VICTORIA — The B.C. government is considering expanding the types of surgeries it funds at private clinics, as critics demand it instead spend that money on opening unused operating rooms in public hospitals.

The Health Ministry said in a policy paper that it is considering allowing private clinics to do surgeries that require up to three-days of post-operative in-patient care, using public money. Currently, the government only allows day surgeries at private facilities, when no public operating room is available.

“Improved access to surgical services may include performing select surgical procedures which have length of stay up to three days, in private surgery centres, using public funds,” reads the document. It says this will require changes to the law.

But doctors and nurses say there are many operating rooms in public hospitals that are unused because of funding shortages and a lack of specialized nurses, anesthesiologists and surgeons.

“We would like to see public money be forwarded to public health facilities,” said Gayle Duteil, president of the B.C. Nurses’ Union. “Operating rooms sit empty hour after hour, and by putting this money into the private health care system, where exactly do you think the nurses are going to come from?”

Of the 295 main operating rooms in B.C. hospitals, only 82 per cent are staffed and open for procedures. The situation worsens during summer holidays, when 23 per cent of operating room capacity is closed. Few operating rooms operate on evenings and weekends, except to handle emergencies.

Health Minister Terry Lake announced $10 million Monday for an additional 1,000 surgical day procedures for patients who’ve been waiting more than 40 weeks, and said some of these will be done in private clinics due to a lack of public operating space.

Lake was unavailable for an interview Tuesday, and his ministry said it did not know how much it would cost to hire the staff necessary to get unused operating rooms functional.

“It is not simply a matter of throwing more funding to the system to open or run more ORs,” the Health Ministry said in a statement. “We know that over the past number of years we have increased the number of surgeries significantly — at a higher rate than population growth, but despite that, the issue persists, as demand continues to rise tremendously.”

The government has put $58 million toward recruiting and retaining anesthesiologists, for example, because a shortage of that specialty can often leave a surgery team without the ability to operate, said the ministry.

“We’re looking at those areas of weakness, because in many cases we have the facility there but not the team to run the facility,” said the ministry.

Vancouver Coastal Health, which expects some of its additional 350 surgeries to be done in private clinics, said the main reason it has unused operating rooms is lack of staff.

But the organization representing B.C. doctors said it has members trained and willing to work, yet unable to find surgical space.

“There are some types of surgeons who cannot get jobs in the system and that’s really ironic,” said Dr. Bill Cavers, president of Doctors of BC. “We know there are orthopedic surgeons who have finished their training, are ready and willing to provide services, but they can’t get access to OR time.”

Cavers said he supports the government using private clinics with public funds as a “safety valve” for the system when patients have been waiting too long for surgery. The government needs better guidelines on what is an acceptable wait for certain procedures, he said.

The government’s policy document admits to poor planning that led to a constant shortage of some OR staff and added that there are many inefficiencies and problems in B.C.’s system of booking surgeries. The ministry said it is also looking at Saskatchewan’s model, where the province aims to get all patients into surgery within three months, using private facilities as needed.

rshaw@vancouversun.com

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