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A volunteer demonstrates the driving simulator set up with a FMRI (functioning mri) at 3.0T MR at Sunnybrook Research on Nov 25 2011.Fred Lum/The Globe and Mail

The health accord of 2004 prompted hospitals to whittle down backlogs in five areas, including cataract surgery and diagnostic MRI scans. But these may not have been the right priorities. Greater access to primary care might have been a better choice.

Only 32 per cent of patients have 24/7 access to multidisciplinary health-care teams despite the $800-million federal Primary Health Care Transition Fund. While there are more MRI machines and many more scans are being done, wait times for these are unchanged and, in some parts of Canada, are on the rise.

The Senate subcommittee on social affairs, science and technology has reviewed the accord and tabled its report last week, which found there was success in meeting wait-times targets in four of the five areas: all except diagnostic imaging. The provinces could not all agree on how to measure it. Moreover, there is still no national pharmaceutical strategy, and the slow progress on electronic medical records is seen as a partial failure.

The accord saw $41.3-billion poured into health care over a decade, indexed at 6 per cent, which includes the $5.5-billion to address wait times; it was supposed to be a fix for a generation when former prime minister Paul Martin announced it.

Wait times are still being tracked from the moment a patient reaches the specialist's office – not from the first contact of care. As a result, the length of time in the queue remains a mystery.

"Overall, I don't think the Canadian people have got the best of what they need in terms of timely access to quality care," said Art Eggleton, the subcommittee's deputy chair. "So I think we still have a fair bit of work to go."

The accord was a good first step. But hospitals must face the realities of measurable goals, timetables, annual public reporting and customer service. If they do that, Canadians will truly have a system to be proud of.