Calgary to receive Saskatchewan surgical patients, raising concerns among Alberta doctors

Saskatchewan is preparing to send surgical patients to Calgary to help reduce its backlog — a strategy that's concerning some Alberta surgeons. 

This week, Saskatchewan's health minister announced the province would temporarily contract a private Calgary clinic in the fall to perform 20-25 knee and hip replacement surgeries a month, though the government wouldn't cover travel costs. 

"This option would be offered to patients, on a fully voluntary basis, who have waited the longest for their joint replacement procedures while work is ongoing to accelerate expansion plans in public and private facilities in Saskatchewan," the Saskatchewan Health Authority told CBC News. 

It declined to name the Calgary facility in question, saying further details would be announced once the contracts were finalized. 

"My reaction is one mostly of sadness in that this is obviously a move of absolute desperation," said Dr. John Fernandes, a family physician and office surgery specialist at Northwest Surgical Clinic in Calgary. 

"None of this is manageable in any way. What's going to happen is for every patient that comes from Saskatchewan, there's potentially an Alberta patient that is not going to be able to access that type of surgery."

He noted Alberta is also dealing with similar issues, and he frequently has to refer patients out of province for surgeries.

Alberta's government says the "small number of surgeries involved" in the Saskatchewan contract should have no impact on efforts to reduce Alberta's own surgical waitlist. Just under 72,000 adults are waiting for procedures in Alberta. 

"Alberta was aware that Saskatchewan issued a request for proposal late last year looking to contract chartered surgical centres in Canada. However, Alberta Health was not aware that an Alberta facility will fulfil this contract," a statement from Health Minister Jason Copping's office said. 

It added Saskatchewan is communicating with Alberta about the initiative going forward. 

Staffing shortages, surgeon availability a concern

Dr. Anthony Gomes, head of the Alberta Medical Association's general surgery division, explained patients who are getting private surgeries are usually going through an employer or workers' compensation, not the public waitlist. However, he said the demand for surgeons, operating room nurses and anesthesiologists could have repercussions on Alberta patients. 

"It takes surgeons away from work they could be doing in the public hospitals," he said.

"Our system does not have the resources to deal with the number of patients that need procedures."

Alberta's government is also outsourcing procedures to chartered surgical facilities to reduce the backlog, but only within the province. Some specialized procedures that are not available within Alberta, like for rare cancers, are regularly referred to other provinces.

Copping's office says the total number of orthopedic and ophthalmology surgeries completed this fiscal year will be 44 per cent higher than last year, eating into the pandemic backlog. More than 87,000 surgeries have been completed between April and August.  

These contract strategies, according to Fernandes, indicate a health-care system in desperate need of reform.

"It is becoming increasingly apparent that there is no solution with the current design of our health-care system, and it's going to fall apart in different areas, like a stack of dominoes." 

Gomes agreed something has to change to effectively reduce wait times for necessary surgeries. 

"There needs to be some long-term thinking and long-term investment. And it has to be aligned with the needs of patients."