EDITOR’S NOTE: This article originally appeared on The Trillium, a Village Media website devoted to covering provincial politics at Queen’s Park.
On a crisp Saturday afternoon on Day 4 of the election campaign, Liberal Leader Bonnie Crombie unveiled her party’s bright red campaign bus in downtown Toronto.
Plastered across one side of the bus — “11,000 people died waiting for surgery last year” — is a mark of the Liberals’ focus on health care during this election campaign. Data obtained by The Trillium, however, tells a different story.
Last year, from January to November, 1,365 adult Ontarians died while on a waitlist for surgery, according to data from provincial agency Ontario Health. Another 26 children and youth, aged 0 to 19, also died.
The year before, in 2023, there were 1,584 adults and 33 youth who died.
One surgeon who spoke with The Trillium cautioned that even those smaller numbers should not be interpreted as the number of people who died because they were waiting for surgery. Many, he noted, were waiting for non-life–saving surgeries like cataract removals and knee surgeries and likely died of old age or unrelated causes.
“Nobody is dying from their cataracts, like cataracts don't explode, they don't stop your heart, they don't give you a stroke, they just cause visual impairment,” said Dr. David Urbach, professor of surgery at the University of Toronto and head of the Department of Surgery at Women's College Hospital, who also acknowledged that there are problems with accessing care in the health system.
Some, including the hosts of the #onpoli TVO podcast, have noted the Liberals’ bus is reminiscent of a red bus that Boris Johnson, former prime minister of the United Kingdom and former London mayor, used as part of the “Vote Leave” campaign during the Brexit referendum in 2016.
“We send the EU £350 million a week. Let’s fund our NHS instead,” said large white letters across the side of the bus, referring to the United Kingdom’s publicly funded health-care system.
The claim drew attention, including because it was considered inaccurate.
Back in Ontario, the Ontario Liberal Party isn’t the only group that has used the “11,000 people” figure and referred to it as the number of people who have died while waiting for surgery.
A Jan. 31 news release from CUPE’s Ontario Council of Hospital Unions (OCHU-CUPE) noted the union’s upcoming efforts during the election to draw attention to the “crisis in Ontario’s health care.”
This included “250,000 people waiting for surgeries, 11,000 of whom died on the waitlist.”
Reached by phone on Wednesday, OCHU-CUPE president Michael Hurley acknowledged that number was incorrect.
“We've stopped using the number, and I guess we'll have to apologize for using an incorrect number there,” said Hurley, pointing to a Feb. 3 post from SecondStreet.org, which describes itself as a think tank that uses “storytelling as a way to discuss public policy issues.”
SecondStreet.org included in its post data that it said it obtained from Ontario Health showing 11,500 Ontarians died in 2022-23 while on surgical (2,096 people) or diagnostic scan (9,404 people) waitlists. Some news outlets reported on this data in the fall of 2023, noting that the total referred to both surgical and diagnostic waitlists.
Hurley said while the specific number of people dying while on a surgical waitlist was incorrect, many Ontarians “are waiting beyond the recommended time limits for their procedure and the reality is … a fairly significant number of people are dying waiting for that surgery.”
He said the important question in this election campaign is what parties’ plans are to address the surgical waitlist.
“So far, we have to hear about … plans to run operating rooms 24/7, to recruit in a meaningful way the nurses and doctors to be able to step up to handle increasing capacity in our hospitals to be able to meet the demand, which we currently aren't meeting, and which in some cases, unfortunately, is having tragic consequences for individuals and their families,” Hurley said.
Asked by The Trillium about the Liberals’ bus at a campaign stop in Scarborough on Thursday morning, the party’s leader, Crombie, spoke of the millions who don’t have access to a family doctor and patients who are being treated in hospital hallways.
“(Doug Ford) flippantly said one day if you wanted to get an MRI or a (CT) scan, you should go to a veterinary office. How offensive is that, that our doctors aren't equipped, our hospitals aren't equipped with the right equipment, right machines to provide care and analysis and testing for Ontarians?” she said.
“So we stand by our statistics,” Crombie added.
“If there will be any change, we will get back to you, but our statistics hold,” she said, calling up fellow candidate Adil Shamji, the incumbent running again in Don Valley East, who was also the party’s health critic.
Shamji acknowledged the number was more than just surgeries, saying the statistic of around 11,000 people “dying on surgical and diagnostic imaging waitlists in 2023 has been widely recorded.”
“But my honest personal experience, and from what I've heard from colleagues, is, if anything, that's the tip of the iceberg. There are far more. There are far more people who are suffering in other ways,” Shamji said.
“The number of people who've died on waitlists is a shadow of the number of people who've suffered irreparable harm, who are struggling at home, who are unable to make ends meet, who are unable to pursue gainful employment because their basic fundamental health-care needs guaranteed under the Canada Health Act have not been met,” he said.
After requesting the source of the statistic the party used on its campaign bus, a spokesperson sent several news articles that included reference to the OCHU-CUPE’s claim, which the union has since said was “incorrect,” and a news article from 2023 that noted the number included those waiting for both surgeries and diagnostic scans.
The data The Trillium obtained for 2024, broken down according to the type of surgery and up until the end of November, included 145 people on a waitlist for general surgery, 75 people waiting for vascular surgery, 216 waiting for orthopaedic surgery and 484 people waiting for ophthalmic surgery.
It includes patients categorized as priority level 2 (urgent), 3 (semi-urgent) and 4 (elective) cases, but not priority level 1 emergency cases or palliative, reconstructive and diagnostic cancer surgeries (treatment cases are included).
While surgical waitlists and people dying on them has trickled into the provincial election, some are recommending caution when trying to make sense of such data.
The Trillium requested an interview with an Ontario Health official, but instead got an email with information, some of which was already included in the documents with the data.
The agency stressed that the data on “cancellations of surgeries due to patient death must be interpreted with caution.”
“These surgical statistics do not indicate that patients passed away as a result of wait times. Mortality can be affected by many complex and interrelated factors unrelated to the surgery. For common surgeries like hip and knee replacement, or cataract, for example, surgery is not life-saving and outcomes are less time-sensitive,” the email stated.
Urbach, the professor of surgery at the University of Toronto, echoed this.
“You really have to be careful about how to interpret it, and a lot of analysis would have to go in before you would make any conclusion about whether this reflected some really serious catastrophe in the health system,” said Urbach.
He pointed to the number of people who died during the first 11 months of 2024 — 484 people — who were on the waitlist for ophthalmic surgery. Most of these, he said, would likely be cataract surgeries.
“The numbers that you see are going to be a combination of the age of the people who are waiting for these procedures and the number of people who are waiting for these procedures,” he said.
When it comes to cancer surgeries, Urbach said it’s similar where he doesn’t think people died because they were waiting a few extra weeks, for example.
“There are lots of people waiting for a surgery of one type or another, and they will just never get there, but it's not something that earlier surgery would have done something about,” said Urbach, who acknowledged that there could be “isolated cases.”
“I'd be surprised that any percentage of the population is not on a waitlist for something when they die,” he said.
Dr. Dominik Nowak, president of the Ontario Medical Association, said it’s difficult to interpret the data because “there are a number of other things that could happen” to individuals on a waitlist for care.
But he added that waits have “serious impacts” on people.
“As doctors, we all have stories of people who were on (waitlists) and in large part because of the longer waits, couldn't get the care they needed and had serious impacts from that,” Nowak said. “And whether that impact is a worsening condition or worsening cancer or worsening preventable disease or death, I think we all have stories like that in our practices, and especially more so in the last few years.”
—Data visualization by Jessica Smith Cross