We consider the options to reduce wait times based on our experience with cancer services in Ontario, we comment on the promise of private provision versus private insurance in improving access, and we conclude with some of the immediate considerations for cancer services in the light of Chaoulli v. Quebec (Attorney General).1 The rationing of services is intrinsic to all health care systems. [...] The Supreme Court of Canada’s judgment in Chaoulli concerned the latter; excessive waiting was deemed by the majority to be a breach of the Quebec Charter of 1 human rights and freedoms protection of the right to life, and to personal security, inviolability and freedom. [...] The courts in the Cilinger case to date seem to be unwilling to demand that governments be held responsible to ensure the delivery of timely and effective cancer service, but the Supreme 3 Court appears ready to open up the delivery system to private insurance. [...] The Index consists of the results of 25 quality indicators, with expanded reporting of waiting times including cancer assessment, surgery, chemotherapy and radiation treatment.28 Cancer Care Ontario has mandated each of the regional cancer leaders to integrate the annual results of the Index into their planning and quality improvement cycles. [...] A more recent discussion with the leader of the cancer program in the UK suggest progress toward the two week rule is in fact progressing well, driven in part by the huge influx of new capacity and 11 resources for cancer in the UK.32.
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