MRI at a public hospital in Calgary (Adrian Wyld/Canadian Press)

Long waits for diagnostic tests, access to specialists and some surgeries have long been at the heart of complaints about the failings of Canada's health-care system. Fix that, Roy Romanow concluded in his $15-million report, and Ottawa will go a long way towards satisfying Canadians' concerns about medicare.

Waiting times have made it to the top of the political agenda since the former Saskatchewan premier made his recommendations in the 2002 report on the future of health care. Since then, the federal government has put $5.5 billion into funding to address the problem. Provinces, meanwhile, have been coming up with their own plans and are working toward meeting national standards.

More recently, the Harper government laid out its wait-times guarantee as one of the five key priorities that it wants to usher in during its mandate.

In his report on how to fix medicare, Senator Michael Kirby recommended that the government should pay for out-of-province or out-of-country treatment for patients who don't receive timely care.

Romanow, on the other hand, figured the problem could be handled with a little cash and some organization, and one of his key recommendations was that the provinces should manage wait lists, and set benchmarks and provide patients with wait times they can expect.

Wait times guarantee

It appears that Ottawa and the provinces have heard the advice of both men. The federal government is working at implementing a wait-times guarantee that would be in place by 2008. Health Minister Tony Clement said in August 2006 that patients should expect to receive treatment for procedures within an acceptable time. If this does not happen, he said, the patient would be able to seek "recourse."

So if a patient couldnt get treatment for, say, a hip-fracture treatment, the recourse would allow the patient to go to "another provider, another facility or another jurisdiction," paid with public funds, to get that treatment. "Recourse should be fair and equitable for all patients," Clement said. This brings to the fore the issue of whether public money will fund treatment at private clinics.

The groundwork for the government to move forward on wait times was set by a health accord signed by the provinces and Ottawa in 2004. It brought an extra $5.5 billion in funding to reduce wait times. Most of that money, $4.5 billion, has already been allocated.

And in that time, many of the provinces have moved to manage wait time, and all of them have agreed to set maximum acceptable wait times for key procedures, which they announced in December 2005.

The national benchmark for these procedures:

• Radiation therapy to treat cancer within four weeks of patients being ready to treat.
• Hip fracture treatment within 48 hours.
• Hip replacements within 26 weeks.
• Knee replacements within 26 weeks.
• Surgery to remove cataracts within 16 weeks for patients who are at high risk.
• Breast cancer screening for women ages 50 to 69 every two years.
• Cervical cancer screening for women 18 to 69 every three years after two normal tests.
• Cardiac bypass patients will get treatment within two weeks to 26 weeks, depending on the severity of the case.

The Wait Times Alliance, created in 2004 to provide governments with advice from the physicians' perspective, put out an interim report card in November 2006 on the progress made. It said governments have reduced the wait to be treated for cancer and other priority health problems. Governments were given a grade of A for funding, but an "incomplete" mark for making meaningful reductions in wait times.

Each province was to come up with its own strategy on how it would improve access. Many of them have wait-times information on websites, including B.C., Alberta, Saskatchewan, Manitoba, Quebec, Ontario, Nova Scotia and New Brunswick.