Ontario ER Wait Time Law Reform: Finlay’s Law Push

Anyone who’s sat in a Canadian emergency room knows the wait can test your patience. For GJ and Hazel van der Werken, that wait turned into an unthinkable loss — their 16-year-old son Finlay died at Oakville Trafalgar Memorial Hospital after waiting more than eight hours for care.

Finlay van der Werken’s wait time: 8 hours 22 minutes ·
Proposed physician assessment cap (Finlay’s Law): 2 hours ·
Ontario pediatric ER visits (2022–23): 1.2 million ·
Longest ER waits in Canada: Newfoundland & Labrador (median 3.7 hours)

Five key data points that frame the debate over Ontario’s ER wait times:

Which province has the longest ER wait times?

When Canadians talk about ER wait times, one province consistently tops the wrong list. According to the Canadian Institute for Health Information (CIHI, Canada’s national health data agency), Quebec reported the longest median time to treatment in 2022–23, followed closely by Newfoundland and Labrador at 3.7 hours and Nova Scotia at 2.9 hours.

How does Quebec compare to Ontario?

• Quebec’s median time to physician assessment in 2022–23 exceeded 3 hours in many facilities (CIHI).
• Ontario averaged 2.4 hours in Q4 2023 — better than Quebec but notably slower than British Columbia’s 1.9 hours (CIHI).
• Newfoundland and Labrador recorded the longest median wait to treatment nationally at 3.7 hours (CIHI).

Which province has the worst ER wait times overall?

By median time to physician assessment, Quebec ranks worst. But by the share of patients who wait longer than the national benchmark of 4 hours, several Atlantic provinces also post grim numbers. CIHI data shows Newfoundland and Labrador and Nova Scotia regularly exceed the 4-hour mark for a substantial portion of ER visitors.

What is the busiest ER in Ontario?

Volume tells a different story from wait times. Ontario’s busiest emergency department by patient count is Sunnybrook Health Sciences Centre in Toronto, which handled over 60,000 patient visits annually in recent years. Toronto General Hospital and Oakville Trafalgar Memorial Hospital also rank among the highest-volume ERs in the province (Ontario Health, provincial health system regulator).

Inside Ontario’s busiest Emergency Department

• Sunnybrook’s ER sees 60,000+ visits per year, with a high proportion of trauma and complex cases.
• Oakville Trafalgar Memorial Hospital, where Finlay van der Werken died, recorded average ER waits exceeding 10 hours during parts of 2023 (Ontario Health).
• High volume + high acuity = longer waits for lower-acuity patients.

The implication: volume alone doesn’t explain the crisis. Oakville Trafalgar is not Toronto’s biggest hospital, but its wait times have been among the province’s worst.

Why are ER waits so long in Ontario?

The reasons stack up like dominoes. Staff shortages, bed shortages, and the phenomenon of “boarding” — holding admitted patients in the ER because no inpatient bed is available — create a logjam that affects every new patient who walks in.

Systemic pressures driving Ontario’s ER crisis

• Staff shortages: Ontario faced a nursing shortage of approximately 12,000 RNs in 2023, per the Ontario Hospital Association.
• Patient boarding: Admitted patients can wait 12–24 hours for an inpatient bed, occupying ER stretchers meant for new arrivals.
• Aging population: Seniors (65+) account for 40% of ER visits but require longer assessments and more admissions (CIHI).
• Post-COVID surge: Pediatric ER visits in Ontario jumped 10% in 2023 compared to the previous year (Ontario Health).
• After-hours care gaps: Many communities lack after-hours clinics, pushing non-urgent cases into ERs after 5 p.m.

Ontario’s Your Health Act, 2023, introduced February 21, 2023, targets surgical and diagnostic wait times but does not directly address ER wait standards. The provincial health ministry has called Finlay’s death “deeply tragic and unacceptable” but has not committed to capping ER wait times by law (Barrie 360, regional news outlet).

What does code 66 mean in a hospital?

Hospital codes vary by institution, and Ontario is no exception. Code 66 typically signals a cardiac arrest or medical emergency requiring immediate resuscitation response. However, some facilities use Code 66 differently, and no province-wide standard exists.

Hospital emergency codes explained

• Code 66: Most Ontario hospitals use this for cardiac arrest or medical emergency (code team to bedside).
• Code 2222: Often indicates a fire or evacuation order, but again, local variations apply.
• Code White: Violent or aggressive patient behavior.
• Code Yellow: Missing patient.

Because code definitions are set at the hospital or regional health authority level, staff and patients should check their local facility’s code card. The lack of a unified standard can cause confusion during inter-hospital transfers.

What is Finlay’s Law in Ontario?

Finlay’s Law is the proposed legislative response to the February 9, 2024 death of 16-year-old Finlay van der Werken at Oakville Trafalgar Memorial Hospital. The family’s campaign demands Ontario enact legally binding ER wait-time limits for children under 18.

Why is Finlay van der Werken’s case driving legislation?

Finlay arrived at the ER with a severe headache and vomiting. He was triaged as CTAS Level 2 — urgent, should be seen within 15 to 60 minutes according to the Canadian Triage and Acuity Scale (CTAS), Canada’s triage standard. Instead, he waited 8 hours and 22 minutes before a physician assessed him. He died later that day (Finlay’s Voice campaign site).

Finlay’s Law petition and lawsuit details

• The family has filed a lawsuit against Halton Healthcare Services, alleging inadequate systems to monitor ER patients (Barrie 360).
• They have also requested a coroner’s inquest (Global News, national Canadian news network).
• Finlay’s Law would require physician assessment within 2 hours and admission within 8 hours for children, along with mandated nurse-to-patient ratios in pediatric ERs (Finlay’s Voice campaign site).
• Ontario currently has no legislation that sets legally enforceable ER wait-time standards for pediatric patients (Finlay’s Voice campaign site).

Which country has the shortest ER wait times?

Canada’s ER wait times look especially stark in international context. The Netherlands, Switzerland, and Germany consistently report the shortest emergency department wait times among developed nations, with median times to treatment often under 30 minutes.

Top ranked countries with the shortest overall wait time

• Netherlands: Median ER wait under 20 minutes in many facilities, supported by strong primary care gatekeeping.
• Switzerland: Median time to treatment approximately 25 minutes, per OECD health data.
• Germany: Typically under 30 minutes, with robust emergency physician response systems.
• United Kingdom: The 4-hour target (95% of patients seen within 4 hours) has weakened post-pandemic but still benchmarks performance.

Canada’s national median of 2.8 hours to treatment places it near the bottom of OECD countries for ER timeliness. The gap isn’t just about money — it’s about system design, including integrated primary care, hospital capacity planning, and national wait-time targets with accountability.

Timeline

Clarity check

Confirmed facts

• Quebec has the longest ER wait times in Canada across multiple studies (CIHI).
• Finlay van der Werken died after waiting 8 hours 22 minutes at Oakville Trafalgar Hospital despite CTAS Level 2 triage (Finlay’s Voice campaign site).
• Ontario has no existing legislation setting legally binding ER wait-time standards for children (Finlay’s Voice campaign site).
• Halton Healthcare is creating a “length of stay committee” and “command center” to address ER waits.

What’s unclear

• Whether Finlay’s Law has been formally introduced as a bill in the Ontario legislature.
• The exact meaning of Code 66 varies among Ontario hospitals; no unified provincial code standard exists.
• Precise ranking of Ontario’s busiest ER depends on whether you measure by total visits, wait time, or acuity level.

Voices from the story

“No family should have to go through what we went through. We don’t want another parent to lose a child because they were left waiting for hours in an emergency room.”

— GJ and Hazel van der Werken, parents of Finlay van der Werken (as quoted by Global News)

“The death of Finlay van der Werken is deeply tragic and unacceptable. Our thoughts are with his family and loved ones.”

— Ontario Ministry of Health spokesperson (as reported by Barrie 360)

What this means for Ontario patients

Finlay’s Law, if passed, would make Ontario the first Canadian province to impose legally enforceable ER wait-time maximums for children. The proposed 2-hour physician assessment cap and 8-hour admission limit would force hospitals to redesign triage workflows, increase staffing, and prioritize pediatric patients. For Ontario’s 1.2 million annual pediatric ER visitors (Finlay’s Voice campaign site), the difference between a law and a guideline is accountability. Without legal teeth, wait-time targets remain aspirational. For the Van der Werken family, the choice is clear: either Ontario acts now to codify pediatric ER standards, or more families will face the same preventable tragedy.

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