Most other developed countries have more machines per capita.

OTTAWA - Despite pumping billions of dollars into medicare in recent years to buy such high-tech diagnostic technology as MRI machines, Canada still lags well behind many other Western industrialized countries, a new report shows.

And it says that despite repeated government promises to reduce patient waiting times, they appear to have lengthened rather than getting shorter.

The report, released yesterday by the Canadian Institute for Health Information (CIHI), revealed Canada's supply of the machines per capita ranks below many OECD (Organisation for Economic Co-operation and Development) countries and is even below the median ranking.

A broad range of other countries -- from Spain to Korea to Finland -- has more MRI and CT scanners per million people than does Canada.

The report also reveals that despite promises from federal and provincial governments to solve the problem, waiting times for MRIs appear to have increased nationwide. It says that while definitive and comparable data on waiting times is unavailable, Statistics Canada surveys of patients in 2001 and 2003 are worth noting.

Those surveys suggested Canadians waited, on average, 47 days for non-emergency MRIs in 2003 -- up from 39 days two years earlier.

The results were better for CT scans, with patients waiting an average of 31 days in 2003, compared with 35 days in 2001.

The CIHI reported that while there are more high-tech machines in the health system than a decade ago, the supply of medical imaging professionals available to operate the technology and read the diagnostic results has remained constant.

The new data has prompted a national association of radiologists to warn that unless governments get a handle on the problem, there will be a continuing explosion of private clinics where patients pay out-of-pocket for diagnostic imaging services.

"Obviously, we're not doing the right thing," Normand Laberge, chief executive officer of the Canadian Association of Radiologists, said in an interview. "If they simply add machines, they're shooting themselves in the foot."

Mr. Laberge said governments must embark on a three-pronged strategy: purchase more machines, increase the supply of staff, and just as importantly, use the expensive machines more efficiently.

Otherwise, he said, Canadians will increasingly turn to the private system for faster treatment.

"The private clinics are filling a void that is there. Somebody has to fill the void.... It's totally ridiculous. The real problem is access, it's not the clinic. And if we don't fix the access problem, we'll have, and we already have, a two-tier system. That's the issue for government. If they don't make the decision about two-tier, it will happen anyway," he said.

Indeed, the CIHI report reveals there are a substantial number of private clinics operating in Canada.

Ujjal Dosanjh, the federal Health Minister, has signalled he is disturbed by the growth of the private clinics and is prepared, if necessary, to punish provinces if he determines the Canada Health Act is being violated.

Mr. Dosanjh's senior officials recently sent letters to British Columbia, Quebec, Alberta and Nova Scotia informing them of federal concerns about how private MRI clinics in their provinces are charging fees -- possibly resulting in "queue-jumping" within the health system.

The findings of the CIHI report are bound to call into question whether the public system is keeping up with patient demand.

It found that Canada had 151 MRI scanners at the beginning of 2004, more than four times the number it had a decade ago (40), and up from 144 in 2003. The report also revealed the number of CT scanners had risen during the past decade to 338 from 234.

Among the provinces, Ontario had the most MRI machines with 52, while Prince Edward Island acquired its first MRI scanner in 2003.

Still, the report reveals Canada is not keeping pace with the rest of the world.

Canada ranked 13th among 20 OECD countries that have reported how many MRIs they have per million people. According to the most recent data, Canada had 4.6 MRI scanners per million, while Japan and the United States had the highest number with 35.3 and 19.5 per million respectively. The median was 6.1.

Canada was in 16th place among the 21 OECD countries reporting data on CT scanners, with 10.3 machines per million people. Japan and Korea had the highest number at 92.6 and 30.9 per million, respectively. The median was 13.3.

"With $2.5-billion being spent on equipment [in Canada] over the past few years, we're still a poor country in terms of access to equipment," Mr. Laberge said.