Surgeons blame long wait times for hip and knee replacements on Health Ministry for short-changing London region
Dr. Bob Litchfield, medical director of the Fowler Kennedy Sport Medicine Clinic in London, says Ontario’s Health Ministry is to blame for long waiting lists and cancelled surgeries because it under-funds our region. DEREK RUTTAN / THE LONDON FREE PRESS
People waiting to replace hips or knees in the London region face the longest waits in Ontario because the health minister is short-changing the region, local surgeons say.
Doctors aren’t certain exactly how much less the London region receives, but some suggest the share here is barely half that of central Toronto even though our elderly population is close to 80 per cent as much.
“The bottom line is Southwestern Ontario is underfunded,” said Dr. Robert Litchfield, medical director of the Fowler Kennedy Sport Medicine Clinic in London.
The lack of funding goes beyond joint replacement and is so pervasive, some patients go to Toronto and Litchfield is left booking patients with sports injuries for surgery in 2017.
“There’s really something wrong without us being able to look after our own,” he said.
The ministry wants surgeons to slow the queue of patients so funding doesn’t run out before the end of the budget year. “They want us to trickle patients over 12 months,” he said.
That edict seemed clear this week when the official who oversees health spending in much of Southwestern Ontario fired a salvo at hospitals in Strathroy and Woodstock. Their offence? Speeding through allotted hip and knee replacements so quickly, the operating rooms will go dormant for a couple of months starting in January.
A surgeon at one of the two hospitals says Health Minister Eric Hoskins and the South West Local Health Integration Network (LHIN), the agency that oversees spending in the greater London portion of Southwestern Ontario, prefer patients wait longer for surgery to avoid the bad public relations that comes with empty operating rooms.
“Our job is to get (surgeries) done as soon as possible. Is that not better for patients?” said the doctor, one of a number of surgeons who spoke to The London Free Press but did not want to be named, fearing a backlash from higher-ups.
Forcing patients to wait for major surgery increases the risk they won’t fare well — or even survive — going under the knife, he said.
The doctor said he gives each patient a letter now that places the blame on the ministry and includes phone numbers and e-mails for area MPPs and the regional regulator.
“Your access to care is being compromised . . . Please contact the (regulator) as well as your local (MPP) . . . Don’t take no for an answer,” the letter says.
Todd Stepanuik, chief executive of the Middlesex Hospital Alliance, which includes the Strathroy hospital, defends surgeons for doing operations quickly. “It’s a benefit (to patients),” he said.
The Strathroy hospital has two orthopedic surgeons who could replace more than 400 hips and knees in a year, but the ministry funds 60 hip and 121 knee replacements.
Asked about the concerns of surgeons, the head of the LHIN, Michael Barrett, said each hospital could have flagged those concerns before signing annual funding agreements but none objected to the allotment.
“We’re happy to have that conversation at any time,” he said.
Barrett acknowledged wait times here to replace knees and hips trail provincial targets, but was unsure if they were the longest in Ontario.
While hospitals in Strathroy and Woodstock come under fire, the London Health Sciences Centre has followed the direction of the ministry, periodically slowing the pace of surgery so budgets last until year’s end.
Those slowdowns included a two-week stretch in March when most non-emergency surgeries were cancelled. Back then, a hospital official said the reduction was because surgeons and patients went on vacations. But now, the hospital chief executive says such slowdowns are required in a province where funds are limited.
“Every year we have the same issue,” Murray Glendining said. “At Christmas, we’ll slow down, in March we’ll slow down, in the summer we’ll slow down . . . We always have to manage within the resources we have.”
There are discrepancies in how much the ministry gives to each region, Glendining said, and sometimes London gets shorted while in other areas it benefits.
“I urged greater parity,” he said.
Despite the slowdowns, Glendining says the London hospital is doing five per cent more surgeries now than four or five years ago, though numbers are down for some types of surgeries.
One London patient, who was among the victims of cancelled surgeries, used to work at the hospital herself. Jamie Hooper was a medical laboratory technologist for 27 years. Diagnosed with a neurological condition called trigeminal neuralgia that’s so painful she sometimes falls to her knees, Hooper was designated for surgery in January before her operation became one of 500 postponed by the London hospital.
“I am now at the mercy of both the pain and the medication. The prospect of living like this for months is unimaginable,” she wrote to Glendining.
Jamie Hooper was told her surgery for Trigeminal Neuralgia was being postponed until April due to surgery cutbacks at London Health Sciences Centre. Mike Hensen/The London Free Press
After The Free Press asked the hospital about her surgery, she was told her January operation was back on.
The newspaper sought a response Thursday from Hoskins but a spokesperson said to expect a reply instead on Friday. Earlier in the year, after elective surgery came to a near-halt in London in March, Hoskins was also asked about the concerns of patients and surgeons and replied, “I don’t know the specifics in (London) but I certainly will be looking into that.”
- London area surgeons say Ontario has shorted the region’s funding for surgery, causing lengthy delays.
- London hospitals are pushing back 500 surgeries to balance the books.
- Hospitals in Woodstock and Strathroy used up their allotment for hip and knee replacement months before the end of the budget year.
- Surgical patients say they’re suffering and in limbo.