(Quebec) The Omicron tsunami has not spared the surgery waiting list, which has grown by more than 7,500 names in three months. Quebec wants the troops to “regain strength” before presenting an update of its catch-up plan. Associations of surgeons are pleading to speed up the pace from March and review the criteria for prioritizing waiting patients.
Posted at 5:00 a.m.
According to the latest report from the Ministry of Health and Social Services (MSSS), dated January 29, 158,933 Quebecers are waiting to go under the knife. Of this number, 36% have been waiting for more than six months, or 57,102 people. Quebec continues to move away from the targets it has set itself to regain the upper hand.
In June, the Legault government had in its sights to reduce the number of pending operations to 150,000 as of October 2021 and, above all, to reduce the list of those who have been waiting for more than six months to some 42,000 names.
But Quebec missed its target even before the fifth wave of the pandemic. As of October 9, 151,352 patients were waiting, including 52,512 for more than six months.
As the network regained strength in the fall and saw a way out of the crisis, we were hit hard by the Omicron variant. With tens of thousands of fewer health care workers, this obviously disrupted our plans for repeat surgeries.
The office of the Minister of Health and Social Services, Christian Dubé
Quebec does not deny that it will have to update its catch-up plan, but Minister Dubé first wants “that health personnel regain strength”. A meeting was held Tuesday evening between the MSSS, the Federation of Medical Specialists of Quebec (FMSQ) and several associations of surgical specialties to discuss this catch-up plan.
The MSSS confirms that the strategy unveiled in June is maintained, but that the “different dates related to the different milestones” will be revised in the coming weeks.
Reinvestment of 400 million
The government also announced on Tuesday the reinvestment of 400 million in the “resumption of post-COVID activities”, including offloaded surgical procedures.
These amounts were generated by the work of the Institute for the relevance of medical acts, created in the wake of the agreement concluded between the government and the FMSQ. They will make it possible to carry out an additional volume of operations, estimated at 125,000, by 2023-2024.
In its plan presented in June 2021, Quebec gave itself two years to catch up with the delays caused by the pandemic.
For a “realistic” plan
The Quebec Association of Surgery (AQC) pleads for its part for the resumption of remedial activities as of next month. “It’s doable if everyone is back to work,” said the president, the Dr Mario Come. “As early as March, we could look at a plan that is realistic, but it will not be easy to define. »
The AQC estimates that to make up for the delays, Quebec must maintain the agreements concluded with 25 private medical clinics beyond the pandemic. According to the Dr Come on, we must also “diversify” the operations and the patients we treat there in order to increase their capacity.
These agreements made it possible to minimize load shedding at the height of the health crisis. “Without these contracts, we would do 59% of surgeries in Quebec, whereas we currently do 74%,” said Minister Dubé’s office. The “majority” of these agreements are for two years.
A “household” is also needed in the waiting list, believes the Dr Come. “This exercise should not be sporadic. This process [de ménage] should be done on a regular basis. For example, the patient who has been waiting for two years, well, you have to ask questions, you have to see this patient again, ”says the doctor.
According to the AQC, extending the hours of operating theaters must be an “ultimate” solution to avoid further exhausting health personnel. “We don’t want to find ourselves in a situation where absenteeism is high and we go back,” adds the Dr Viens, who practices at the Sherbrooke University Hospital Center.
Review priorities
Between 25% and 30% of pending operations are in orthopedics, the “most affected” specialty, according to the president of the Quebec Orthopedic Association, Dr.r Jean-Francois Joncas. The latter indicates that the operating theaters are operating at “between 50% and 75% of their capacity” currently, depending on the region, due to the lack of staff.
The Dr Joncas believes that the resumption of surgical activities must be done gradually, depending on the staff available.
Recourse to the private sector cannot be too extensive, under penalty of “cannibalizing public personnel. And that’s not better…”, he says.
The Dr Joncas also believes that the established order of priority should be reviewed to eliminate the waiting list. No question, according to him, of giving priority to a minor orthopedic case over an urgent case of cancer, for example. But there are some cancers, including thyroid and prostate, where the urgency may be less, he explains.
However, in Quebec, all these cases must be operated on within 28 days. “In Ontario, we removed this 28 days […] There may be a little effort to be made on this side, ”says the Dr Joncas, who recognizes that the exercise will be difficult, since each specialty will preach for its patients.