Silence, inaction cruel while surgery wait times swell Backlog for hip, knee procedures growing despite surge in operations; no progress on plan to send patients elsewhere

Wait times for hip and knee surgery in Manitoba have hit their highest levels in at least six years, even though hospitals are performing near-record numbers of procedures.

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Opinion

Wait times for hip and knee surgery in Manitoba have hit their highest levels in at least six years, even though hospitals are performing near-record numbers of procedures.

Despite that, the province still hasn’t said when — or if — it will send some patients to facilities outside of Manitoba for surgery to reduce a massive backlog built up during the COVID-19 pandemic.

The median wait time for all hip and knee surgeries inched up to 44 weeks in June, an increase from 43 weeks in May, according to the latest wait-time data released Thursday by Manitoba Health. It’s the longest wait time since at least 2016.

Half of patients on hip and knee surgical wait lists are waiting longer than 44 weeks and half are getting their procedures done in less time. Many patients have reported wait times of well over a year, with some waiting more than two years.

It’s not because hospitals are doing fewer surgeries. On the contrary, operating rooms have been working at, or near, full capacity since surgical staff returned to their regular positions earlier this year (after being redeployed to treat COVID-19 patients during the pandemic). Manitoba is performing twice as many hip and knee surgeries as it did just a few months ago.

There were 518 of those surgeries performed in June, up from 495 in May and well above the average of 333 per month in 2021.

There were 518 of those surgeries performed in June, up from 495 in May and well above the average of 333 per month in 2021.

The province reached a record 5,049 hip and knee surgeries in 2019, the year before the pandemic, and wait times fell to 25 weeks. Once the pandemic hit and surgeries were cancelled, wait times began to rise again.

The problem now is there isn’t enough capacity in the system to reduce the pandemic backlog, at least not in the short term. Add in the fact demand for hip and knee surgery is growing by an estimated five per cent a year — owing to a growing and aging population — and it’s no surprise hospitals can’t keep up.

Manitoba needs more capacity, either from within the province or outside. It needs to perform about 6,000 hip and knee surgeries a year just to keep up with regular demand. To eliminate the backlog (estimated by Doctors Manitoba at about 3,000 cases), the province would have to exceed 6,000 a year.

At roughly 500 surgeries per month, Manitoba is now doing enough to keep up with regular demand. However, it’s not enough to eliminate the backlog.

At roughly 500 surgeries per month, Manitoba is now doing enough to keep up with regular demand. However, it’s not enough to eliminate the backlog.

The longest delays are at Grace Hospital, where the median wait time in June was 57 weeks. It was 29 weeks at Concordia Hospital (up from 22 in January), 48 weeks at Brandon Regional Health Centre (up from 42 weeks in January) and 50 weeks at Boundary Trails Health Centre, which has seen its wait times soar from 10 to 15 weeks earlier this year. As operating rooms return to normal levels, surgeons are booking more patients. That’s driving up wait times because there isn’t enough capacity to keep up.

A plan to expand orthopedic surgery at Concordia, which will add up to 1,000 surgeries per year, is expected to help. However, the expansion has been delayed until sometime in 2023-24. That means sending patients out of province may be the only way to start chipping away at the backlog in the short term.

Premier Heather Stefanson’s diagnostic and surgical recovery task force, created last year, indicated in June it plans to send some patients out of province for hip and knee surgery. But there have been no announcements on when, or how many Manitobans, could have their procedures done elsewhere.

MIKE DEAL / WINNIPEG FREE PRESS FILES

The longest delays are at Grace Hospital, where the median wait time in June was 57 weeks.

The problem is worse for knee surgery than it is for hips. The median wait time in June for knee replacement was between 47 and 55 weeks; for hips it was 27 to 48 weeks. They’re both unacceptably long.

The concern among some in the heath-care field is that wait times could get longer before they get shorter. Given the size of the backlog and the growing demand for orthopedic surgery, no one knows for sure when the current trend will reverse. It could continue at these levels well into 2023. That would be devastating for people already waiting a year or two — or more — for surgery. Many have severe mobility issues and are deteriorating rapidly. There are likely thousands of Manitobans, mostly seniors, waiting in agony, often with no clear idea when they can expect to see the inside of an operating room. A solution is desperately needed. This is inhumane.

tom.brodbeck@freepress.mb.ca

The province reached a record 5,049 hip and knee surgeries in 2019, the year before the pandemic, and wait times fell to 25 weeks. (Dreamstime/TNS)

Tom Brodbeck

Tom Brodbeck
Columnist

Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.

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