The B.C. government is trying to shorten surgical waiting lists, and one strategy could use private facilities to manage the backlog.
The health ministry announced this week it is putting an extra $10 million into an effort to reduce surgical waiting lists. The goal is to do 1,000 extra surgeries from June to August, including orthopedics, hernias and cataracts. These are mainly elective procedures where the ministry has promised to improve its performance. The government wants to find operating rooms for patients who have waited more than 40 weeks for surgery.聽
Some of the work will be done in hospitals, and some in private clinics. All will be publicly funded, so patients don鈥檛 have to pay anything.
The problem is that demand for elective surgeries like hip and knee operations keeps climbing. This is a Canada-wide 鈥� indeed international 鈥� challenge that gows as our population ages. 聽
One option is to聽expand the province鈥檚 main surgery wards. That means more money for staff and everything that goes on behind the scenes.
Another way is to contract out some procedures to pivate facilities, as suggested in a policy paper from the Provincial Surgery Executive Committee. According to the paper, allowing patients to stay as long as three days in private surgical facilities would help deal with the backlog. But it would also require changes to the Hospital Act.
This is a significant departure from present practice. It virtually concedes that the public health system cannot manage the challenges that lie聽ahead as our population聽ages. Many聽public health researchers adamantly oppose this聽solution.
Yet admittedly, private surgery is not new. While most publicly funded surgeries are done in hospitals, about one per cent are done in private clinics, all of them day-care procedures. In 2013/14, that was 5,503 procedures out of 541,886 total surgeries.
The decision to use more private surgery facilities puts the province in an uncomfortable position, as it is in the midst of a lawsuit with Dr. Brian Day, a surgeon who runs the private Cambie Surgery Centre. His suit argues that people should be allowed to pay for private care if public wait lists are too long.
Day says that Canada should follow the model used by a few European countries, which have a mixture of public and private health care. The result, he alleges, is shorter wait times and better health outcomes. Many experts also contest that suggestion.
Does the proposal聽to allow overnight stays in private surgical centres mean B.C. is moving closer to his point of view? If so, will British Columbians care, as long as they can get on an operating table more quickly?
The private-surgery route is only one of many options that are up for discussion. The surgery committee is trying to find long-term solutions to the problem. Its policy paper looked at a range of changes that could make a difference.
It is examining ways to improve the booking of surgeries so patients can find the surgeon with the shortest wait time. Training and recruitment of additional surgeons, anesthesiologists and surgical nurses is another focus.
Using a team approach is a possible avenue, in which surgeons would work with a group of nurses and other health-care workers. It could involve what is called 鈥渇irst-available surgeon鈥� referrals. That means a patient would be sent to a surgeon who is free, rather than waiting for a particular doctor.
British Columbians know their health system faces challenges. They need to take a hard look at the possible solutions and understand what those solutions mean for the future.
