Waiting list insights

Re: B.C. judge rejects private medicine, Sept. 11

I am an 83- year- old retired surgeon and the articles on private v.s. public health care systems reminded me that we should remember our history.

I did a year of post-graduate training in England where there was a public as well as a private system. Waiting times in the public system were often two or three years for elective procedures. Emergencies were promptly dealt with. Many of the unions had private coverage.

After starting practice in Toronto in 1970, I rapidly found myself to be quite busy. The hospitals I worked in were quite accommodating as they were being reimbursed by the government on a fee per service basis. My elective operating days started at 8 a. m. and ended at 5: 30 p. m. Emergency cases that presented during the day would be worked in or added on. My typical waiting list was about three weeks.

Over the years the government changed the hospital funding to a global budget system. As time went on and hospital costs increased, my surgical time was cut back to 4: 30, then to 3: 30 and then an afternoon cut back. Needless to say waiting times increased. Eventually I was put on a salary to make up for my lost income. Since hospital incentives were diminished, operating room turnover times between cases increased. What had once been 10 minutes stretched out to 30 or more. Is it any wonder that waiting times increased?

Over the years I did have occasion to visit colleagues in various parts of the province. My impression was that many smaller hospitals, particularly in smaller communities, functioned more efficiently than what I experienced in Toronto.

I am no longer a healthcare provider but a healthcare recipient.

Jacob Friedberg, Toronto