Manitoba’s surgical and diagnostic backlog is worse than it was four months ago, as the number of delayed procedures has swollen to 10 per cent of the province’s population.
"The window of opportunity between the third and fourth pandemic waves has been lost, and there is a significant risk that surgeries will be further disrupted in the weeks ahead," a report from Doctors Manitoba says.
The association’s head says patients are getting sicker because of delayed procedures, and doctors are scrambling to find ways to alleviate people's pain.
"Physicians are tired of seeing their patients waiting and suffering," said Dr. Kristjan Thompson. "Our patience is wearing thin, and Manitobans deserve to see more progress."
Doctors Manitoba normally takes a collaborative tone by avoiding direct criticism of the province, but its report, released Thursday, said there had been "little concrete progress to address the backlog" during the summer.
Shared Health said it has intentionally tackled the issue slowly, to preserve ICU capacity. Health Minister Audrey Gordon said the government has been proactive in contracting out surgeries to cut down the backlog.
In its report, Doctors Manitoba said the backlog, which was 110,000 procedures in June, currently sits at 130,000 procedures — about one-tenth of Manitoba's 1.38 million population, though some patients may be waiting for more than one procedure.
The group cobbled together its numbers from Manitoba Health data shared with federal bodies, Shared Health’s public statements and estimates from physicians who make referrals.
The group warns that delayed care will exacerbate patients' medical concerns. It said the backlog will continue to grow.
Thompson said he’s seen patients experience heart failure while waiting for bypass or valve surgery; some physicians believe their patients have died because they were forced to wait too long for care.
"No one should have to die unnecessarily, waiting for a surgery," he said.
Doctors Manitoba chalks up the problem to surging COVID-19 hospital admissions, a lack of nurses and technologists, and a hospital system staffed so tightly before the pandemic that it buckled under even marginal increases in patients.
As a result, Manitoba was the only province that significantly lost surgical capacity in the second wave, with a percentage drop in procedures that was four times worse than any other province.
In recent years, Manitoba has undertaken a chaotic reorganization of health services, and last spring it was forced to turn to the military to help out in hospital wards. It has been the only province that has sent ICU patients to other jurisdictions to be treated.
Thompson said fixing the problem will require not just an increase in government spending, but also adequate staffing.
"At the crux of it, we're seeing a very tenuous and critical health human-resource shortage," he said.
The Manitoba Nurses Union said a new nursing contract should help alleviate the nagging problem.
"Investment in health care is more important now than ever to ensure Manitobans receive the care they deserve," said union president Darlene Jackson.
"There is still much work to be done, to get Manitoba’s health-care system back to where it ought to be."
Gordon responded by saying her government welcomes the damning report.
"It's through partnerships and collaboration, and open and honest dialogue that we will be able to move forward, in terms of addressing the surgical backlog," she said.
In March, the PC government promised to spend $50 million to deal with the backlogs; as of Thursday the government says it has allocated $13.7 million.
Gordon said that money has been spent on five contracts to have public and private medical companies provide 8,300 key surgeries, from cancer treatment to cataract removal.
"We certainly haven't been delaying in any way, in terms of addressing the surgical backlog," she said, noting that all hospitals except HSC and St. Boniface have returned to full surgical staffing.
Doctors Manitoba said it wants the province to set a target date to clear the backlog. Gordon said that will come as part of a special task force that is still being formed.
Shared Health said it has gradually phased in surgery teams because so many Manitobans have been in intensive care.
"Efforts to increase surgical capacity to pre-COVID levels following the third wave have been slow and carefully considered, to ensure appropriate support remained in our ICUs," wrote Shared Health spokesman Kevin Engstrom.
He said administrators are working to recruit and redeploy staff to make up for those who have retired or quit.
The province publishes monthly data on wait times and volumes, but Doctors Manitoba wants monthly updates on the backlog. Engstrom said it’s hard to quantify how many non-urgent surgeries have been delayed, as some haven’t even been scheduled, while some patients have delayed seeking treatment.
Doctors Manitoba found he province has slightly improved its diagnostic imaging backlog, due to clearing a logjam of 5,472 CT-scans by August — yet the current wait time for those scans is now triple what it was before the pandemic.
The union for diagnostic workers called that smoke and mirrors.
"We don't have enough technologists in the system, never mind to keep up with the demand right now, but to make headway," said Bob Moroz, head of the Manitoba Association of Health Care Professionals.
Since the spring, the need has only gone up for ultrasounds, MRI scans and myocardial perfusion tests. As of August, Manitobans were waiting 18 to 20 weeks for those three tests. The province is still below its capacity for mammograms and diagnostic endoscopies.
"It's unconscionable that we're making people wait this long, without putting our minds to a proper solution, with the right number of people to do this work," said Moroz, who asked to meet with ministers back in June.
"We've seen nothing that even resembles a human-resources plan."