Health care in Canada: Children face unsafe surgery wait times, report says

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Four out of ten child patients in Canada are facing unsafe spinal surgery wait times, according to a new report.


Published Monday, the report also estimates that delaying access to pediatric spinal surgeries costs the Canadian health-care system at least $44.6 million.


“Wait times in Canada for spinal surgery that children need far exceed the recommended safe clinical time frame in several provinces,” states the report from the Conference Board of Canada, a not-for-profit think tank and research organization. “Beyond pain and emotional distress, wait times that lead to delayed surgeries result in increased costs due to disease progression, complications, more complex procedures, extended hospitalization, readmissions, and rehabilitation journeys.”


The report focuses on the spinal condition scoliosis to highlight the broader issue of prolonged pediatric surgery wait times following the COVID-19 pandemic.


Scoliosis is a condition where the spine is curved in a sideways “S” or “C” shaped. While most curvatures can be corrected with braces and exercises, severe cases may lead to interventions like surgically-implanted rods or spinal fusion. The report estimates that 2,778 children are currently waiting for scoliosis surgery in Canada.


While the clinically recommended time frame for paediatric spinal surgery is six months, the report estimates that only 38 per cent of pediatric scoliosis patients are having surgeries within that period in Canada.


Paul Fontaine’s daughter is one of them.


“They’re hoping within a year,” Fontaine told CTV National News from Winnipeg. “But they can’t really give us a time, she’s on a waitlist and it’s priority-based.”


According to available data, the situation appears to be the most severe in Nova Scotia, where 68 per cent of pediatric patients are receiving back or spinal surgeries after the recommended six months. In the report’s analysis, Nova Scotia was followed by British Columbia (45 per cent), Saskatchewan (44 per cent), New Brunswick (37 per cent), Ontario (29 per cent) and Alberta (13 per cent).


Prolonged surgery wait times, the report states, can lead to further spinal curvature, complications and the need for even more complex procedures. The report estimates this could cost the health-care system $44.6 million, while also creating an economic impact of $1.4 million in lost productivity as caregivers take time off work to look after children.


“More extensive, complex surgery increases the risk of potential adverse events and surgical complications, leading to a higher likelihood of extended stay in hospital, readmission, and additional operations,” the report explains. “These costs increase as the cohort of children waiting for surgery grows.”


Dr. Erik Skarsgard is chief surgeon at B.C. Children’s Hospital and a medical professor at the University of British Columbia.


“We do know that when children wait a long time for scoliosis surgery, that the curvature of their spine worsens, the complexity of the operation required to fix it and the time to recovery afterwards all increase, and that’s why these children stay in hospital longer and why they cost the health system more,” Skarsgard told CTV News. “So there’s great benefit both to the child and family, but also to our health system, if we’re able to get these surgeries done in a timely manner.”


The report’s recommendations include more investment in pediatric health-care, increasing surgical capacity to reduce backlog, prioritizing surgeries that were postponed during the COVID-19 pandemic, and creating a pooled referral system so the first available doctor can take on patients from a central waiting list.


“Wait lists and surgery backlogs in pediatrics have persisted for many years and were aggravated by COVID-19, which strained health care in Canada and globally,” Chad Leaver, the Conference Board of Canada’s health and human capital director said in a news release. “While surgery volumes have improved, we won’t see a meaningful reduction in the backlog until surgeries are performed at a greater pace than before the pandemic.”


In Ontario alone, 17,091 children were on surgery wait lists in 2022, which was a 26 per cent increase over the 2019-2022 pandemic period. In B.C., approximately 7,000 children were waiting for surgeries as of June 2023.


The first in a three-part series, the report was written by the Conference Board of Canada with financial support from Children’s Healthcare Canada, a national association of child health services providers.


“This research series highlights the need for strategic and sustained investments across the continuum of children’s healthcare systems to make sure children and youth across Canada receive the care they deserve, when they need it and where they need it,” Children’s Healthcare Canada president and CEO Emily Gruenwoldt added. “Children’s Healthcare Canada thanks The Conference Board for helping put a price tag on the delays our children experience accessing essential healthcare.”  


Kandra West-Pettigrew of Dartmouth, N.S. says her daughter has fully recovered from scoliosis after receiving surgery.


“It’s agonizing to see your child suffering, no matter what degree it is, no matter what diagnosis it’s for,” West-Pettigrew told CTV News. “It’s very painful and stressful on the dynamic of your family, on the parents trying to help communicate with the children, because normally they’re usually very young.”


With files from CTV National News Toronto Correspondent Heather Butts

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