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Eight Patients Die In Manitoba While Waiting For Heart Surgery

Intensive care, saving the patient s life. Doctors do everything possible to save a person from pneumonia of the virus covid 19. Epidemic, blue filter.

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SecondStreet.org recently obtained new data about patients in Manitoba dying while waiting for heart surgery.

The data brought to mind an interesting question –

Why does the Manitoba government disclose more details about renovations to private pizza restaurants than the government discloses about patients who die while waiting for surgery?

Here’s a bit of background and the data we acquired…


BACKGROUND:

In 2019, the CBC ran a story about echocardiogram wait times:

Manitoba: 70 weeks
Saskatchewan: 1 week

Just imagine having to wait over a year for such an important test.

According to the Mayo Clinic, timely echocardiograms are important as they can detect heart disease, congenital heart defects and problems with valves or chambers in the heart.

So, what would happen if someone had to wait too long to identify a problem and died prematurely because of it?

Stories like this contributed to SecondStreet.org’s decision to conduct national research into just how many patients die each year in Canada while waiting for surgery and diagnostic scans. We subsequently gathered data from hospitals and health regions nation-wide and released two Died on a waiting list reports – one in December 2020 and one in June 2021.

Unfortunately, we didn’t receive any data from the Winnipeg Regional Health Authority (WRHA) … until recently.


WRHA DATA

The data we obtained from the WRHA only covers patients who died while waiting for cardiac cases (click here to view). Here is a summary:

  • Eight patients died between April 2019 and April 2021 while waiting for cardiac surgery;
  • Two of the patients waited more than 120 days for surgery – one waited longer than the maximum recommended time period;
  • For three of the patient deaths, no maximum recommended wait time was identified; and
  • The WRHA wasn’t able to tell us the scheduled surgical dates for the eight patients – there may not have even been scheduled dates.

Did any of the patients die because they waited so long for an echocardiogram?

Did any die because they waited too long for surgery?

What about patients who died while waiting for other surgeries and diagnostic scans?

Isn’t this important information to know and disclose?


THE DOUBLE STANDARD

Consider what the Manitoba government discloses about businesses who don’t properly follow government rules.

In 2019, the Manitoba government shut down the Wood Fired Pizza restaurant in Brandon and disclosed the following:

“Extensively remodel[ing] a food handling establishment without first registering.”

The government disclosed the name of the business and reason for shutting it down. Readers can envision what occurred – the business did a large renovation project and didn’t get the government’s nod of approval before selling food to the public.

That seems fairly minor compared to a patient dying while waiting for surgery from the government, doesn’t it?

Details around serious incidents in the health care system are less forthcoming.

Since 2006, Manitoba has required “critical incident reports” to be created when “health services are provided to an individual and results in a consequence to him or her that is serious and undesired.”

For example, between July 1, 2019 and September 30, 2019, a patient passed away in Manitoba and the following critical incident information was disclosed:

“There was a delay in recognition of acute changes to diagnostic information leading to a missed opportunity for earlier intervention.”

This tells readers and researchers very little about what happened.

How long was the delay? What was the acute change to diagnostic information? The short blurb suggests the patient died because of the mistake … was anyone held accountable? Which health facility was responsible? What changed as a result?

In total, there were 15 deaths reported with “critical incidents” in the province of Manitoba during the three-month period.

Understandably, some parts of a patient’s adverse health experience cannot be shared publicly in order to protect the patient’s identity.

But there is lots of room for improvement when it comes to tracking and disclosing data pertaining to patients dying while waiting for surgery and diagnostic scans – and critical incident reports.

As our Died on a waiting list reports show, many other health regions do a much better job when it comes to tracking these details (click here to see what Nova Scotia provided).

As it stands right now, the Manitoba government discloses more info about pizza restaurants that don’t register their renovations than what health regions are required to track and disclose about patients dying while waiting for care.


Colin Craig is the President of SecondStreet.org

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.