It’s no surprise to Thelma Lee that emergency room wait times are not meeting provincial targets.

Lee said her 41-year-old daughter, Marlene Stephens, died Saturday after waiting nearly 90 minutes at the William Osler Health Centre’s Etobicoke campus emergency room with breathing problems.

Lee feels her daughter was not seen fast enough by medical staff.

“They didn’t touch her,” said the grieving Lee. “She was crying out, ‘I can’t breathe, I can’t breathe’. . . Nobody attended to my daughter.”

On Monday, Auditor General Jim McCarter released his annual report which found that despite putting an extra $200 million into shortening emergency room wait times over the last two years, “significant province-wide progress has not yet been made.”

“Complaints about overcrowding and delays in hospital emergency rooms have persisted for years,” McCarter told a news conference on Monday.

Emergency room waits for people with serious conditions sometimes reached 12 hours or more, the report said. That is far greater than the province’s 8-hour wait time target, the report found.

And for emergency patients who need a hospital bed, they waited on average for about 10 hours but some waited 26 hours or more, according to the 2010 Annual Report.

“Our audit found that wait times for patients with less serious ailments have been reduced somewhat,” McCarter said. “However, there has been only minimal progress in reducing wait times for patients with more serious conditions.”

Health Minister Deb Matthews defended the province’s ER wait times strategy, saying Ontario is the first province to set targets and measure waits.

“When we started, about 81 per cent of people who went to emergency departments were seen within the target,” she said. “Now we are at 85 per cent . . . a lot of hard work goes into getting those wait times down.”

McCarter’s report shows the real problem with ER waits doesn’t necessarily start in the emergency department.

A big part of the problem is the lack of in-patient beds, which forces admitted patients to be housed in the emergency departments, the report said.

The lack of in-patient beds is influenced by two things, McCarter found. Beds are being blocked by patients who no longer require hospital care but who are waiting for a long-term care bed and by “less-than optimal practices” by hospitals in managing patient flow to free up space.

“There is no question; the ER is the canary in the coal mine. When something isn’t being properly being managed anywhere in the health system, the problems then show up in the emergency department,” Matthews said, adding that is why the Liberals are expanding homecare initiatives.

Progressive Conservative Leader Tim Hudak said the auditor has been saying for some time that an investment in long-term care beds can help the backlog.

“It makes me sad when I hear about families who have to wait 23 hours with their sons or daughters in an ER room,” Hudak said.

“It is absolutely outrageous when you see the money is there but it has been abused and wasted in scandals . . ..”

Hudak said getting rid of Local Health Integration Networks — 14 bodies across Ontario that direct community-based health care planning — would save the system $250 million. That money could go back into hospital care, he said.

New Democratic Leader Andrea Horwath said Ontario families are forced to play a waiting game for services and even life-saving programs.

“Families are waiting longer in emergency rooms . . . and to get their loved ones into long-term care or see them provided with home-care support,” she told reporters.

Lee called 911 early Saturday morning after her daughter collapsed with breathing problems when she came down the stairs.

Paramedics arrived quickly, but Lee said her daughter waited for about 90 minutes in the emergency room before being treated.

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“This should not be happening in Canada,” Lee told the Star on Monday.

Stephens, an early childhood educator and mother of two sons, did not have any pre-existing breathing problems, said Lee.

Susan deRyk, chief communications officer for William Osler Health System, said the hospital cannot comment on any individual patient case due to patient privacy. “Our sympathies go out to the family,” she said.