Surgeons at work in Surrey Memorial Hospital.

Fraser Health penalized for long surgery waits

Incentive target missed for knee, cataract patients

Fraser Health failed to meet provincially mandated targets to rein in surgery wait times in 2010-11 and as a result lost out on an extra $2.6 million in incentive funding that’s dangled by the government each year as a carrot to improve.

“Although we increased surgery volumes about three per cent, we were unable to shorten the wait times as much as we needed to meet the target,” health authority spokesman David Plug said.

The payments through the health ministry’s patient-focused funding branch rewards health authorities that meet targets to keep waits down and punishes them if they don’t – the money instead goes to reduce the province’s deficit.

The rules require no more than 10 per cent of patients wait longer than 26 weeks for knee and hip surgery and 16 weeks for cataract surgery in order for each authority to qualify for activity-based funding in each of those categories.

But 19 per cent of patients waited longer than 26 weeks for a knee replacement in the Fraser Health region in the 2010 fiscal year, so the authority lost out on nearly $1.8 million, Plug said.

And the authority was docked another $834,000 because 39 per cent of cataract patients waited longer than 16 weeks.

Statistics show 55 cataract patients in Fraser actually waited longer than a year for surgery, so the authority also failed in clearing a separate bar that no patients wait more than 12 months.

On hip replacements, 11 per cent of patients waited more than 26 weeks – just missing the target – but Plug said the ministry agreed that was close enough and credited the authority $1.6 million.

He said the incentive system encourages the region to make its booking and surgery system more efficient, perform more procedures and reduce waits.

Fraser tries not to double book the same patient or keep patients on wait lists whose conditions have changed and are no longer ready for surgery.

“That helps us have a more accurate list and wait times can come closer to the target,” Plug said.

The region also strives to make sure operating rooms have enough capacity to handle scheduled cases and to make sure hip and knee replacements have time reserved.

Burnaby Hospital has emerged as a specialty centre for those surgeries, Plug said, and patients are now sometimes being sent there to avoid longer waits elsewhere.

It’s not yet clear if the region will hit all three surgery targets this fiscal year, which ends at the end of March.

“We’re within 50 or so people of making the hip target,” Plug said, adding Fraser is close to the targets on knee and cataract surgery as well.

Fraser performed 2,400 hip replacements and 15,000 cataract surgeries last year.

Fraser’s surgery wait statistics are considerably worse than in the Vancouver Coastal region, which serves Vancouver, Richmond and the North Shore.

Just one per cent of Vancouver Coastal patients waited longer than 26 weeks for hip or knee surgeries and just four per cent waited longer than the target for cataracts. As a result, that region lost no money.

No cataract patients in Vancouver Coastal waited longer than a year, nor did any on Vancouver Island or in the Interior.

The Northern Health Authority was the only region that performed worse than Fraser, with more than a third of hip replacement patients waiting too long and nearly half of knee and cataract surgeries exceeding the target. Sixty-five cataract patients there waited longer than a year.

The money at stake is not much compared to overall budgets.

Fraser’s penalty last year was less than one-tenth of one percent of its $2.75-billion budget.