Timely access to health services is an expectation of consumers in every developed country and is the topic examined in this issue of Longwoods Review - our focus on policy. Authors Baker and Schwartz discuss the issue of waiting times for cancer services in Ontario. They indicate that as the population ages there is increasing demand for services so there is a need for a system of queuing or prioritizing those in need of services using formal criteria. The problem is particularly challenging for cancer services where patients are sick and anxious to receive appropriate treatment as soon as possible.

The purpose of this paper is to describe the Ontario situation and to examine the experience of other countries in dealing with the same problem. Baker and Schwartz describe three approaches to waiting lists: measure and monitor them; improve or expand the services; and system redesign to improve coordination of services. They suggest three critical steps in dealing with waiting list problems: (1) engage experts who have had experience in solving this type of problem; (2) find local champions who are willing to participate; and (3) carry out pilot work to test solutions.

Commentators on the Baker and Schwartz paper are Glynn who describes the approaches used in Saskatchewan and Nova Scotia, and Lewis who provides insights from New Zealand. Lewis concludes: "… in a just and well-ordered system, all waits should be insignificantly long." Food for thought.

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