Almost half of Ontario patients who require urgent cancer operations don't get them within the recommended two weeks or less. One quarter of nursing home residents don't need to be in long-term care, while many of those who do spend months waiting to get in.
A new report of the Ontario Health Quality Council suggests one of the most costly health care systems in Canada - consuming 46 cents of every program spending dollar - is squandering precious resources due to inefficiency.
Although quality council chairwoman Lyn McLeod stressed the report was to encourage hospitals to do better, even she noted: "In many areas of care, too many people wait too long."
Chief among her concerns is that one in every six hospital beds is occupied by patients who are awaiting nursing home placement. That causes a domino effect: Many urgent cancer patients cannot undergo operations when needed due to lack of beds, and emergency patients wait for hours to be moved to a room.
Despite costly solutions over more than a decade - adding 20,000 nursing home beds and opening up more medical school spots - the $46-billion health care system is headed for a fiscal crunch. Last week, Toronto-Dominion Bank economists suggested paying doctors based on quality of care to keep the system sustainable, warning that, left unchecked, health spending will rise to 80 per cent of total program spending in Ontario by 2030.
The new health-care report wasn't all bad news. Hospitals showed improvement in cataract, hip and knee surgery and elective cardiac operations. And there was the occasional star: North York General Hospital was getting urgent cancer operations done within two weeks, 97 per cent of the time.
For those trying to access the system, there were problems. In 10 other countries, most sick patients can see their family physician the day they call for an appointment or the next day, but only 53 per cent of Ontarians can. And 730,000 adult Ontarians don't even have a doctor.
"The lack of access to family doctors is surprising, given the supply of health professionals has been increasing steadily," said Ben Chan, the chief executive office of the quality council, a government-funded independent agency.
The report is being closely read by hospital chief executives. The quality council is slated to obtain expanded powers - to make recommendations on clinical practice guidelines, among other things - through the government's Excellent Care for All Act, which passed third and final reading on Thursday.
Under that new act, pay-for-performance rules for hospital chief executives - 14 of whom made more than $500,000 last year - could lead to a rise or fall in compensation, depending on performance.
Adalsteinn Brown, assistant deputy minister of health and a key force behind the legislation, said the new rules will make hospitals strive to reduce waits and attain uniform high quality of care.
"For the first time," Mr. Brown said in a telephone interview, "there will be a yardstick that is very clear and objective."
Christine Elliott, health critic for the Ontario Progressive Conservatives, said record amounts have been spent on health care and the "biggest problem is that the government does not have a plan."
But Ontario Health Minister Deb Matthews told reporters yesterday that she was "absolutely committed to doing better."
She acknowledged the province's hospitals still have too many beds occupied by patients who should not be there. But those hospitals that are tackling the problem head on by making the "right investments," she added, and showing improvement.
"Are we there yet? No, we've got a long way to go," said Ms. Matthews. "But are we starting to see those changes? Absolutely yes."
With a report from Karen Howlett