Patients in the dark on wait time data

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This article was published 19/07/2024 (759 days ago), so information in it may no longer be current.

For a government that ran on “fixing health care” and slashing long wait times for surgical procedures, the recent cancellation of cataract surgeries is bad news for the provincial NDP.

At least one patient, Ann Bowman, 72, spoke out this week after her cataract surgery was cancelled. She received a letter three weeks ago from her surgeon saying the provincial government did not renew its contract with a private clinic where she was supposed to have the procedure done on July 17. Her surgery will be rescheduled, but no date has been set.

Vision Group is one of the private clinics the province contracts with to perform surgeries. The province is being cagey about that contract and others the previous Progressive Conservative government signed on with.

The Manitoba government has been contracting with private clinics for certain medical procedures for decades, including cataracts. It’s unclear whether the new NDP government, which has stated often that it is no fan of private health care, will continue with those contracts or try to reduce the province’s reliance on them.

It gets complicated when government mixes ideology with health-care policy.

Most patients likely don’t care where their surgery is performed, as long as it’s covered by Manitoba Health, and is safe and of high quality.

While in opposition, the NDP regularly stated the province should rely less on private companies to deliver health care. Wab Kinew, now Manitoba’s premier, said that if elected to government, he would beef up capacity in the public system.

One of the first things the Kinew government did after being sworn into office in October was cancel out-of-province surgeries paid for by Manitoba Health, including for hip and knee procedures. The former Tory government was sending some patients to clinics in Ontario and the U.S. for certain procedures to help reduce wait times. After the NDP cancelled that option, wait times for hip and knee surgeries grew.

It now appears the NDP government is scuttling contracts with private clinics, perhaps for the same ideological reasons that drove the cancellation of out-of-province surgeries.

Manitobans don’t know what the real wait times are for cataract surgery. The province’s online wait time dashboard shows the median wait time for cataract surgery in the province is nine weeks. That is inaccurate, for a number of reasons.

The way the province calculates wait times for cataract surgery is deeply flawed. Cataract surgery is typically performed one eye at a time, usually with a week or more between procedures. The province calculates the median wait time — the point at which half of patients wait longer and half wait less — for the first eye and combines it with the time it takes to do the second eye. It takes the average from both and publishes it as the median wait time for cataract surgery. It’s inaccurate and misleading.

The wait time is the length of time it takes to see a specialist and the period of time it takes to have the first eye done. That’s the data government should be publishing.

The province’s wait time dashboard also doesn’t include some private clinics. So, it’s incomplete. It doesn’t give the public a full, accurate picture of wait times for cataract surgery.

All of this means it’s impossible for the public to track the real wait times for cataract surgery.

More importantly, Manitobans now have a government that appears to be ideologically opposed to contracting with private clinics, even though previous NDP governments used them. It’s unlikely the Kinew government would eliminate the use of private clinics entirely, but it appears they might be trying to minimize that option.

That will have consequences. It means people such as Ann Bowman have to wait longer for their procedures as their eyesight deteriorates.

Governments contract with private providers for all kinds of health-care services, including supplies, staffing, diagnostic procedures and surgeries. It gives governments flexibility and, in many cases, cost savings. Most importantly, it helps the province build capacity in the system.

For example, Western Surgery Centre, a private clinic in Winnipeg, has been doing cataract surgeries for the province for years, including under previous NDP governments. Does it really matter where the surgeries are performed, as long as they’re of high quality and competitively priced? It shouldn’t.

Health care should be patient-focused. It’s government’s job to provide the public with the fastest service possible at the best prices available. If that means more contracts with private clinics, so be it. Ideology should play no part in it.

tom.brodbeck@freepress.mb.ca