctors and nurses, which is affecting patient care,” said Yurek.

“You notice any other funding announcement this government makes, a good portion of it goes to administration, not to direct patient care. That is why we’re seeing a rationing of healthcare throughout the province counting surgeries, long wait times for treatment and it’s all to the detriment of Ontarians seeking help,” added Yurek.

As an example, Yurek points to a recent announcement by the province about hiring 84 new vice presidents, or six for each of the province’s Local Health Integration Networks (LHINs) to help implement new legislation. He also referred to a report from the Ontario Auditor General last year which found 39 per cent of the money going to Community Care Access Centres is earmarked for administrative costs.

Yurek and Alam are not alone in their concern for the province’s healthcare system and dwindling resources for patient care.

The Toronto Star published a column Feb. 8 by executive director of the Li Ka Shing Knowledge Institute at St. Michael’s Hospital in Toronto, Dr. Andreas Laupacis, titled Wait times for specialists need our attention. While stopping short of claiming patients are dying on waiting lists, he echoed some of the same concerns and agreed the province’s statistics don’t tell the whole story.

“In Ontario we know how long people wait for surgery for selected procedures (like) cataract removal, hip and knee replacements, cancer surgery, cardiac surgery, but even then we only know about the wait from the time the patient and surgeon agree surgery is indicated until the surgery is performed. We have no data about the wait from the time of the primary care providers’ referral to when the surgeon sees the patient for the first time. Both waits are important to patients,” said Laupacis. “And we have no data on how long people wait to see specialists who are not surgeons.”

Alam also sees a disconnect between the administration and what frontline workers are dealing with. She cites stories of doctors having to close down additional services while struggling to staff offices, and specialists with waiting lists so long they are forced to refuse referrals because they’ll never get to them. All things Yurek says he and his staff are increasingly being contacted about by voters.

“They don’t see the suffering, they don’t take it seriously, they don’t have to look patients in the eye and say to them, ‘I’m sorry, you ‘re going to have to wait two years, wait four years, five years for that surgery. I’m sorry your surgery got cancelled again because the hospital ran out of beds. I’m sorry you can’t see the specialist because they’ve had to close their offices due to cuts to healthcare. I’m sorry you can’t get home care because there is no money left in CCAC.’ They never have to deliver news like that to patients,” said Alam.

“What I want this government to do is grow up and start taking healthcare seriously. I want them to not just fund healthcare around the time of elections. I want them to take a smart approach to managing healthcare,” she added.