2024-03-30 08:05:27
The waiting list for surgeries in Quebec continues to grow despite the adoption of a catch-up plan by the Ministry of Health and Social Services (MSSS) almost a year ago.
The number of people waiting for surgery for more than a year stood at 12,221 in February, far from the target of 7,600 planned for March 31, 2024.
The government of François Legault and medical specialists had set this interim objective in May 2023 while waiting to return to the pre-pandemic threshold of 2,500 before the end of 2024.
In mid-February, the president of the Federation of Specialist Physicians of Quebec (FMSQ), Dr. Vincent Oliva, said in an interview with First hour on the airwaves of ICI Première that this target would not be achieved, that the objectives were unrealistic and that they had to be revised.
People waiting more than a year are prioritized in the current plan, but the total number of patients waiting on the overall list was 161,760 as of February 24, 2024.
That’s a lot of patients waiting and it hasn’t decreased in a year, indicated the president of the FMSQ.
We must see that the operating theaters in Quebec are not functioning enough; they operate at around 85%.
A quote from Dr. Vincent Oliva, president of the Federation of Specialist Physicians of Quebec
What we deplore is that the catch-up plan on which we agreed in May 2023 is not being implemented, denounced Dr. Oliva.
To reach the ultimate target of 2,500 patients waiting for more than a year at the end of the current year, it will be necessary to correct the situation and send the right directives to the field, he maintained.
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Dr. Vincent Oliva, president of the Federation of Specialist Physicians of Quebec (Archive photo)
Photo : Radio-Canada
Lack of staff
The agreement concluded with specialist doctors provided for the optimization of the use of operating rooms (beyond usual hours) as well as the reopening of those which are closed.
The objective is to allow doctors to complete their daily operating program by ensuring, in particular, the availability of the required staff as well as a capacity programming of beds, recalls the spokesperson for the FMSQ, Pâris Psychogyios, in an email sent to Radio-Canada.
MSSS to implement the conditions required to ensure the maintenance or opening of operating theaters in sufficient numbers to follow the catch-up plan”,”text”:”The doctors have responded but unfortunately still come up once morest the ‘inability of the MSSS to implement the conditions required to ensure the maintenance or opening of operating theaters in sufficient numbers to follow the catch-up plan”}}”>The doctors responded but unfortunately still come up once morest the inability of the MSSS to implement the conditions required to ensure the maintenance or opening of operating theaters in sufficient numbers to follow the catch-up plan, adds the spokesperson.
This is also the same story from Dr. Hai Nguyen, orthopedic surgeon at Charles-Le Moyne Hospital and Jean-Talon Hospital. We don’t have the staff to [faire fonctionner] the rooms and [pour suivre] the programs that were set up to reduce waiting lists, he says.
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Dr. Hai Nguyen (File photo)
Photo : Radio-Canada
A team for a surgery includes an anesthetist, three nurses and attendants, he specifies, adding that it is not the physical locations that are lacking but rather the staff to operate the operating rooms.
The Federation therefore remains very concerned by the number of surgical interventions still canceled every day in health establishments.
A quote from Pâris Psychogyios, public affairs advisor at the Federation of Specialist Physicians of Quebec
One in 10 surgeries is canceled every day in Quebec. Therefore, around 150 of the 1,200 surgeries (the daily average) must be canceled when hospital staff realize that the duration of the operation might exceed the end of the working day, around 4 p.m.
h and he is told: “We will not do your surgery because we are afraid of being overwhelmed”, this is not acceptable”,”text”:”We are talking regarding a waiting list and number of cases, but they are patients. The patient, when he has reached 2 p.m. and is told: “We will not do your surgery because we are afraid of overflowing”, this is not acceptable”}}”>We talk of a waiting list and number of cases, but they are patients. The patient, when he has reached 2 p.m. and is told: “We will not do your surgery because we are afraid of overflowing”, this is not acceptable, denounced the president of the FMSQ .
The ministry must send clear directives to hospitals so that hospital administrations organize themselves so that [les opérations de] these patients are not canceled, declares the president of the Federation of Specialist Physicians of Quebec, specifying that its members note that these directives are not followed on the ground.
Patients who have been waiting for more than a year, when they are called, they show up, assures Dr. Hai Nguyen.
Early cancellations, patients who are no longer available on the day of the operation, sick employees and lack of staff are to blame, according to a spokesperson for the Ministry of Health.
An underestimated problem
Additionally, lists can be manipulated, notes Dr. Hai Nguyen. The lists that the government offers are really an under-representation of the real problem. There are many ways currently [avec lesquelles] we play with the lists to make them appear better than they are, he laments.
It must be taken into account that the game of hiding patients who have been waiting for more than a year can intensify [à mesure qu’]We are approaching the elections and the time when it counts, warns Dr. Nguyen.
He gives the example of patients who have been waiting for more than a year but, for whatever reason, have not been available for a certain period of time. They are counted once more only when they become available once more.
Furthermore, the FMSQ believes that the sharing of data by the Ministry of Health is a step in the right direction. Dr. Oliva would like the number of canceled surgeries per day to be indicated on the MSSS dashboard (New window).
This is objective and measurable data whose improvement can easily be observed. The deployment of the catch-up plan necessarily requires a precise portrait of surgical interventions in Quebec, of which daily cancellations are a part, believes the spokesperson for specialist doctors.
$50M used…. on a budget of $400 million
The Ministry of Health says it does not have at its disposal the exact amount spent for each health establishment, but it indicates that approximately $50 million of the $400 million envelope has been allocated so far.
These sums were to be used, among other things, to finance overtime pay for employees in the health network in order to extend opening hours.
This amount was taken from doctors’ payroll and we see that this envelope has not really been touched yet, notes Dr. Nguyen.
The $400 million was in fact an amount reinvested thanks to the work carried out by the Institute for the Relevance of Medical Acts (IPAM) in collaboration with the MSSS and the FMSQ, the Quebec government clarified in a press release.
IPAM freed up this sum by withdrawing certain medical procedures that technology had made obsolete.
MSSS to implement, for almost a year now, the conditions required to ensure the participation of other healthcare professionals in the plan.”,”text”:”The FMSQ recalls that it is up to the MSSS to implement has been implementing, for almost a year now, the conditions required to ensure the participation of other healthcare professionals in the plan.”}}”>The FMSQ recalls that it is up to the MSSS to implement, for almost a year now year, the conditions required to ensure the participation of other healthcare professionals in the plan.
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Minister Christian Dubé declared last year that he wanted to recruit “top guns” from the private sector to run Santé Québec. (Archive photo)
Photo: The Canadian Press / Ryan Remiorz
Health Quebec
Dr. Nguyen says he is concerned regarding the arrival of the new health agency. Santé Québec is a beast that we don’t yet know. What we know, by [contre]is that it is a centralized entity which is even further from the field than what we have known in the past, he confides.
: is this really something that will be applicable in hospitals, with patients, in everyday life? We have doubts”,”text”:”So, that scares us because any entity that is far from the field, that is in its offices, that makes strategies: is that really something that will be applicable in hospitals, with patients, in everyday life? We have doubts”}}”>So that scares us, because any entity that is far from the field, that is in its offices, that makes strategies, is that really something that will be applicable in hospitals, with patients, in everyday life? We have doubts, he says.
The attention that will be paid by Québec Santé to the organization of care also concerns the FMSQ.
: make sure that patients who are scheduled for an elective day are not canceled and let’s try to reverse this culture where we cancel the last cases for fear that we will exceed 4 p.m., because there are a lot of patients behind that “,”text”:”I don’t want to be grandstanding, but our concern is that we are not putting enough energy into the organization of care and the directives. And let us say to hospital administrations: make sure that patients who are scheduled for an elective day are not canceled and let’s try to reverse this culture where we cancel the last cases for fear that we will exceed 4 p.m., because there are a lot of patients behind that”}}”>I don’t want to be demagogy, but our concern is that we are not putting enough energy into the organization of care and the directives and that we say to hospital administrations: “Make sure that the [opérations des] patients who are scheduled for an elective day are not canceled and let’s try to reverse this culture where we cancel the last cases for fear that we will exceed [l’échéance de] 4 p.m., because there are a lot of patients behind that,” argues the president of the FMSQ.
With information from Gabrielle Proulx, Audrey Neveu, Daniel Boily and Davide Gentile
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