Top N.S. surgeon expects surgery backlog to grow

Nova Scotians waiting for routine surgery, particularly those who need to undergo complicated operations, will need patience, according to a top health administrator and surgeon.

Although surgeons are doing nearly as many operations as they were this time last year, the backlog created by the ongoing pandemic, and the redeployment of resources by health administrators, means many are still dealing with the 3,200 cases that were delayed by cancelling routine procedures.

According to Dr. Gregory Hirsch, the person responsible for making sure medical procedures run as smoothly as possible and wait times are as low as can be, there are roughly 25,000 people on the surgical wait list.

That's how many there were before hospitals cancelled those 3,200 surgeries to free up beds and reallocate resources to prepare for patients needing care as a result of COVID-19 infections.

Since the pandemic arrived in Nova Scotia, only 49 people who contracted a COVID-19 infection were sick enough to need hospital care. 12 of those needed intensive care.

Hirsch said he and his colleagues were still whittling away at those cancelled procedures.

"We have done about 70 percent of those," he said. "And many of the others are booked with plans to get them done. So we're doing pretty well with that 3,200."

What concerns Hirsch is the impending increase in demand as people turn their minds to new or nagging health problems. Based on past experience, he expects an avalanche of new referrals.

"Not only did we slow down surgery, we slowed down seeing specialists and we slowed down seeing family docs," said Hirsch. "So the only (people) getting through the door were the emergencies, which we continue to do at the same rate as always.

"So the concern is, and the reality probably is a backlog of 12,000 that have yet to emerge."

The issue of space in long-term care has made hospital bed availability "more challenging," said Hirsch. But he said it was imperative for beds to free up now "to take care of the 12,000 yet to show up."

Lack of inpatient beds

Nova Scotia's top health department bureaucrat, Deputy Minister Dr. Kevin Orrell, sent a letter last week informing nursing home administrators that they would no longer be allowed to keep more than three per cent of their beds empty.

It's an attempt to get homes to free up hundreds of beds in their facilities so people in hospital beds can be moved into them.

Meantime, because of a lack of available hospital beds, surgeons are concentrating on doing day surgeries or procedures that require minimal hospital stays.

"It's the [lack of] inpatient beds that are preventing us from doing the more complex patients that need inpatient care," says Hirsch. "You might say we're doing these simple things that aren't really going to cause great grief if they don't get done. But let's use the resource to do something."

With more beds, Hirsch is hoping surgeons will be able to make up lost ground and get wait times similar to how they were pre-COVID-19 — which he said were "not good enough, but maybe 60 percent were getting done within standard."

"Now we're worse than that, so we want to get back to at least where we were, if not better than we were," said Hirsch.

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