Wait times up for cancer patients
Surgery delays are longer at MUHC than at other Montreal hospitals
More cancer patients are waiting considerably longer for surgery at the McGill University Health Centre than at other hospitals in Montreal, the latest provincial government statistics reveal.
The situation is particularly striking at the Montreal Children’s Hospital — part of the MUHC — where three patients were waiting at least 57 days on May 27, the most recent date available in the government registry.
By comparison, at Ste-Justine Hospital — a much larger pediatric centre in Côte-des-Neiges — no child in need of cancer surgery waited beyond a month.
The 57-day delay is set by the Quebec Health Department, and ideally no child or adult cancer patient requiring surgery should have to wait longer than that length of time.
In fact, the government’s own access targets stipulate that 90 per cent of cancer patients who are medically ready for an operation should undergo the surgery within 28 days and 100 per cent should have it done within 56 days.
Yet 13 per cent of Montreal cancer patients on wait lists were on standby for at least 57 days. Worse still, the rates for all five MUHC hospitals were higher than the Montreal rate: 17 per cent at the Royal Victoria, 22 per cent at the Montreal General, 33 per cent at Lachine, 60 per cent at the Montreal Children’s and 67 per cent at the Montreal Neurological.
In total, 317 cancer patients were waiting for surgery at the MUHC on May 27.
In contrast, 348 cancer patients were on wait lists for surgery at the comparable Centre hospitalier de l’université de Montréal (CHUM).
But at the MUHC, 68 of those cancer patients had been waiting more than eight weeks, while the number was 38 at the CHUM.
The statistical portrait is also troubling for the MUHC regarding cardiac surgery. The Royal Vic reported 63.6 per cent of heart patients on surgical lists waited beyond the medically acceptable delays as of March 31 (the most recent date available).
That’s the highest percentage by far of any hospital in the city and compares with a rate of 21 per cent at the Jewish General, an equally busy institution.
The statistics would appear to confirm that the Quebec government’s funding cuts to the MUHC are having a direct bearing on access to what should be timely surgery. Since the government decided last year to fund the MUHC at a bed-occupancy rate of 85 per cent, the hospital network has had no choice but to postpone more than 1,000 elective surgeries.
“This is what happens when you close hospital beds — you get a backlog” of surgical cases, said Pierre Hurteau, a cancer survivor and a member of the MUHC Central Users’ Committee.
“We are dealing with people here, not stats,” Hurteau added later in an email, emphasizing that even one patient who has to wait too long for cancer or cardiac surgery “is one too many and not acceptable.”
Across the province, the government succeeded in decreasing the total number of patients on wait lists for the most common elective or non-urgent surgeries — going from 100,722 patients on May 28, 2016, to 94,707 on the same date this year.
Yet despite the positive trend provincially, the MUHC appears to struggle when it comes to speedy access to surgery — a predicament that lends credence to complaints by senior MUHC officials and physicians that the organization hasn’t been funded adequately enough by the government.
MUHC officials are nonetheless defending their record on surgical wait times, although one spokesperson acknowledged that the figures are partly a reflection of the resources available. “We are always striving to improve our practices with the resources at our disposal — from financial, to human, to our community partners,” said Gilda Salomone, an MUHC communications officer.
Pressed on whether budget cuts were hurting access to surgery, Salomone responded in an email: “To your question about whether funding issues have an impact on wait times, we answer that we are committed to providing the best care possible, within our means.”
Julie White, Health Minister Gaétan Barrette’s press attaché, did not respond to repeated email queries and phone messages by the Montreal Gazette.
In November, Barrette announced that the government was investing an extra $20 million to reduce surgical backlogs. But the money came with strings attached to it as hospitals had to demonstrate that they could balance their budgets. Barrette delivered a stark warning to the deficit-ridden MUHC if it wanted to receive the much-needed funds.
“If they reflect correctly, they will get the money,” Barrette told reporters at the time.
“It’s about (commitments). I’m waiting for them to show they’re really ready. I don’t want excuses. I want results.”
Under Barrette’s plan, the government funded the reopening of three operating rooms at the Jewish General, three ORs at the CHUM and 2.5 at the MUHC.
(During the July vacation period last year, as many as 10 of the MUHC superhospital’s 13 ORs sat idle and for the rest of the year four of its ORs were routinely vacant due to a lack of funds.) In a detailed email, Salomone of the MUHC elaborated on the management of cancer-surgery wait lists.
“As part of our continuum-ofcare approach, as soon as a patient is diagnosed with cancer, they are placed on a surgical-oncology waiting list but some may need chemotherapy prior, so surgery will happen once the necessary chemotherapy is completed,” she explained.
“In cases where chemotherapy treatment is effective, patients will not need surgery. Also, not all cancer cases require surgery within 28 or 56 days.
“Some cancers behave very innocuously and can wait a little longer, such as some thyroid cancers, for example. The prioritization is done by the surgeon.
“Another important factor that has an influence on wait times,” she added, “is due to the integrated nature of the Cedars Cancer Centre; we are attracting more patients with more complex cancer cases.”
(The Segal Cancer Centre at the Jewish General also treats more complex cases, yet its rate of patients waiting at least 57 days for surgery is 12 per cent, just below the Montreal rate.)
Still, in one area the MUHC fared better than most of the city’s cancer centres, with 99 per cent of patients having started their radio-oncology treatment within four weeks.
That compares with 86 per cent at the CHUM, 96 per cent at the Jewish General and 100 per cent at Maisonneuve-Rosemont Hospital.
As for other types of surgery, wait times at the MUHC were either the longest or second longest in the city.
In the case of hip replacements, 33.7 per cent of patients on wait lists for the operation waited at least six months, the longest in Montreal.
In another example, 18 per cent of MUHC patients on cataract-surgery wait lists bided their time for at least half a year, behind a rate of 21 per cent at Santa Cabrini Hospital, the worst in the city.
The financing of the MUHC has become a political football for the government.
Union leaders have deplored burnout among nurses and other staff following what they estimate are $120 million in budget cuts in the past five years.
Barrette has countered that the MUHC is funded “properly.”
However, on July 10, escalating tensions between the minister and the MUHC culminated in the mass resignations of all 10 independent members of the board.
This is what happens when you close hospital beds — you get a backlog (of surgical cases) ...