A White Rock orthopedic surgeon is hoping public awareness can help break a “stalemate” on efforts aimed at tackling wait lists.
Dr. Arno Smit put out the call in frustration over news in February that the Fraser Health Authority had missed out on $2.6 million in incentive funding after failing to meet provincially mandated wait times for knee and cataract surgery in 2010-’11.
“They could probably have done… about 2,000 procedures for that money,” Smit said.
“That money’s gone.”
The payments – made through the health ministry’s patient-focused funding branch – reward health authorities that meet targets to keep waits down and punishes them if they don’t, instead using the money to reduce the deficit.
The rules require that no more than 10 per cent of patients wait longer than 26 weeks for knee and hip surgery, and no more than 16 weeks for cataract surgery, in order for each authority to qualify for activity-based funding in each of those categories.
Because 19 per cent of patients waited longer than 26 weeks for a knee replacement in the Fraser Health region in the 2010 fiscal year, the authority lost nearly $1.8 million. It was docked another $834,000 because 39 per cent of cataract patients waited longer than 16 weeks.
In announcing the patient-focused funding model in 2010, then-health services minister Kevin Falcon said pilot projects demonstrated it resulted in better management of resources and dollars by hospitals and health authorities, and more timely care for patients.
While the situation has since improved for hip and knee replacement waits, Smith noted, many orthopedic procedures have fallen behind and could have benefited from the lost funding.
Flanked by stacks of files representing patients of his who have been waiting more than a year for non-cosmetic, medically necessary surgery “with no surgery date in sight,” Smit said Fraser Health has the capacity to do better, but suffers from an increasing focus on administration, and has trouble making decisions.
Smit said discussions began four months ago on giving a team of Peace Arch Hospital staff use of under-utilized space at the Jim Pattison Outpatient Care and Surgery Centre to help tackle the work load, but “there has been no progress to date.”
But Fraser Health spokesperson Angela Wilson said late last month that officials with the surgical program have no record of a request from Smit for operating-room time.
“ORs at the Jim Pattison Outpatient Care and Surgery Centre are fully allotted and because the outpatient centre is in its first year of operation, the priority is to accommodate the transfer of procedures from Surrey Memorial Hospital,” Wilson said. “We welcome physicians from across the region to apply for privileges at the outpatient centre, but the surgery program does not have a record of a request from Dr. Smit.”
Smit disputes this.
“I respectfully submit that you were given the runaround on the Pattison pavilion,” Smit said.
Smit said he and fellow physicians – Peter Skepasts and Bob Friesen – were told by director of surgical services Linda Lemke that no space could be made available for PAH, even if the hospital provided the necessary staff.
“Quoted reasons reflect institutional intransigence,” Smit said, noting nursing staff have told him that on any given day, 50 per cent or less of the outpatient centre’s ORs are used.
A review of Smit’s patient files shows 64 have been waiting at least two years for procedures to alleviate painful shoulders, feet and knees. Of those, three have been on the list for more than three years.
Smit has another 90 patients who have been waiting more than a year for surgery.
“I have a whole bunch of people waiting two years… some waiting over three years,” he said. “I think that’s outrageous. It can’t get any worse than that.”