More Than 15,000 Canadians Died in One Year While Waiting for Health Services

Ambulances are seen at a hospital in Toronto on April 6, 2021. The Canadian Press/Frank Gunn

Nearly 15,500 patients in Canada died over the span of one year while waiting for surgery or diagnostic scans, according to a new report based on partial government data.

The policy brief titled “Died on a Waiting List,” by the think tank SecondStreet.org, says 15,474 patients died waiting for health services in Canada between April 1, 2023, and March 31, 2024. The organization collected data from provincial health-care bodies across the country through freedom-of-information requests.

The report said only 12 health bodies in seven provinces provided full or partial data, representing 62 percent of the country’s population. The organization estimated that the actual number of deaths could be closer to 28,077. Information obtained for the policy brief generally fell into two groups: cases where patients may have died waiting for life-saving procedures such as cancer treatment, and cases involving patients dying while waiting for surgery or diagnostic scans that could improve quality of life, such as a hip replacement.

“Thousands of Canadians across the country find themselves on waitlists—in some cases for several years—with too many tragically dying before ever getting treated, or even diagnosed,” Harrison Fleming, legislative and policy director at SecondStreet.org, said in a Jan. 15 statement.

“Canadians pay really high taxes and yet our health care system is failing when compared to better-performing universal systems in Europe.”

The 15,474 figure does not include data from Quebec, Alberta, Newfoundland and Labrador, and most of Manitoba, the organization said. Additionally, Saskatchewan and Nova Scotia only provided data on patients who died while waiting for surgeries—not for diagnostic scans.

SecondStreet.org has been tracking this data since 2018 and says it has identified a total of 74,677 cases where someone has died while waiting for health care in Canada.

The report says that government health-care funding is not the issue, citing the provincial governments’ increased spending on health care over the last 30 years, and instead says changes to the system are needed. Total health expenditures represented an estimated 12.4 percent of Canada’s gross domestic product (GDP) last year, which is a record high outside of the 2020 and 2021 pandemic period, according to the Canadian Institute for Health Information (CIHI).

CIHI also said Canada’s health-care spending per capita is among the highest when compared with the other 37 member countries in the Organisation for Economic Co-operation and Development, according to 2022 statistics. At $8,119, Canada spends nearly as much as Sweden ($8,314) and France ($8,212), and more than Australia ($8,073) and New Zealand ($7,463).

Provincial Breakdown

Ontario saw a year-over-year drop in waiting list deaths in both the surgery and diagnostic scans categories.

“However, there were instances where patients were waiting for long periods of time before they passed away,” the policy brief said. One example provided was a patient who required orthopedic surgery in July 2009 but never received it before passing away in May 2023, more than 14 years later.

Data from Ontario Health indicated that 115 patients died while waiting for cardiac surgery in 2023–24. Yet, SecondStreet.org said that number jumped to 378 patient deaths when including those waiting for cardiac “procedures.”

B.C. saw a slight increase in those who died while waiting for surgery, rising from 935 in 2022–23 to 988 in 2023–24.

In Prince Edward Island, there was a slight increase of those who died while waiting for diagnostic scans in 2023–24, but the number of those who died while waiting for surgery held steady at 17, the policy brief said.

Waiting list deaths for those on surgery lists dropped in both Saskatchewan and New Brunswick, SecondStreet said, with Saskatchewan seeing a drop from 402 deaths in 2022–23 to 385 in 2023–24. New Brunswick saw a drop from 77 in 2022–23 to 51 in 2023–24.

Recommendations

The policy brief makes five recommendations to improve health care across Canada.

The first is to have provincial governments improve their data tracking and disclosure. Another is to reform the way hospitals are funded, changing from “block funding,” or annual cheques to cover global budgets, to an “activity-based” funding model where hospitals are paid based on their output in terms of services provided to patients.

Offering more health-care choices is another recommendation. Patients who can pay for private care should be permitted, the policy brief says, saying this would align with “better-performing” health-care systems.

“Allowing patients to pay for treatment at local private clinics would take pressure off the public system – just as better-performing European systems do,” the policy brief said.

SecondStreet.org also recommends that governments in Canada expand partnerships with private-sector health-care providers.

“Governments in Canada and around the world have found that they can often deliver better care for patients by hiring private clinics to provide treatment to patients in the public system,” the authors wrote.

The policy brief notes the positive outcome experienced by the Saskatchewan government in hiring private clinics, saying that, according to the Fraser Institute think tank, these clinics cost 26 percent less per procedure.

Ontario’s auditor noted in 2014 that some services, like MRIs, dialysis, and colonoscopies, were between 20 percent and 40 percent less expensive if delivered in community clinics rather than in hospitals, SecondStreet.org added.

The organization also suggests that governments consider offering reimbursement payments for patients in Canada who find out-of-province or out-of-country care.

“In the European Union (EU), patients have the right to pay for surgeries and diagnostic scans in other EU countries, and then be reimbursed by their own governments,” with the reimbursements covering up to the same amount their own government would have spent to provide the surgery locally, the policy brief said.

“Not only would this benefit patients who decide to travel for health care, it would also benefit those who remain in Canada. This is due to the fact that patients remaining in Canada for health care would move up a spot on the waiting list each time someone ahead of them chose to travel for health care,” the authors wrote.