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Northern Health turning to private clinic to reduce wait times

Northern Health has a matter of days to finish its pitch to the province for surgical support after the health minister announced $10 million to reduce wait times.
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Northern Health has a matter of days to finish its pitch to the province for surgical support after the health minister announced $10 million to reduce wait times.

The health authority was already finalizing an agreement with a private clinic to help cut down on long wait times, in particular for cataract surgery which has 575 on the wait list.

That approach is now something the province is pushing for.

"We are maxed out in Prince George in the hospital and have therefore turned to the Prince George Surgery Centre to help with that," said Michael McMillan, chief operating officer for the Northern Interior.

That agreement has been in the works for months, but the first phase of the provincial strategy has planned as many as 1,000 more surgeries from June to August, which could mean dozens more surgeries in the region.

"Part of our conversation will be is there other work we can do? Can we use some of this funding to ramp up the cataract beyond what we had planned to do already," said McMillan.

In the short term the province's focus will be on patients who have waited longer than 40 weeks. Monday's press release noted that health authorities are seeing "unprecedented demand and increasing wait times" despite also increasing the number of surgeries by 33 per cent in the past 12 years.

Surgeries in the north with wait times longer than the 40-week benchmark include abdominal hernia repair, gall bladder removal, stripping varicose veins and knee replacement. McMillan also highlighted orthopedic surgery as a focus.

Prince George is worse off in some areas including ovarian surgery, fracture repair, knee surgery, shoulder surgery, and uterine surgery. The University Hospital of Northern B.C. consistently has longer waitlists compared to its smaller regional counterparts.

In Dawson Creek skin tumour removal and male reproductive surgery both had top wait times of almost 50 weeks.

"We're working hard on our local action plans," said McMillan, adding those should be sent in a matter of days and Northern Health should have a better idea of what the funding will mean for surgery numbers in a couple weeks.

"It came about fairly quickly," said McMillan of the funding.

For the north, it's less a matter of recruiting the right specialists and more about the space.

"I think we've done a good job of attracting surgeons. I would say it's about creating more capacity - actually provide operating time, particularly in Prince George," said McMillan.

The move to use public money spent at private facilities is something other health authorities are doing, said McMillan. Last month, Island Health put out a request for proposals to house a maximum of 20,000 day surgeries over five years and a further 35,000 endoscopies in the south and central island in that same period.

There's no provincial standard rate for using private entities. Last year about one per cent of all publicly-funded procedures happened in facilities like it - or 5,503 out of 541,886 surgeries.

"What happens is health authorities issue a tendering process and ask for contracted services," said McMillan, comparing it to residential care through private providers.

The Prince George Surgery Centre has three operating rooms and a six-bed recovery unit.

The one-time funding will see its second phase roll out in the fall, said the release, which referred to a February 2015 policy paper on improving surgical care in the long-term.

"The policy paper also supports alternative practice models, such as team-based physician practices that share referrals to the first available surgeon, multidisciplinary teams that include physicians, nurses and other allied health care workers, and increased use of contracted surgical services," the Ministry of Health release said.

It recommended permitting stays up to three days in private clinics, which would require changes to the Hospital Act.

Meanwhile the BC Nurses' Union said the capacity should focus on staffing levels, in particular nursing shortages.

"We know that B.C.'s 295 operating rooms often sit empty - especially at night and on weekends - because of a lack of funding," Tuesday's press release said. "Only 82 per cent are regularly staffed. The $10 million should be used to create capacity there first, not to increase profits for private clinics."

What is considered an acceptable wait time varies from surgery to surgery and from speciality to specialty, McMillan said. Cancer, for example, has a very short window.

"There's this constant striving for improving our performance against waitlist targets," said McMillan, noting the province used to aim for 52 weeks as a benchmark.

"We're working hard to understand where we can create some additional capacity and what that capacity can do in terms of reducing the long wait times for some people."

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