A new market has opened for Vancouver's private surgical sector after the Richmond Hospital issued a call for contractors to perform some day surgeries. The hospital, located in a fast-growing Vancouver suburb, has about 6000 people on its surgical waiting list, half of whom wait at least 90 days. The problem is exacerbated because the hospital can afford to operate only 5 of its 8 operating rooms.
The Vancouver Coastal Health Authority (VCHA) has responded by inviting private sector facilities that provide surgery to bid to perform on about 3000 procedures, such as arthroscopic operations, annually.
This will potentially free 16 to 20 hours of operating room time weekly, says VCHA spokesperson Clay Adams. However, Adams says he does not know how much capacity exists within the private surgical sector. Initially, he expects that only about 750 procedures will be assigned to contractors.
In North Vancouver, low-risk cataract surgery has been farmed out to a private facility for 4 years. Adams says this “very successful” arrangement resulted in a 23% decrease in the surgical waiting list at the Lions Gate Hospital in the first year. The waiting time is now about 45 days.
Under the contractual arrangements, says Adams, the health authority controls the waiting list so that “there is no risk of cherry picking” by private providers. To meet requirements of the Canada Health Act, the surgeons bill the provincial government directly; patients are not charged.
The president of the BC Medical Association says he favours “anything that expands our operating room capacity, but we need to be sure that facilities have appropriate safeguards.” However, Dr. John Turner does caution that while the private sector may help reduce waiting lists, “not every surgery can be done on an outpatient basis.” — Heather Kent, CMAJ