Emails reveal forecast impacts, 'dire' staff concerns during Yukon hospital cuts last year

The Yukon Hospital Corporation expected its sweeping service cuts last year would double wait times for some MRIs and CT scans, exacerbate surgery waitlists and risk nurse burnout.

Internal documents reveal surgeons were caught by surprise. They accused officials of risking the safety of Yukoners for a balanced budget.

The documents, released to CBC through an access to information request, lay out the hospital corporation's serious cash-flow concerns.

In late October, it told the Yukon government's Department of Health and Social Services it was tracking toward a year-end deficit of $6 million. 

Senior staff prepared a list of planned "cost containment measures" to reduce the deficit to $4.6 million. 

They said they were imposing a hiring freeze, raising cafeteria prices and limiting travel and conference spending.  

In the surgical services department, the corporation slashed elective surgeries by a third, by taking operating rooms temporarily out of service from mid December.

In the medical imaging department, it capped the number of non-urgent imaging appointments and dropped from two MRI technologists to one.

Corporation forecast savings, longer waitlists 

The documents show the corporation expected to save $625,000 on agency nurses across the two departments.

However, it acknowledged wait times would grow, there'd be an increased risk of nurse burnout, and more people might face medical emergencies. 

While the service reduction was in place, it said the waitlist for scopes would increase by 39 people a month, the waitlist for orthopaedic services by 17 people a month and the general surgery waitlist by 15 people a month.

In the medical imaging department, it forecast people would be waiting three times longer for non-urgent CT scans — 18 months instead of six months.

It predicted people would be waiting twice as long for MRIs — pushing semi-urgent cases to five months, and non-urgent cases to 2 years.

For mammograms, it expected the minimum wait time would grow from 11 months to 14 months. 

Staff condemned 'shortsighted' cuts

The news reached surgical staff in mid-November.

Fourteen physicians and surgeons wrote to the Yukon premier and ministers to express "disappointment and anger."

"Rather than 'putting people first', as is their mandate, Yukon Hospitals is fundamentally risking the safety of all Yukoners for a balanced budget," they said. 

They said cutting costs and stretching current nurses was "certainly not the solution" to ongoing nursing shortages.

They said it would also negatively impact every patient needing their care. 

"We are concerned that the hospital administration, and your government, are not aware of the potentially dire impacts such cuts will have for our patients and your constituents. The intention of this letter is to lay out the high stakes of such shortsighted cuts as they are likely to cost the Yukon's healthcare system more in the long run than they are immediately worth."

One of the surgeons who signed the letter was Dr. Alex Kmet.

"As an individual provider, I was one of the anesthesia doctors at the hospital ... I felt surprised with how quickly things unfolded," he explained.

In another letter, the surgical services associate chief of staff urged the CEO to "stand up in front of those most affected, and explain things."

"I think it would go a long way if you, as CEO, were the one presenting or at least present to explain or take questions when implementing major changes such as a 30 pe rcent reduction in surgical services ... this is HUGE," he wrote.

"I know that you care about your front-line workers, however, many of my colleagues feel otherwise."

Regular services resumed — but waitlists still long

In December, the Yukon government announced more funding for the Yukon Hospital Corporation.

In a brief email response to CBC, the corporation said that helped it resume "regular service levels" in its medical imaging and surgical services departments.

It's still restricting spending on travel and conferences, and no new positions can be created.

Dr. Rao Tadepalli, who works in Whitehorse General Hospital's emergency department, said he's worried the corporation will keep going overbudget and having to cut services.

He said in Whitehorse, services were still extremely strained.

"There is an ongoing crisis with beds, causing an enormous staff burnout," he said.

"We do not have a place for patients to be looked after. The hospital is over capacity all the time. So if it is over capacity, obviously this is causing more budget overruns."

He said last year's cuts were a case of mismanagement and chronic underfunding. 

"When patients are awaiting surgery and ORs are cancelled or postponed, the problem tends to magnify and patient suffering increases. So that clogs up the emergency room even more," he said.

"The last thing to do would be shut down the OR. If things have come to that extent, it means healthcare has crumbled."

Kmet, who is also the head of the Yukon Medical Association, was more optimistic. 

"I'm glad that the funding gap got resolved," he said.

"The government heard that public experience quite quickly and responded with funding very quickly." 

Kmet was hopeful officials would be "flexible to respond", if the hospital ran over budget again. 

However, he said last year's cuts may have lingering effects.  

"During the COVID pandemic.. when surgical and diagnostic imaging services [were] curtailed in other parts of the country, you saw, initially, a significant decrease in for example, cancer centre referral volumes - and then thereafter a huge backlog and increases in demand," he said. 

"What magnitude November and December added on to waitlists, I don't know."

The Yukon Hospital Corporation declined CBC's interview requests.