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Fraser Institute

Canada’s median health-care wait time hits 30 weeks—longest ever recorded

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From the Fraser Institute

By Mackenzie Moir and Bacchus Barua

Canadian patients in 2024 waited longer than ever for medical treatment, finds a new study released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

“While most Canadians understand that wait times are a major problem, we’ve now reached an unprecedented and unfortunate milestone for delayed access to care,” said Bacchus Barua, director of health policy studies at the Fraser Institute and co-author of Waiting Your Turn: Wait Times for Health Care in Canada, 2024.

The annual study, based on a survey of physicians across Canada, this year reports a median wait time of 30 weeks from referral by a general practitioner (i.e. family doctor) to consultation with a specialist to treatment, for procedures across 12 medical specialties including several types of surgery.

This year’s median wait (30 weeks) is the longest ever recorded—longer than the 27.7 weeks in 2023 and the 20.9 weeks in 2019 (before the pandemic), and 222 per cent longer than the 9.3 weeks in 1993 when the Fraser Institute began tracking wait times. Among the provinces, Ontario recorded the shortest median wait time (23.6 weeks, up from 21.6 weeks in 2023) while Prince Edward Island recorded the longest (77.4 weeks—although data for P.E.I. should be interpreted with caution due to fewer survey responses compared to other provinces).

Among the various specialties, national median wait times were longest for orthopedic surgery (57.5 weeks) and neurosurgery (46.2 weeks), and shortest for radiation (4.5 weeks) and medical oncology treatments (4.7 weeks). For diagnostic technologies, wait times were longest for CT scans (8.1 weeks), MRIs (16.2 weeks) and ultrasounds (5.2 weeks).

“Long wait times can result in increased suffering for patients, lost productivity at work, a decreased quality of life, and in the worst cases, disability or death,” said Mackenzie Moir, senior policy analyst at the Fraser Institute and study co-author.

Median wait times by province (in weeks)

  • In 2024, physicians across Canada reported a median wait time of 30.0 weeks between a referral from a GP and receipt of treatment. Up from 27.7 in 2023.
  • This is 222% longer than the 9.3 week wait Canadian patients could expect in 1993.
  • Ontario reported the shortest total wait (23.6 weeks), followed by Quebec (28.9 weeks) and British Columbia (29.5 weeks).
  • Patients waited longest in Prince Edward Island (77.4 weeks), New Brunswick (69.4 weeks) and Newfoundland and Labrador (43.2 weeks).
  • Patients waited the longest for Orthopaedic Surgery (57.5 weeks) and Neurosurgery (46.2 weeks).
  • By contrast, patients faced shorter waits for Radiation Oncology (4.5 weeks) and Medical Oncology (4.7 weeks).
  • The national 30 week total wait is comprised of two segments. Referral by a GP to consultation with a specialist: 15.0 weeks. Consultation with a specialist to receipt of treatment: 15.0 weeks.
  • More than 1900 responses were received across 12 specialties and 10 provinces.
  • After seeing a specialist, Canadian patients waited 6.3 weeks longer than what physicians consider to be clinically reasonable (8.6 weeks).
  • Across 10 provinces, the study estimated that patients in Canada were waiting for 1.5 million procedures in 2024.
  • Patients also suffered considerable delays for diagnostic technology: 8.1 weeks for CT scans, 16.2 weeks for MRI scans, and 5.2 weeks for Ultrasound.

 

Mackenzie Moir

Senior Policy Analyst, Fraser Institute

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

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Business

Massive government child-care plan wreaking havoc across Ontario

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From the Fraser Institute

By Matthew Lau

It’s now more than four years since the federal Liberal government pledged $30 billion in spending over five years for $10-per-day national child care, and more than three years since Ontario’s Progressive Conservative government signed a $13.2 billion deal with the federal government to deliver this child-care plan.

Not surprisingly, with massive government funding came massive government control. While demand for child care has increased due to the government subsidies and lower out-of-pocket costs for parents, the plan significantly restricts how child-care centres operate (including what items participating centres may purchase), and crucially, caps the proportion of government funds available to private for-profit providers.

What have families and taxpayers got for this enormous government effort? Widespread child-care shortages across Ontario.

For example, according to the City of Ottawa, the number of children (aged 0 to 5 years) on child-care waitlists has ballooned by more than 300 per cent since 2019, there are significant disparities in affordable child-care access “with nearly half of neighbourhoods underserved, and limited access in suburban and rural areas,” and families face “significantly higher” costs for before-and-after-school care for school-age children.

In addition, Ottawa families find the system “complex and difficult to navigate” and “fewer child care options exist for children with special needs.” And while 42 per cent of surveyed parents need flexible child care (weekends, evenings, part-time care), only one per cent of child-care centres offer these flexible options. These are clearly not encouraging statistics, and show that a government-knows-best approach does not properly anticipate the diverse needs of diverse families.

Moreover, according to the Peel Region’s 2025 pre-budget submission to the federal government (essentially, a list of asks and recommendations), it “has maximized its for-profit allocation, leaving 1,460 for-profit spaces on a waitlist.” In other words, families can’t access $10-per-day child care—the central promise of the plan—because the government has capped the number of for-profit centres.

Similarly, according to Halton Region’s pre-budget submission to the provincial government, “no additional families can be supported with affordable child care” because, under current provincial rules, government funding can only be used to reduce child-care fees for families already in the program.

And according to a March 2025 Oxford County report, the municipality is experiencing a shortage of child-care staff and access challenges for low-income families and children with special needs. The report includes a grim bureaucratic predication that “provincial expansion targets do not reflect anticipated child care demand.”

Child-care access is also a problem provincewide. In Stratford, which has a population of roughly 33,000, the municipal government reports that more than 1,000 children are on a child-care waitlist. Similarly in Port Colborne (population 20,000), the city’s chief administrative officer told city council in April 2025 there were almost 500 children on daycare waitlists at the beginning of the school term. As of the end of last year, Guelph and Wellington County reportedly had a total of 2,569 full-day child-care spaces for children up to age four, versus a waitlist of 4,559 children—in other words, nearly two times as many children on a waitlist compared to the number of child-care spaces.

More examples. In Prince Edward County, population around 26,000, there are more than 400 children waitlisted for licensed daycare. In Kawartha Lakes and Haliburton County, the child-care waitlist is about 1,500 children long and the average wait time is four years. And in St. Mary’s, there are more than 600 children waitlisted for child care, but in recent years town staff have only been able to move 25 to 30 children off the wait list annually.

The numbers speak for themselves. Massive government spending and control over child care has created havoc for Ontario families and made child-care access worse. This cannot be a surprise. Quebec’s child-care system has been largely government controlled for decades, with poor results. Why would Ontario be any different? And how long will Premier Ford allow this debacle to continue before he asks the new prime minister to rethink the child-care policy of his predecessor?

Matthew Lau

Adjunct Scholar, Fraser Institute
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Banks

Scrapping net-zero commitments step in right direction for Canadian Pension Plan

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From the Fraser Institute

By Matthew Lau

And in January, all of Canada’s six largest banks quit the Net-Zero Banking Alliance, an alliance formerly led by Mark Carney (before he resigned to run for leadership of the Liberal Party) that aimed to align banking activities with net-zero emissions by 2050.

The Canada Pension Plan Investment Board (CPPIB) has cancelled its commitment, established just three years ago, to transition to net-zero emissions by 2050. According to the CPPIB, “Forcing alignment with rigid milestones could lead to investment decisions that are misaligned with our investment strategy.”

This latest development is good news. The CPPIB, which invest the funds Canadians contribute to the Canada Pension Plan (CPP), has a fiduciary duty to Canadians who are forced to pay into the CPP and who rely on it for retirement income. The CPPIB’s objective should not be climate activism or other environmental or social concerns, but risk-adjusted financial returns. And as noted in a broad literature review by Steven Globerman, senior fellow at the Fraser Institute, there’s a lack of consistent evidence that pursuing ESG (environmental, social and governance) objectives helps improve financial returns.

Indeed, as economist John Cochrane pointed out, it’s logically impossible for ESG investing to achieve social or environmental goals while also improving financial returns. That’s because investors push for these goals by supplying firms aligned with these goals with cheaper capital. But cheaper capital for the firm is equivalent to lower returns for the investor. Therefore, “if you don’t lose money on ESG investing, ESG investing doesn’t work,” Cochrane explained. “Take your pick.”

The CPPIB is not alone among financial institutions abandoning environmental objectives in recent months. In April, Canada’s largest company by market capitalization, RBC, announced it will cancel its sustainable finance targets and reduce its environmental disclosures due to new federal rules around how companies make claims about their environmental performance.

And in January, all of Canada’s six largest banks quit the Net-Zero Banking Alliance, an alliance formerly led by Mark Carney (before he resigned to run for leadership of the Liberal Party) that aimed to align banking activities with net-zero emissions by 2050. Shortly before Canada’s six largest banks quit the initiative, the six largest U.S. banks did the same.

There’s a second potential benefit to the CPPIB cancelling its net-zero commitment. Now, perhaps with the net-zero objective out of the way, the CPPIB can rein in some of the administrative and management expenses associated with pursuing net-zero.

As Andrew Coyne noted in a recent commentary, the CPPIB has become bloated in the past two decades. Before 2006, the CPP invested passively, which meant it invested Canadians’ money in a way that tracked market indexes. But since switching to active investing, which includes picking stocks and other strategies, the CPPIB ballooned from 150 employees and total costs of $118 million to more than 2,100 employees and total expenses (before taxes and financing) of more than $6 billion.

This administrative ballooning took place well before the rise of environmentally-themed investing or the CPPIB’s announcement of net-zero targets, but the net-zero targets didn’t help. And as Coyne noted, the CPPIB’s active investment strategy in general has not improved financial returns either.

On the contrary, since switching to active investing the CPPIB has underperformed the index to a cumulative tune of about $70 billion, or nearly one-tenth of its current fund size. “The fund’s managers,” Coyne concluded, “have spent nearly two decades and a total of $53-billion trying to beat the market, only to produce a fund that is nearly 10-per-cent smaller than it would be had they just heaved darts at the listings.”

Scrapping net-zero commitments won’t turn that awful track record around overnight. But it’s finally a step in the right direction.

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