"The opposite of talking isn't listening," mused American writer Fran Lebowizt.

"The opposite of talking is waiting."

For health care administrators and patients in York Region, there's no shortage of irony in this pithy adage.

Both camps continue to indulge vocally in the former while silently enduring the latter.

As federal and provincial health nabobs mobilize plans, programs and protocols to stabilize funding, improve home and elder care, add services and introduce a pharmaceutical strategy, all in the name of whittling wait lists, York's health system remains Godot-like.

A recent report by the Ontario Association of Radiologists predicts 94 per cent of MRI patients, 89 per cent of CT scan and 72 per cent of ultrasound patients are waiting longer than "medically appropriate".

The report contends 90 per cent of radiologists have seen little or nor progress in reducing waiting lists a year after the Ontario Liberal government was elected to trim medical wait times.

After the First Minister's health summit in September, the provinces agreed to reduce wait times by March 31, 2007 in the areas of cancer, heart, diagnostic imaging, joint replacements and sight restorations.

The current prognosis is still hurry up and wait, advised officials at York's three hospitals. The proviso, it seems, is it's a matter of taking a step back to move two forward.

"It's going to get worse because our population is increasing and demand will follow," Southlake Regional Health Centre president and CEO Dan Carriere said.

"There are a lot of variables that affect wait lists."

Mr. Carriere estimates Southlake patients can wait up to six months for elective surgery and up to a year for some diagnostic imaging.

Cataract surgery has a four to six-month wait list and with only five orthopedic surgeons on board, a new hip or knee can entail a wait up to 12 months. He points out emergency and cancer surgeries continue to be prioritized.

"Diagnostics is over run with demand," he said. "Right now we have 10 functioning operating rooms for elective and emergency surgery and two of them are specific for cardiac procedures. The numbers may drop to eight during our renovations. That's a concern.

The hospital shares one MRI with Markham and Richmond Hill and one catscan. Both are running 16 hours a day. Operating rooms go from 8 a.m. to 4 p.m. and certain ones are open 24 hours, Mr. Carriere said.

"We're at capacity."

With a medical staff of more than 300 and about 500 volunteers handling 17,000 in-patient admissions and 70,000 emergency room visits yearly, Mr. Carriere suggested Southlake is about to turn the corner.

"Our deficit reduction plan is a real success story," he said. The hospital, which has a $180-million budget, entered 2004-05 with a projected deficit of $19 million. Through cost-saving measures, benchmarking exercises and the creation of efficiencies, Mr. Carriere said anticipates the deficit will be less than $3 million. In 2005-06 he's projecting a deficit of less than $4 million.

"Considering the demand and population base, it's pretty remarkable. Everyone has done a great job," he said.

Southlake's proposed strategy to improve services and trim wait times is viable, Mr. Carriere said. With its expansion and the Stronach Regional Cancer Centre scheduled for 2007, infrastructure will be in place to ease demand.

Southlake is also considering a private sector partnership to ease the burden. The concept is known as a surgi-centre, small, efficient medical facilities designed specifically for minor procedures.

"We feel we can take those procedures from our day surgery and move them to an external surgi-centre and free up ORs for more complex procedures," he said. "It would be a bonus in that there are no tax dollars involved and it would be very cost and time effective for us."

Markham Stouffville Hospital may follow suit, said Lorne Zon, senior vice-president.

"There's an opportunity to set up regional cataract programs, for example, where we build special purpose ORs," Mr. Zon said. "They could be in a hospital or free standing. Ophthalmologists could book time to do their surgery and make a huge dent in cataract waiting times. We are looking at opportunities to move more difficult cases to similar locations."

The hospital hasn't got specific wait list statistics because they reside with the individual doctors, Mr. Zon said.

"I don't think the wait lists have come down," he said. "It's status quo. In York, it's something we have to look at with our aging and growing population."

York Central Hospital, still awaiting a promised $80-million phase one redevelopment cheque from the province, is coping and hoping.

"This year we've increased the number of hip surgeries by 31 and the hips by 24," said public affairs director Melina Cormier. "We're submitted a funding proposal to the (Health) ministry to increase procedures. We're hoping for approval by January."

Also without detailed wait lists, York Central continues to receive 65,000 annual emergency patients in a department built to accommodate 25,000.

The hospital introduced a new fast track system in its ER for non-urgent cases, Ms Cormier said, a waiting time reduction of under two hours.

The hospital's shared CT scan, installed this summer, processes 6,500 patients. A second unit, awaiting approval, will add 7,000 more procedures per year, she added.

"Wait lists that were four months will be reduced to one or two," she said. "We hope to have a new MRI unit running in January. That would cut wait times in half."

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DID YOU KNOW?

· 94 per cent of MRI patients wait longer than "medically appropriate", according to the Ontario Association of Radiologists;

· 70,000 people use Southlake's emergency room each year;

· Several operating rooms at Southlake run 24 hours a day.