The COVID-19 pandemic is exacerbating serious existing cracks in Ontario’s health-care system, according to new information released by the Canadian Constitution Foundation (CCF). And it’s going to take innovative thinking about health-care delivery to mend this broken system.
Documents obtained through freedom of information legislation show that the pandemic has created a massive backlog of surgeries, which could potentially take years to clear. The documents from the Ministry of Health show that the number of surgeries and diagnostic procedures performed between March 18 and July 27 dropped dramatically compared to the same time period in 2019.
For example, the number of pediatric procedures performed between March 18 and July 27 in 2020 dropped by over 75% when compared to the same time period in 2019. Children are supposed to have shorter surgical wait times because of the amount of development that happens in childhood, so the fact that pediatric surgeries have been so significantly delayed is deeply concerning.
It is not just pediatric surgeries that have been delayed. The number of non-oncology surgeries dropped by over 74%, the number of oncology surgeries dropped by 24%, and the number of MRIs has dropped by 43%.
These numbers were described by the Ministry of Health in the documents as “unprecedented,” and a direct result of the ministry directive requiring all non-essential and elective services to be ceased or reduced to minimal levels.
The term “non-essential” and “elective” can be misleading. It includes things like knee replacements, cataract surgeries, cardiac procedures and transplants. These are medically necessary procedures, the delay of which can leave people waiting in pain. There is significant evidence that waiting can actually make health outcomes worse, so the delay of these surgeries can have long-term consequences for patients.
Early reports from April estimated that nearly 100,000 surgeries in Ontario had been delayed by the pandemic. However, even this stark projection now looks rosy compared with the reality revealed in the documents released by the CCF. Based on the same 19-week period last year, 168,498 fewer surgeries have been performed. And the data ends at July 27. Hospitals today are still not performing surgeries at 100% capacity, as phase 2 requires hospitals to leave capacity for a second wave. This means the backlog will have grown even larger.
Long wait times for surgeries was a problem before the pandemic hit, and hallway health care has become the rule in Ontario hospitals rather than the exception. Reporting by CBC shows that some of Ontario’s biggest hospitals were filled beyond 100% occupancy nearly every day in the first half of last year. Chronic overcapacity means non-emergency surgeries get postponed.
Last year, 83 hospitals were over 100% capacity for more than 30 days, 40 hospitals averaged 100% capacity or higher, and 39 hospitals hit 120% capacity or higher for at least one day. As hospitals return to normal, it is unclear how the now even larger backlog of scheduled surgeries will be addressed when overcrowding was already a problem.
Clearing this backlog will take both innovative thinking and more resources. In British Columbia, the government estimated it could take up to two years to clear the backlog of 30,000 surgeries. To reduce this unacceptable wait, B.C. is now turning to independent non-government surgical clinics. These private clinics have existed in B.C. for over 25 years, and are now a crucial part of the solution to the pandemic backlog.
If Ontario is to clear our massive surgical backlog, we need to consider all options, including allowing the creation of clinics like those that are solving B.C.’s backlog problem.
This article was originally published in the Toronto Sun.