System review proposal raises concern for women
Tubal ligations, breast reductions among procedures on ‘limited clinical value’ list
Shannon Belanger hopes a breast reduction surgery she has scheduled for April will stop the pain in her back, neck and jaw, the anxiety, depression, pinched nerves and numb hands.
She was irate when a provincial health system review recommended the government potentially tamp down on procedures of “limited clinical value,” including breast reductions.
“This surgery is not a simple cosmetic procedure that I have chosen to have for vanity purposes,” Belanger said Thursday.
“Eliminating medically necessary breast reduction surgery is not going to bring oil and gas jobs back to the province.”
Belanger, 45, stood alongside Opposition NDP Leader Rachel Notley Thursday as she called for Health Minister Tyler Shandro to reject one of the recommendations in a sweeping review of Alberta Health Services (AHS).
Released publicly earlier this month, the $2-million review by Ernst & Young included 57 recommendations AHS could adopt to operate more efficiently and save money.
The 220-page report points to Britain’s National Health Service (NHS), which tracks “procedures of limited clinical value,” which have alternative, effective treatments that can avoid surgery.
The report listed the 10 most common of these procedures in Alberta, which include hernia repairs, carpal tunnel syndrome, hemorrhoids, removing tonsils, and tubal ligations and breast reductions for women. It said some of the procedures could be done in private surgical clinics.
Although Shandro said the procedures will still be insured, critics question how accessible they may become.
Notley said asking doctors to redirect women and gender diverse people away from sterilization procedures and breast reductions when they might be the best medical option is sexist policy.
Women are also disproportionately affected by carpal tunnel syndrome, she said.
“I have an issue with (Health Minister) Tyler Shandro, who, to my knowledge, doesn’t have to wear a bra every day, or consider the implications of pregnancy personally, suggest that more doctors would just say ‘No,’ so we can cut $100 million or so,” Notley said.
The report estimates cutting back on procedures with other treatment options could save $47 million to $100 million a year.
AHS has until May 13 to provide the minister with an action plan based on the report.
The Opposition is cherry-picking information from the report, Shandro said in a Thursday statement. Hernia repair, breast reductions and all the surgeries listed in the report will still be covered in Alberta, he said.
The NHS list is about procedures that are overused or sometimes used inappropriately, not about gender, Shandro said.
“I think it’s really disappointing that a former premier would mislead patients in this province that badly,” Shandro told reporters in Calgary.
Notley said Shandro is contradicting himself by accepting the report’s recommendation, yet saying the procedures will still be insured.
Calgary obstetrician and gynecologist Dr. Fiona Mattatall said Thursday she shook her head in disbelief when she saw tubal ligations on the list of potentially avoidable surgeries in the AHS review. She does the procedure to prevent pregnancies and to reduce the risk of ovarian cancer in women predisposed to the disease, she said in a phone interview.
Some women have the surgery because other forms of birth control failed or caused complications, their pregnancy could be high risk, or they live in poverty and can’t afford intrauterine devices or the birth control pill.
Restricting access to tubal ligations could lead to more unplanned pregnancies and potentially, more abortions, she said.
To insinuate surgeons are wheeling patients into operating rooms when there are better, safer non-surgery alternatives is “hugely insulting,” she said.