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Surgeon consulting pelvic x-rays for a hip replacement. (iStockphoto)
Surgeon consulting pelvic x-rays for a hip replacement. (iStockphoto)

Globe Editorial

Health accord has run its course: time for innovation Add to ...

Ever since the federal government made five medical procedures a priority in its 2004 health accord, hospitals have been scrambling to meet targets. The latest figures suggest that effort, although laudable, has reached a plateau.

Improvements in wait times for hip and knee replacements, cataract operations, heart surgery and diagnostic imaging have levelled off. Some provinces are failing to maintain the gains they have made, according to recent Canadian Institute for Health Information figures.

While part of that is due to an aging population – treating 90 per cent of patients in a timely manner is harder to do when there are so many more of them – the health accord may have run its course.

Financial incentives were offered to clear backlogs, especially for hip and knee replacements. For cancer radiotherapy patients, it has been particularly good: 97 per cent underwent treatment in the suggested 28-day time frame.

“Overall, we’ve done a lot of surgeries,” said Tracy Johnson, CIHI’s manager of emerging issues. “But what are the outcomes? For the most part, we hear good stories.”

The talk now, at least in health circles, is about the appropriateness of cataract surgery and MRI scans. Cataract operations, for example, have increased from 276,000 in 2004-05 to 361,000 in 2010-11. And while there are more MRI machines and many more scans are being done, wait times remain unchanged or rising in most parts of Canada.

The $5.5-billion federal fund, created while Paul Martin was prime minister, helped burn through treatment backlogs, which was needed at the time, in part to help restore Canadians’ confidence in medicare.

Now it’s time to look for other wait-time reduction strategies, including an enhanced understanding of surgical outcomes to better predict which patients will receive the greatest benefit.

As the so-called fix for a generation nears its end, it’s time for Canada to find a new fix for a new generation.

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