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Patients languish on wait lists while ORs sit empty, Ontario Health Coalition claims

Posted: November 24, 2023

(November 23, 2023)

By: Joanna Frketich, The Hamilton Spectator

The Ontario Health Coalition says the majority of Hamilton’s operating rooms (OR) are not used on evenings or weekends.

The advocacy group claims Hamilton Health Sciences (HHS) has at least two ORs that have been permanently shut down and that other operating rooms sometimes close when there isn’t enough staff.

“In Hamilton, there’s so much unused operating-room capacity while patients are languishing on wait lists,” said Natalie Mehra, executive director of the Ontario Health Coalition. “It’s not being used because they don’t have the staffing and the funding to run them.”

The coalition is calling on the province, in a report released Nov. 2, to expand the use of operating rooms in public hospitals instead of increasing the number of surgeries done privately but paid for by OHIP. In May, the Progressive Conservative government passed Bill 60, which allows more surgical and diagnostic procedures to be offered at private clinics.

“There’s no reason whatsoever to pay to rebuild or expand operating rooms in private clinics,” said Mehra. “There is tons of unused operating room capacity in the local public hospitals that we have all paid to build over decades. They’re sitting there.”

HHS did not answer questions about whether it has shutdown operating rooms or provide how many ORs run on evenings and weekends.

The hospital network has 14 functioning operating rooms at Hamilton General and is restoring a pre-existing OR to bring that number up to 15. There are also nine operating rooms at Juravinski Hospital, two at Grimsby’s West Lincoln Memorial Hospital, and eight at McMaster Children’s Hospital and McMaster University Medical Centre.

HHS has struggled to get the number of surgeries back to what it was before COVID — it is currently at 90 per cent of its pre-pandemic surgical volume and doesn’t expect to reach 100 per cent until spring.

“This activity can vary on a daily/weekly basis in response to the availability of physicians and staff, and the availability of inpatient beds,” the hospital network said in a statement. “Increasing surgical activity is a key priority.”

A major barrier has been unprecedented staff shortages. HHS had 2,333 job openings in July, including 731 for nurses — this includes permanent, temporary, casual, full-time and part-time jobs.

Surgery has been hit particular hard with an acute shortage of perfusionists, who operate heart-and-lung machines. HHS also created a controversial unregulated job in 2021 to assist in operating rooms because the hospital network didn’t have enough specialized surgical nurses.

It has recently recruited 10 anesthesiologists, who will start in the upcoming months, but HHS still needs nurses, perfusionists and other critical perioperative staff.

The coalition fears these shortages will only get worse as the number of private procedures expand — despite the Conservative government saying the bill has safeguards to prevent an exodus of staff from hospitals.

“People think the private clinics are an add-on. But they are, in fact, a take-away because there’s only one set of staff,” said Mehra. “They take the staff out of the public hospitals.”

Another major issue is funding, as both St. Joseph’s Healthcare and Joseph Brant Hospital (JBH) are doing more surgeries than the province pays them to do.

JBH is 12 per cent above its provincially funded surgical activity.

“We are working with the province on funding,” the Burlington hospital said in a statement. “We will continue to explore opportunities and find new ways to increase access to health care for our patients and community and reduce wait times.”

Joseph Brant has nine operating rooms — one is used on evening and weekends. There is potential for a 10th OR that has not been fully built.

“At the time of redevelopment of the hospital in 2018, JBH built shelled-in space for the purposes of a future 10th OR,” stated the hospital. “This shelled in space has not been fitted out and is not in service today as a functioning OR.”

St. Joseph’s is performing six per cent more surgeries than it gets funding to do. It has 20 operating rooms — four at the King Campus and 20 at the Charlton campus, including four dormant ORs that the province recently paid to refurbish. The newly opened operating rooms are not just used by St. Joseph’s surgeons, but also by doctors from across Hamilton, Niagara, Burlington, Brant and Haldimand.

“This approach is highly innovative and allows for surgeons to provide surgical care at St. Joe’s, thereby reducing the overall wait lists in the entire region,” stated the hospital network.

St. Joseph’s also didn’t answer questions about how many ORs run on evenings and weekends.

“St. Joe’s physicians and staff understand the stress and burden patients are facing given COVID-19 pandemic-related surgical delays,” St. Joseph’s said in a statement. “They have been working diligently to address the significant backlog.”

A spokesperson for Health Minister Sylvia Jones says the expansion to OHIP covered procedures in private clinics will allow for 14,000 additional cataract surgeries a year, and 50,000 more hours of MRI and CT scans.

“We know there will always be those who are opposed to innovation that will deliver more connected and convenient health care to Ontarians,” said spokesperson Hannah Jensen. “Our government is not OK with the status quo.”

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