Ortho surgery wait list crippling

By David Carrigg-Staff writer

The B.C. Orthopedic Association has joined a push for private health care by suggesting people with money be able to jump the queue for orthopedic surgeries, to reduce the waiting list for people who can't afford to pay.

Association president Dr. Ken Hughes said underfunding of hip and knee replacement surgeries in the public health system has created the longest waiting list for any surgery in the province.

It now takes about nine months for a patient to see an orthopedic surgeon after a general practitioner's referral, then another year to 18 months before they can be operated on. The waiting list for orthopedic surgery in B.C. is 9,000 and growing.
"It's not for want of orthopedic surgeons, it's for want of resources," Hughes said.
Each year, the province tells hospitals how many surgeries they can do. In the case of knee or hip replacements, the surgeon is paid about $680 by the Medical Services Plan and the hospital is given about $6,000 to pay for the new joint and operating room time.

Dr. Hughes said there are times when surgeons can't operate because of hospital understaffing. The problem is only expected to get worse as the number of people requiring orthopedic surgery increases with the aging population.

"If we have 100 people on the wait list and 25 per cent can purchase early access or have private health insurance, then we can capture some of that money and put it to reducing the public waitlist. It's queue jumping, but if that allows the public list to decrease, then I don't see the down side," said Hughes.

Carolyn Darbyshire says her general practitioner identified osteoarthritis, a chronic, painful disease resulting from deterioration of cartilage in joints, in her lower back and right hip in January and she's been waiting ever since to see an orthopedic surgeon.
She says she would pay to get ahead of the queue because she's desperate. "I don't want favouritism but at the same time, you get to a desperate stage-you can't wait any longer," said the 60-year-old, who works at St. Joseph's Hospital overseeing a program helping elderly and disabled people avoid injury at home.

Darbyshire wants to work until she's 65, but can only just walk now and fears her condition will worsen to the point her bones will deteriorate, making the surgery more difficult and affecting her recovery time.

The Canada Health Act forbids queue-jumping, except for those with extended health insurance plans, such as unionized employees, and motor vehicle accident and Worker's Compensation Board claimants.

However, Hughes said the act is already being challenged in Vancouver by two specialist clinics that allow patients to pay up front for a consultation. The two clinics are able to get around the Canada Health Act because it only governs specialist consultations with a general practitioner's referral.

Some minor private surgeries, where the patient goes home at night, are already being performed at the False Creek Surgical Centre.

The idea of paying customers subsidizing the public system has also been successfully tested at St. Paul's' Hospital, where patients can pay $1,000 for a CAT scan without a doctor's referral. The money has been used to pay for another technician, so the waiting list for free CAT scans has dropped from five months to one.
The Vancouver Coastal Health Authority is currently reviewing surgical services and staffing and will consider ways to shorten the surgery waiting list in the New Year.
The province's health care unions oppose any privatization of the health care system and launched a billboard advertising campaign last week urging people not to support privatization.

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