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Good morning. Wendy Cox in Vancouver today.

Newly released data from the Canadian Institute for Health Research confirms what anyone who has had to visit an emergency room lately has already figured out: The waiting is awful.

As Andrea Woo writes, Canadians spent more time waiting in emergency departments in 2021 than in any other year. For 90 per cent of people who were eventually admitted to hospital in 2021, it took about 40.7 hours. That’s up from 33.5 hours in 2020.

The data show that things were slightly worse in British Columbia: 90 per cent of such visits were completed within 47.7 hours in 2021-22, compared with 32.8 hours the year prior. In Ontario, it took those patients 32.5 hours in 2021, up from 29.1 in 2020. In Alberta, 90 per cent of visits that ended in admission were completed in 27 hours, up slightly from 26.2 the year prior.

But as is frequently the case with cross-Canada health care data, the figures from CIHI are not a full picture. They come from hospitals that submitted data to the National Ambulatory Care Reporting System, or NACRS, but not all hospitals participate. In B.C., for example, 30 facilities reported to NACRS in 2021-22, accounting for an estimated 73 per cent of emergency department coverage, compared to 178 facilities in Ontario, accounting for about full coverage.

Still, Andrea notes the figures contribute to the picture of the crisis playing out in hospitals across Canada. Staffing issues, barriers to accessing primary care and longstanding pressures on a health care system further strained by a pandemic are leading to sicker patients who are ending up in emergency.

One children’s hospital in Vancouver is double-bunking patients to accommodate an increase in sick kids, another in Calgary has opened a heated trailer to accommodate overflow, and patients in Edmonton have been treated in the hallways of crowded hospitals. A number of emergency departments across the country have had to close because of critical staffing shortages.

Prime Minister Justin Trudeau said in a year-end interview with The Canadian Press that he doesn’t think health care reform should get kicked down the road any longer.

“It wouldn’t be the right thing to do to just throw more money at the problem and sit back and watch the problem not get fixed because we didn’t use this moment to say, ‘No, no, no, it’s time to improve the system,’ ” Mr. Trudeau said.

But he also said he needs the provinces to commit to change before Ottawa sends more money their way.

“Canadians are right to look at all orders of government and say, ‘This is terrible. You guys really need to solve this,’ ” he said.

Imposing performance measures on the provinces that affect their access to the Canada Health Transfer is more or less unheard of, said Haizhen Mou, a professor at the University of Saskatchewan who studies health policy.

It’s understandable that provincial leaders don’t want to change that precedent, she said in an interview Tuesday.

“I don’t think the federal government has the right to impose such performance indicators on the broad kind of health transfer,” she said, but added that she understands why the Liberals don’t want to continue to put money toward a system that’s not working.

Globe reporter Greg Mercer wrote this week about a pool of well-trained Canadian doctors who could help out with the staffing shortages if only the Canadian system would let them.

He travelled to the Royal College of Surgeons in Dublin, where nearly 300 Canadian students are enrolled. They are there because it’s nearly impossible to get one of the 2,800 first-year seats in the country’s 17 medical schools – where roughly nine out of 10 applicants are rejected, often despite impeccable grades and qualifications, since demand far outstrips supply.

As Greg writes, many want to come home but can’t: the road to a medical career in Canada remains closed because of a lack of provincially funded residency positions – the two-year-long, postgraduation supervised training period required to become a licensed physician.

These international medical graduates are increasingly working as doctors in other countries.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.

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