N.S. Health president ready to swear on a Bible that surgery backlog will fall

The president and CEO of Nova Scotia Health, Karen Oldfield, said she is ready to swear to God that the number of people waiting for a surgery in Nova Scotia will be reduced by 10,000 cases in the next few years.

"Where is a Bible?" asked Oldfield before addressing members of the legislature's health committee on Tuesday in Halifax. "We don't have a Bible? Then I cross my heart. I cross my heart."

Oldfield told the all-party committee there are currently about 22,000 people on surgical waits lists across the province and, according to national benchmarks, only 12,000 Nova Scotians should be waiting for an operation.

She publicly pledged to eliminate that excess between now and mid-2025.  

"We will provide the right care, in the right place to Nova Scotians as quickly as we possibly can and that is a promise," Oldfield told MLAs.

Speaking to reporters after the meeting, Oldfield said fulfilling that promise would require a concerted team effort. 

"We need to find ways to do our 50,000 annual surgeries, plus eat into that wait list," Oldfield told reporters. "So if you just took that over four years, you would say 2,500, 2,500, 2,500, 2,500 [surgeries]."

"It's not that simple, but that just gives you order of magnitude." 

Oldfield suggested that could be done in a variety of ways, including doing more same-day procedures that do not require a hospital stay, increasing operating room time, perhaps at private facilities, and finding efficiencies by using a single, provincewide surgical referral system which will be available in March 2023.

Private clinics in the mix

"Everybody's trying to find a way that they can do a little bit more to eat into that list," said Oldfield.

Dr. Philip Cyr, CEO of Scotia Surgery, who was also called before the committee but not asked any questions, said his private clinic adjacent to the Dartmouth General Hospital was willing to take on more work for the province.

"If the demand is there, the capacity is there to convert some of the space on the surgical floor for a third [operating room]," said Cyr who said he made that pitch to government three months ago, but received no response.

Cyr said he would need a commitment from Nova Scotia Health or the IWK Health Centre that they want more capacity at his clinic before he creates a new operating room.

Oldfield said that option was "definitely on the table."

Coincidence 'convenient'

But opposition politicians were skeptical of Oldfield's promise to reduce the wait list in the next three and a half years, partly because the target lines up with the next provincial election date, fixed for July 2025.

NDP Leader Claudia Chender called that coincidence "convenient."

She also said Oldfield's plan to chip away at the list depended on the number of people waiting for surgery not growing.

"That's assuming that the list of 23,000 people waiting for surgery remains static over the next four years, which it will not.  And also it doesn't take into account the many, many, many people just waiting for a consultation," said Chender. "I hope that those benchmarks are exceeded because Nova Scotians deserve that, particularly from a government that promised to fix health care."

Liberal MLA Brendan Maguire pointed to the fact the Progressive Conservative government already promised to hit the wait list benchmarks by early next year.

In the mandate letter Premier Tim Houston issued to Health Minister Michelle Thompson in September 2021 — under the heading Address Surgical Wait Times — he wrote:  "Meet the benchmark standards for wait times as established by the wait time alliance, within 18 months of being elected." 

"They're now saying that they're going to hit those benchmarks before the next provincial election," said Maguire. "And I can guarantee you what's going to happen is they're going to say there's some complications.... 'This thing was a lot more complicated that we thought. We had to clean up a bigger mess than we thought.'"