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The 2014 Commonwealth Fund Survey, which ranked Canada last in timeliness of care, was one of many studies highlighting the country’s dismal record on health-care wait times. As wait times increased in the 1990s and evidence mounted about their adverse effects on patients, governments were slow to respond, in part because the health-care system was dominated by providers, rather than focusing on patients.

Pressure to address wait times came from the Supreme Court of Canada’s 2005 decision in the Chaoulli case, which focused on the right to timely treatment, from patient accounts of suffering while waiting for care, and the Fraser Institute’s annual survey of physicians across Canada, which highlighted how wait times for elective surgeries were longer than clinically reasonable.

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The institute’s study also showed that Saskatchewan had some of the longest wait times in the country in the late 1990s and throughout the 2000s. In 2010, the Saskatchewan government made the bold promise that by 2014 no patient would wait more than three months for elective surgery as part of its wait-time reduction strategy, the Saskatchewan Surgical Initiative (SSI).