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Island hospitals struggle to deal with backlogs

The wait is NOT over

There is a great deal of variation in the waiting times for surgical procedures faced by patients across Vancouver Island.

Depending on the procedure, available space and the number of specialists in the hospital where it is to be performed, patients from the Island can wait just a few weeks to more than a year. And different procedures can happen faster, or slower, depending upon which community your surgery is scheduled.

For example, according to latest statistics from Island Health, most people waiting for hip replacement surgery at Nanaimo Regional General Hospital can expect to wait up to 63 weeks from the original referral from their doctor. Most patients waiting for the same surgery at St. Joseph’s General Hospital in Comox can wait up to 51.2 weeks.

Wait times for a breast mastectomy at NRGH can be up to just four weeks, while it’s up to eight weeks at St. Joseph’s General Hospital.

The Fraser Institute’s 2014 edition of Waiting Your Turn, which catalogues waiting times for medical procedures across the country, indicates that the waiting times are getting longer everywhere.

According to the report, specialist physicians surveyed across the 10 provinces and 12 specialties reported an average waiting time of 18.2 weeks between referral from a general practitioner to the medical procedure.

This wait time is 96 per cent higher than in 1993 when it was just 9.3 weeks.

In B.C., the average wait from referral by a general practitioner to treatment was  21.1 weeks in 2014, up dramatically from 10.4 weeks in 1993.

Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences: “Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish,” the report states.

“In certain instances, they can also result in poorer medical outcomes, transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities.”

The issue is one this reporter is not unfamiliar with.

Last year, my walking turned into a stumbling gait and after a visit to my doctor, it was determined that both hips were in such a state of deterioration that they needed to be replaced as soon as possible.

Of course, as soon as possible meant as soon as a specialist was available for the surgery and space could be found for me in a hospital.

It took 36 weeks from the diagnosis before I was finally put under the knife, and those weeks were some of the toughest and most painful of my life.

As my surgery was considered a special case because it required the unusual decision to replace both hips at the same time, the procedure was done at the hospital at the University of B.C. in Vancouver where some of the best hip specialists in the province are located.

As well, because of the increasing serious of my condition, I was put on the fast-track for the surgery and had it completed in about half the wait time it would have taken if it was done at NRGH. But most in similar situations have to just wait it out for a lot longer in anticipation for the call from the health authorities giving them their surgery dates.

The provincial government announced in June that it will pump $10 million into the province’s health care system to help some of the patients languishing on surgery wait lists get treatment sooner.

Health Minister Terry Lake said at the time that people who have already been waiting more than 10 months will be given priority when the funding kicks in.

But Lake said the one-time funding is only designed as a short-term solution to B.C.’s long wait lists.

He said his ministry has tasked the Provincial Surgery Executive Committee with coming up with a long-term plan to deal with the issue.

Alison Dormuth, director of surgical services for Island Health, acknowledged that the waiting lists are getting longer for many surgeries and other medical procedures on the Island, despite the small cash infusion from the government this summer.

She said there are different demands for surgical services on Vancouver Island, but much of the increased demand is connected with the growing population of seniors who are moving here.

“There’s no doubt that medical conditions related to aging, like the need for orthopedic joint replacements and cataract operations, continue to grow,” Dormuth said.

“There’s not a lot health authorities can do to provide more specialists to help deal with the wait lists.

“It’s really up to the Ministry of Health to address this issue by working with medical schools to try to fill these demands, among other initiatives.”

 

Dormuth said there are a number of ongoing advances in medical technology that are helping to deal with some of the wait lists.

She said, for example, that cataract surgery used to take more than hour and the patient would be required to spend several days in hospital.

“Now the procedure takes 20 minutes and most patients are sent home on the same day,” Dormuth said.

“That has certainly helped lessen the wait time for those surgeries.”

As for patients being transferred

to other hospitals that have shorter wait times for their required procedures, Dormuth said special referrals can be made by a patient’s family doctor.

She said those referrals are often related to the seriousness of the medical condition and the availability of other hospitals and specialists to do the procedure sooner.

But, Dormuth said, priority is always placed on those whose conditions are considered life threatening.

“In a lot of cases, it’s up to the individual patients who know their own conditions best to encourage their family doctors to explore other options,” she said.

Valerie Wilson, a spokeswoman for Island Health, said simpler medical procedures, like x-rays and blood samples, are usually done the same day in the community where they are required.

She said they are usually done either at the local hospitals or at private labs and centres that Island Health contracts work out to.

 

How the wait lists of Vancouver Island communities compare

Estimated maximum wait times for various surgical procedures in hospitals where they are available on Vancouver Island:

 

Hip replacement

•  Nanaimo Regional General Hospital (62.9 weeks.)

•  Campbell River & District Regional Hospital (61.4 weeks.)

•   St. Joseph’s General Hospital in Comox (51.2 weeks.)

•  Cowichan District Regional Hospital (59.9 weeks)

•  Greater Victoria’s hospitals (58.1 weeks)

 

Knee replacement

•  NRGH (64 weeks.)

•  St. Joseph’s General Hospital (56.8 weeks)

• Campbell River & District Regional Hospital (72.8 weeks.)

• Cowichan District Regional Hospital. (60.1 weeks.)

• Greater Victoria hospitals (58.9 weeks.)

 

Cataract surgery

• NRGH (43.7 weeks.)

• Cowichan District Regional Hospital (14.6 weeks)

• St. Joseph’s General Hospital (30.7 weeks.)

• Greater Victoria hospitals (40 weeks.)

 

Breast mastectomy

• NRGH  (four weeks)

• Campbell River & District Regional Hospital. (3.1 weeks.)

•  St. Joseph’s General Hospital (eight weeks).

•  Cowichan District Regional Hospital (4.1 weeks.)

• West Coast General Hospital (3.4 weeks.)

•  Greater Victoria hospitals (7.4 weeks.)

 

Kidney stone removal

• NRGH (three weeks.)

• St. Joseph’s General Hospital (10.7 weeks.)

• Cowichan District Regional Hospital (3.8 weeks.)

• West Coast General Hospital (8.6 weeks.)

• Greater Victoria hospitals. (12.2 weeks.)

 

Robert Barron

Black Press