Intended for healthcare professionals


Canada sends patients with cancer to United States

BMJ 1999; 318 doi: (Published 05 June 1999) Cite this as: BMJ 1999;318:1507
  1. David Spurgeon
  1. Quebec

    Faced with long waiting lists for cancer treatment, the government of Quebec province, Canada, plans to send patients to the United States at a cost of $US15000 (£9375) each. About 1200 patients are waiting for radiotherapy, 500 in Montreal alone, some for as long as five months.

    Dr Carolyn Freeman, director of the division of radiation oncology at the McGill University health centre, estimates that about 280 patients could seek treatment in nearby Burlington, Vermont, and Portland, Maine.

    As head of a government advisory committee composed of cancer researchers in Montreal, Dr Freeman approves of sending some patients to the United States as part of a short term solution but says that long term planning is essential. The province also needs to buy new equipment and recruit more doctors, including perhaps some from Europe. She says that the government should buy four new linear accelerators, which cost $C2.5m (£1m) each, and other equipment totalling at least $C20m.

    The health minister, Pauline Marois, said that the plan to send patients to the United States would be considered “a valve we would use to ease the pressure if we don't succeed in reducing our lists to have clinically acceptable delays.” She said that the situation was under control in some parts of the province. Government plans include sending patients to areas where waiting lists are shorter, training more oncologists, and extending restricted practice privileges to foreign doctors who are willing to undertake a two year residency in Quebec.

    The opposition Liberal Party health critic blamed the Parti Quebecois government for a crisis of its own making, contributed to by cuts in health funding, forced retirement for doctors, and a cap on entry to medical school.

    The cancer treatment problem is the latest in a series of difficulties experienced by Quebec's health system. Earlier this year, hospital emergency rooms in the province suffered from overcrowding and long waiting lists (27 February, 556).