Bigger health-care budget alone does little to shrink surgery wait times

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This article was published 11/04/2024 (561 days ago), so information in it may no longer be current.

Here’s a sobering statistic in Manitoba: despite well over $1 billion in extra health-care spending over the past year, wait times for hip and knee replacement surgery continue to rise.

According to the latest data released by the province, the median wait time for hip replacement surgery jumped to 28 weeks in February, up from 25 weeks the month before. In February 2023, it was 20 weeks.

The median wait time for knee replacement surgery was 32 weeks in February, down slightly from 34 weeks the month before, but still no improvement over the past year and higher than it was in 2019, the year before the COVID-19 pandemic.

Taxpayers are paying a lot more for health care and, in some cases, getting worse results.

Consider the following: the provincial budget for health care in 2022-23 under the previous Progressive Conservative government was $6.66 billion. That jumped to $7.24 billion in 2023-24.

As is the case most years, the province overspent in health care in 2023. Because last year was an election year and the Tories blew the bank trying to get re-elected, projected spending in health for 2023-24 skyrocketed to a staggering $8.14 billion. The final numbers won’t be in for that fiscal year, which just ended March 31, until the public accounts are released in September. But the amount will likely be in that neighbourhood.

The NDP government is projecting to spend $8.22 billion in health care for 2024-25, although it will almost certainly exceed that.

Despite going from a $6.66-billion health budget in 2022-23 to well over $8 billion today, wait times for two of the most common surgical interventions — hip and knee replacements — are longer today than they were prior to the pandemic.

Hospitals are performing more procedures than ever. The problem is that they can’t keep up with demand. There were 205 hip replacement surgeries performed in February, the same as in January. That’s one of the highest volumes of any month over the past five years. The average number of hip replacement surgeries per month in 2023 was 200, up from 182 the year before.

It’s similar with knee replacements. There were 310 procedures performed in February, up from 273 in January. The average monthly number in 2023 was 313, an increase from 240 in 2022.

At the same time, a growing and aging population is putting the system under increasing pressure. More people are in need of orthopedic surgery and other medical services. The average number of people in Manitoba waiting for hip replacement surgery at any given time in 2023 was 859. That’s up from 622 in 2019.

That number represents only the people who have seen a surgeon and have been put on a wait list. It doesn’t include those still waiting for an appointment with a specialist to find out when or if they can get surgery. The province doesn’t post wait times for that category.

The length of time people are waiting is also measured in median wait times. That means half the number of people are waiting longer and half are getting surgery sooner. Many people are waiting far longer than the posted median wait times (I hear from them every time I write about health-care waits).

Between the time it takes to see a specialist and the fact many wait longer than the median wait time (some wait less), the length of time for many to get orthopedic surgery is often measured in years, not months.

It would be useful if the province posted 90th-percentile wait times for surgical procedures; the Winnipeg Regional Health Authority does that for emergency-room wait times. That measurement shows the longest wait time for nine out of 10 patients. It’s a more realistic measurement. However, governments are loath to use it because it paints a bleaker picture of the health-care system.

Will spending over $1 billion more this year than in 2022-23 reduce wait times for surgical procedures such as hip and knee replacements? The only way that will happen is if hospitals can recruit more staff. It’s not just about recruiting more surgeons, it’s about hiring more nurses and support staff to increase the volume of surgical slates. That’s no easy feat in the midst of a national shortage of health-care workers.

Unless that happens, hospitals will continue to fall behind the growing demand for services, including orthopedic surgery. Money alone won’t solve it.

tom.brodbeck@freepress.mb.ca