Be patient. Results will come.

That's the main message Manitoba's health minister delivered in reaction to a new national health-care performance report that says fewer Manitoba patients are getting timely access for key procedures.

The percentage of patients who received hip replacements, knee replacements or cataract surgery within the recommended waiting period once again dropped between 2017 and 2018, according to annual figures published Thursday by the Canadian Institute for Health Information (CIHI).

It's the fourth consecutive year those percentages have dropped in Manitoba, according to CIHI.

"There is clearly work still to do," said Manitoba Health Minister Cameron Friesen.

"It's exactly the reason we're undertaking the work to transform our health-care system, because we know these have been historical challenges that more money alone into our health system were unable to solve."

Health Minister Cameron Friesen says despite some poor results in CIHI's latest report, he remains optimistic that his government's health-care overhaul will pay off down the road. (Jaison Empson/CBC)

The institute's report says 49 per cent of Manitoba patients received a hip replacement within the recommended wait time of six months in 2018 — down from 53 per cent of residents in 2017 and 66 per cent in 2016.

For knee replacements, the figure was 37 per cent in 2018, compared to 43 per cent in 2017 and 58 per cent in 2016. And for cataract surgery, 29 per cent of Manitoba patients got their surgery within a recommended 16-week period in 2018, compared to 32 per cent in 2017 and 34 per cent in 2016.

In each of those cases, the percentages were below Canadian national averages.

"The results that we're seeing from CIHI do not accommodate the results of the additional investment we've made," Friesen told reporters on a conference call Wednesday.

In November, the province announced an injection of more than $5.3 million to perform at least 1,000 more hip and knee replacement surgeries in 2019 — a 25 per cent increase — and at least 2,000 additional cataract surgeries this year.

"As more data in the future is reported, we're going to see what the results [are] of those additional 1,000 hip and knee surgeries and 2,00 cataract surgeries."

Friesen also cited an aging population as an ongoing challenge for the province's health-care system, saying that puts pressure on the system to deliver an increasing number of procedures.

I think patience, for Manitobans, is probably running out. - Laura Tamblyn Watts, Canadian Association of Retired Persons

Laura Tamblyn Watts, chief public policy officer for the Canadian Association of Retired Persons, said the results are shocking but not surprising.

"We've been very worried at the downward trend in Manitoba and the results speak for themselves," she said.

"But what it doesn't speak to is the pain and suffering that many people, especially older adults, are having to endure on a daily basis because of these wait times."

She concedes "it's no easy thing" to sort out an entire health-care system, but says talk of improvements has been heard before and "for a very long time," yet the wait times continue to worsen.

"I think patience, for Manitobans, is probably running out. And I think a very sincere look has to be taken at where investment is going and what the priorities of this government really are," she said.

The CIHI report found Manitoba performed above the national average when it came to hip fracture repairs and radiation therapy, with 92 and 100 per cent of Manitoba patients, respectively, receiving treatment within the recommended waiting periods for those procedures.

The province also says since 2015, the number of CT scans performed has increased by 26 per cent, to nearly 217,000 last year, while the number of MRIs has increased by 29 per cent to nearly 94,000 over the same period.

New MRI scanners in Dauphin and Selkirk have helped reduce a backlog, the province said.

Restructuring to blame: Opposition

Opposition NDP Leader Wab Kinew blamed the hip and knee replacement and cataract surgery results on the Progressive Conservative government's changes to the province's health-care system.

"This is what happens when the government only focuses on cutting costs and ignores the needs of patients," he said in a written statement.

Kinew noted that 71 per cent of patients requiring hip and knee replacements had surgery within the recommended wait times in 2014, when the NDP was in power.

The CIHI report shows the trend toward longer wait times began in 2015 — when the NDP was in power — and has continued in each year of the Progressive Conservative government's first mandate.

"These are not complex types of surgeries," said Tamblyn Watts.

"We know how to do it and we've seen in other provinces, where significant investment has been made, the numbers are supposed to be going up. And that has been a success story in many provinces but we have not seen that in Manitoba," she said.

"We know what money is going into the Manitoba health-care system. We don't see where the return on it is.

"Manitoba is going in the wrong direction."

With shorter waits in other provinces, Tamblyn Watts said there are people who will move in order to get their surgical procedures more quickly than they can in Manitoba.

"But most people are just left in pain. They don't go somewhere else — they don't have the ability to do so."