Calling for the government to act to clear the massive backlog of surgeries and diagnostic procedures

 This week I was active in calling on the provincial government to implement a plan to address the very large backlog of surgeries and diagnostic procedures. 

On Tuesday October 5, we issued a call on the government to deliver the plan to address the crisis - our press release is below:

Manitoba Must Act Now To Start Clearing Massive Backlog of Tests and Surgeries

Treaty 1 Territory, Métis Homeland, Winnipeg, MB - Manitoba Liberal MLAs say the PCs need to immediately get to work with doctors and other health care professionals to come up with a plan for clearing the province’s massive backlog of medical procedures.

Wait times for hip and knee replacements and cataract surgery were all getting steadily worse while the PCs cut and froze Manitoba’s health care system, then lists exploded during the pandemic as procedures were cancelled and personnel moved to fighting Covid.

Manitoba Liberal Health Critic Dr. Jon Gerrard said it is routine to hear of people waiting more than a year for hip or knee replacement surgery, adults having to wait more than a year for cataract surgery, and children having to wait two and a half years for an ophthalmology consultation.

There are also extra-long waits for cardiac surgery and for many other diagnostic procedures as well as many other surgeries. In June, Doctors Manitoba warned that the backlog was over 110,000 procedures.

Manitoba Liberal MLAs say Manitoba must act now to address the backlog, by:

-          Lifting the cap which puts artificial limits on the number hip and knee replacements and cataract surgeries per year, and allow surgeons and their teams to do more procedures

-          Rebuild and reinvest in the public system with a focus on long-term retention of physicians, nurse and staff

-          Define wait times realistically, as being from “diagnosis to treatment” – and not as the Manitoba’s health system often currently measures it - from a scheduling a procedure to getting one
“There are tens of thousands of Manitobans who are stuck suffering on waiting lists when, with treatment, they could be walking, seeing and working,” said Dr. Jon Gerrard, Manitoba Liberal Health Critic. 

Gerrard said there needs to be a particular focus on rebuilding eye care in Manitoba. Current waitlists for cataracts and other eye procedures are enormously backlogged, and there is a shortage of doctors and facilities – despite the “Centre of Excellence” at the Misericordia Hospital.

The Manitoba Liberals said waitlists for pediatric eye treatments are so long that children of 5 may wait half their lives before getting treatment. By that point, the part of the child’s brain dedicated to processing vision may never develop, even if surgery is successful.

Manitoba Liberal Leader Dougald Lamont said only investment in the public health care system will work.

“We can’t let the PCs use the excuse that because they broke the public health system, that it can’t be fixed. This practical reality is that so few people can afford private treatment that it won’t make a difference in wait lists. Rebuilding the public system is the only way to clear the backlog, and it needs to start now. Investing in making Manitobans healthier always pays off.”

A 2020 Conference Board of Canada report on eye care showed that, “The economic benefits of preserving vision far outweigh the costs of ophthalmic interventions… In 2007, the cost of vision loss in Canada was estimated at $15.8 billion and is projected to grow to $30.3 billion by 2032.”

Wednesday October 6:  I asked for action in Question Period.  Sadly the Minister of Health did not even try to answer the questions I asked. 

Surgery Backlogs - Request to Address

Hon. Jon Gerrard (River Heights): Madam Speaker, under this gov­ern­ment, tens of thousands of Manitobans are waiting and suffering in pain or with poor eyesight because of massive surgical backlogs. For more than a year the gov­ern­ment has known that there would be backlogs and yet we still have not been shown the plan to address them.

      Instead, the gov­ern­ment is ensnarled in a leadership race and is missing in action when it comes to critical issues which are needed for Manitobans.

      Why has the gov­ern­ment abandoned tens of thousands of suffering Manitobans?

Hon. Audrey Gordon (Minister of Health and Seniors Care): Madam Speaker, today I rise in the Chamber for the first time as the Minister of Health and Seniors Care, in addition to my existing role as the Minister of Mental Health, Wellness and Recovery. I want to thank the Premier (Mr. Goertzen) for this op­por­tun­ity to serve Manitoba as we enter the fourth wave.

      I also want to say thank you to our doctors, nurses, health-care aides, paramedics, EMS workers and countless other health-care pro­fes­sionals. 'Manitobas' are grateful for your heroic efforts.

      Today, Madam Speaker, is a sig­ni­fi­cant milestone in our vac­cina­tion campaign. Manitoba's administered 2 million doses. 

Wednesday October 6, I asked in Estimates about the measurement of wait times.  Often government reported wait times are much shorter than wait times experienced by patients.  As Minister Gordon explains, the surgical procedure must be booked before they start counting the wait time.  Often, there are delays between the time the surgeon asks for time and when the time is allocated (booked), so that the government reported wait times are artificially much shorter than the real wait time is.  The difference, in some instances, can be great so that government reported wait times can be very misleading.  

Hon. Jon Gerrard (River Heights): Thank you, Madam Minister. There often seems to be dis­crepancies between what patients are reporting and what, in the case–indeed, physicians are reporting and what the gov­ern­ment reports in terms of wait times.

      So what is it that starts the clock in terms of the gov­ern­ment-reported wait times? Does this start when the schedule–the surgery is actually scheduled or when the diagnosis happens, or when the individual first sees a specialist and the specialist says that I'm going to do the surgery?

Ms. Gordon: I thank the member for River Heights for the question, and we do have this infor­ma­tion available on our public-facing website for the de­part­ment, and I'm pleased to share what is available in terms of the question when does a wait time start and end.

      And so, historically, the starting point for wait times does vary but all provinces and territories have agreed that the measurement of wait time should start when the physician

determines that the patient is medically ready and the patient consents to treatment as indicated by the booking of the service. And the wait time ends when the patient receives the service.

      And that infor­ma­tion is trans­par­ent and available, as I said before, on our public-facing website. [I looked on the public web site and it was not clear there that the start of the wait time is when the procedure is booked on the OR slate. ]

Thursday October 7: I spoke on a resolution in the Legislature: My speech is below:

Speech Thursday October 7 on a resolution to address the surgery backlogs

 

Hon. Jon Gerrard (River Heights): Mr. Deputy Speaker, we have a very serious issue which we are discussing today. I think everybody realizes that, sadly, we have Conservative and NDP MLAs taking shots at each other rather than provi­ding solutions and ideas that can be used and helpful in having a plan, because we clearly need a plan from where we are now to where we need to go that is delivered by this gov­ern­ment.

      The question is, why has it not already been delivered? We knew by April of last year that there would be a big backlog. There was a year and a half to develop and put forward that plan. Where is it? This gov­ern­ment is abandoning what it should be doing and it's going after a leadership race and focusing on that rather than looking after the health-care needs of Manitobans.

      It is true that there were long wait times at the end of the previous NDP gov­ern­ment. It's true that those extended into areas like eye care. It's true that there were still very long wait times in the year before the pandemic in 2019 for eye care and for eye surgeries. And it is true today that the backlogs have made that situation far, far worse.

      There needs to be a clear plan to address these. It is not there. Putting out $50 million is not enough. The calculations that I hear in terms of just eye surgeries is that you probably need about $38 million in order to address those properly. So $50 million is not going to be enough to cover the whole problem. We need to have it addressed properly and with proper funding.

      There are a number of measures that should be taken. No. 1 is to take off the cap of the number of surgeries like eye surgeries and hip and knee surgeries. This puts artificial limits on the number of surgeries, hip and knee re­place­ments and cataract and other eye surgeries which can be done. Removing the cap will alleviate some of the problems, and as the study by the Conference Board of Canada has shown, in fact, it will save money and it will save more than $200 million each year for Manitoba to have eye care looked after properly, and that is some­thing which the gov­ern­ment needs to realize. They haven't learned how to save money when they look after health care. Sometimes you have to spend it and do it vigorously in order to make sure that you are saving the dollars that can be saved.

      Second, we need to reinvest and rebuild the public health system and with a parti­cular focus on staffing of physicians, nurses and allied health staff. This is clearly a very im­por­tant area.

      Third, we need to define wait times realistically from diagnosis to treatment, not as–I understand from the minister yesterday, from when the surgery is actually booked to when the procedure is done because there is a wait time to see a specialist. There is a wait time very often, sometimes even months before the specialist can actually book the surgery, and so the way we're recording wait times at the moment is not very helpful because it doesn't reflect the reality of what Manitobans are going through.

      The fact is that there are tens of thousands of Manitobans who are stuck suffering on waiting lists. On surgical waiting lists it's said to be about 38,000 and many more in diag­nos­tic tests, often these are essential in order to get access to surgery.

      Where is this gov­ern­ment? They have had a year and a half to bring forward a plan. They've not done so. They've abandoned their respon­si­bility. They've left tens of thousands of Manitoba suffering in pain, in lurch because they haven't done their job. They could be doing their job; they could be doing this effectively and they could be saving health-care dollars at the same time.

      There really is a clear answer to this: there must be a plan; this gov­ern­ment needs to present it. I'm actually quite disappointed that the Health Minister wasn't here today–wasn't speaking today in order to outline her plan. I don't know whether that means she doesn't have a plan, but whatever the situation is we should have had a much clearer plan than we have had presented.

      It should provide the approach in each of the different surgical areas because they're all different and need individual approaches, and eye care is certainly one of the most im­por­tant. It is, I understand, some­thing like the fourth largest specialty across the board. It is a very im­por­tant one, but it has been, sadly, far too much neglected in recent years, and much more attention needs to be paid to eye care.