Tens of thousands of children across Canada are waiting months, and, in some cases, years, for non-urgent but medically necessary surgeries. It’s a situation that threatens their well-being and is leading to millions in preventable health care costs, says a sweeping new report published Monday.
The report, prepared by Children’s Healthcare Canada and the Conference Board of Canada, offers a rare in-depth look at wait times for a variety of pediatric surgical procedures across the country.
It puts a spotlight on wait times for scoliosis surgery, a relatively common but complex pediatric procedure. Scoliosis causes a sideways curvature of the spine and requires surgical correction in a small number of cases. Children are recommended to receive surgery within three to six months to avoid progression of the condition.
But across Canada, about 40 per cent of scoliosis patients are waiting beyond that. Although there’s no national registry that tracks how many patients are waiting for scoliosis surgery, the report estimates there are nearly 2,800 children.
Scoliosis surgery delays vary by province, with 13 per cent of patients waiting beyond the recommended window in Alberta, compared with nearly 70 per cent in Nova Scotia.
Stéfan Parent, an orthopedic surgeon at CHU Sainte-Justine in Montreal, said children are being forced to wait anywhere from 18 months to three years for surgery at his hospital, depending on the severity of their scoliosis, and that delays in treatment can have a devastating impact.
“It’s not good medicine. It’s not the right way of doing things for kids,” said Dr. Parent, who is also professor of surgery at the University of Montreal.
He said there are currently 200 children on the scoliosis surgery wait list at his hospital, but they only perform about 80 procedures a year. That could be increased to 150 a year if they had more time in the operating room, but staffing shortages and other challenges often stand in the way.
As a result, he said he often sees pediatric patients whose conditions worsen as a result of waiting, with some even needing to be hospitalized and put in traction for weeks.
The report estimates that delays in scoliosis surgery alone add up to more than $44-million in health care costs.
Last year in Ontario, more than 17,000 pediatric patients were on surgical wait lists each month on average, the report found. Those in need of heart surgery waited more than two months, a 16-per-cent increase compared with 2019; patients needing orthopedic surgery faced an average wait of seven months, a 42-per-cent increase; and those in need of urologic surgery waited more than a year, a 134-per-cent jump.
And as of June, more than 7,000 B.C. children were on wait lists for surgery, according to the report.
Most of the children are waiting longer than medically recommended for surgical procedures, delays that can lead to short-term complications, including a worsening of symptoms and a more complicated procedure once an operating room is available. Excessive wait times can lead to more long-term challenges, disabilities and irreversible developmental changes, said Emily Gruenwoldt, president and CEO of Children’s Healthcare Canada.
“The big picture is we have a large and growing number of children waiting for essential services and waiting longer than ever before and waiting longer than is medically recommended,” she said.
The number of children facing surgical delays doesn’t include those waiting for specialist appointments, which is another major backlog, Ms. Gruenwoldt said.
Data on children’s wait times are not uniformly tracked across the country and, in some cases, information is unavailable, meaning it can be difficult to understand the true scope of the problem.
There have been a number of initiatives to help address the backlogs in pediatric surgeries. For instance, the report highlights work done in Saskatchewan since 2010 to create a new system to ensure fair operating room allocation and a centralized provincial surgery registry. And Toronto’s Hospital for Sick Children is scheduling surgeries on weekends.
But a shortage of nurses and anesthesiologists is making it difficult to address backlogs, according to the report.
The Globe and Mail, September 25, 2023