Federal-provincial deal could improve quality, access to health-care data
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If Ottawa’s new health-care funding agreement with the provinces provides Canadians with improved data on wait times and medical outcomes, there could be something to salvage out of this deal, after all.
But don’t hold your breath.
The premiers this week accepted Prime Minister Justin Trudeau’s new funding offer, which includes $46 billion over 10 years in extra cash (an annual top-up of about $166 million for Manitoba). It won’t have a material impact on health-care delivery, largely because Canada’s government-controlled system of rationing medical services won’t change.
There is more money on the table, which may slightly improve the quality of medical services Canadians receive. To unlock the full cash amount, provinces must play along with the federal government’s “targeted spending” initiatives (where federal politicians buy photo ops with provincial health ministers on specific funding announcements).
Beyond that, it will be business as usual for Canada’s medicare system — a collection of 13 provincial and territorial insurance plans that run independent of Ottawa under the loosely enforced Canada Health Act.
There may be one exception that could come out of this deal: improved health-care data for Canadians. Ottawa says some of the new funding is contingent on provinces upping their game on collecting and disseminating statistics that measure wait times and hospital operations. It’s unclear what that means specifically, or how those conditions would apply. Like most aspects of this deal, few details have been released.
Still, if it forces provinces to provide Canadians with a clearer picture of how their health dollars are spent, it could be one of the few tangible benefits to emerge from the agreement.
Health-care data in Canada is a mess. Not only is there no uniform way of collecting it nationally, the methodology often differs within provinces, sometimes from one hospital to the next. Statistics published by provincial governments are usually incomplete, unreliable or out of date.
In Manitoba, for example, most wait-time data is not published at all, largely because there are no central wait-time registries for procedures such as shoulder surgery or hernia operations. Even data that is published for procedures such as hip and knee replacements or cardiac surgery is dated. Some of it is misleading.
The Stefanson government dumped $110 million into its Diagnostic and Surgical Recovery Task Force last year to clear COVID-19 pandemic backlogs. Among its tasks is to publish accurate, up-to-date data to show progress on reducing wait times. However, there’s only a handful of surgical and other medical procedures listed on the task force’s online dashboard. For the most part, government simply reformatted existing Manitoba Health statistics (which have been available online for years) and posted them on the new site.
It’s also old information. As of Tuesday, the most recent wait-time data available on the task-force dashboard is from November.
And it’s incomplete, not including the time it takes for Manitobans to see a specialist (only the time from specialist to surgery). It includes only “median” wait times, not those in the 90th-percentile (which provides a more realistic estimate of how long many people are waiting). And the dashboard goes back only to 2019, even though government has data that dates back to the early 2000s.
Manitoba’s wait-time data for cataract surgery is so misleading, it’s essentially useless. Most surgeries are performed on each eye separately, usually days apart. The wait time for the first eye is the long one — sometimes a year or more. The time between the first and second eye is much shorter, usually a few days or a week. Instead of publishing the wait time for the first eye, which is how long people truly wait for cataract surgery, government calculates the average of the first and second eye and publishes that as the “median wait time for cataract surgery.” It’s a deliberate attempt to mislead.
Will the new health accord fix any of this? Will provinces be forced to improve the quality of the data they publish, including making it more comprehensive? Will they at least be encouraged to do so? We can only hope.
Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.