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Surgery shift: London hospitals say they’re on same page as province

Posted: January 16, 2023

(January 16, 2023)

By: Jennifer Bieman, London Free Press

London hospitals hope the province’s push to do more publicly funded surgeries at community clinics will bolster work they’re already doing to streamline patient flow.

The province Monday unveiled a three-stage plan to increase access to publicly funded surgical and diagnostic procedures by tapping into more community-based clinics – whether private or non-profit – a strategy Doug Ford’s Progressive Conservative government says will help clear pandemic-related backlogs.

The province is starting with community surgical and diagnostic centres in Windsor, Kitchener-Waterloo and Ottawa to add 14,000 OHIP-covered cataract surgeries a year. It’s also looking to cover more MRI and CT scans, colonoscopies and endoscopies, and hip and knee replacements at community surgical centres as the next step.

London has few private surgical suites, but in its hospitals, the push to move uncomplicated, routine and lower-risk surgeries out of fully loaded operating rooms into clinical spaces or surgical suites – in or out of hospitals – is nothing new. St. Joseph’s Health Care London looks forward to working with the Health Ministry to reduce surgical wait lists and is eager for details of Ontario’s plan, its vice-president of patient care said Monday.

“There are a lot of unanswered questions and we need to be sure we’re working together to ensure there are no unintended consequences,” said Karen Perkin, who’s also St. Joseph’s chief nursing exec.

“Our model is already an ambulatory surgical model. We’re very much aligned with what is envisioned by the Ministry of Health.” St. Joseph’s has an ambulatory and short-stay surgical centre and has been performing some surgeries in specialized clinical spaces for some time, Perkin said.

“Our cataract and endoscopy suites are separate, outside of the main operating room,” she said. “We’ve been able to be really focused and specialized and ensure we’re optimized both from a quality… (and) efficiency perspective, getting people through as quickly as possible.”

London Health Sciences Centre opened a centre for low-risk elective surgeries across from Victoria Hospital in March 2020. It’s done more than 4,400 procedures.

“This… centre works within current surgical volumes and has been able to offset much-needed operating room capacity at both… University and Victoria hospital(s),…, ultimately creating efficiencies,” LHSC said in a release.

“(We are) working… with government partners and hospital peers to find innovative ways to improve access to care and surgical capacity.” Dr. Sharad Rai, president of the London District Academy of Medicine, said he’s concerned patients get quality, OHIP-funded health care, whether in a hospital OR, hospital-run off-site surgical suite, or for-profit community facility.

“This is an innovative way of tackling a problem that has been festering for years. I think this is a positive move for Ontario’s patients. We just have to wait and see.”

Ontario has a surgical backlog of about 250,000 procedures, provincial officials have said.

Rai said Ontario needs a comprehensive strategy to attract and retain health-care workers, all the more with private surgical and diagnostic clinics pulling from the pool of existing workers. “These measures need to be properly planned, a framework needs to be in place so these are successful,” said Rai, who’s skeptical of critics ‘claims that proliferating private ambulatory clinics will gut the public health system.

The Ontario Nurses Association, the provincial nurses union, has reported the province needs 24,000 nurses to help address patient care.

Peter Bergmanis, who chairs the London arm of the Ontario Health Coalition, said more doctors, nurses and other staff will shift to private clinics at a time hospitals already face staff shortages, hurting patient care. “It’s the same surgeons, doctors, nurses and technicians the two systems will share.”

“How do we have public dollars for private clinics, but not for hospitals?… It will drain public coffers and that money should be invested in the public system and not given to the private sector.” With files by Norm De Bono, The London Free Press

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