Island Health wants to farm out up to 55,000 surgeries

Island Health wants to farm out up to 55,000 day surgeries over five years to private clinics, the largest and longest contract yet to reduce wait times and ease pressure on hospitals.

On Thursday, Island Health posted a request for proposals for private clinics to provide up to 4,000 day surgeries — everything from hip-and-knee surgeries to hernia repairs and gall-bladder removals — each year over a three- to five-year contract for a maximum of 20,000 procedures.

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Island Health is also looking for a private clinic or clinics to provide up to 4,000 endoscopic procedures — colonoscopies — on the south Island and up to 3,000 endoscopies in the central Island each year over the same period for a maximum of 35,000.

The contract could go to one clinic or two clinics, depending on the bids.

“It would be the longest and largest we’ve undertaken,” said Norm Peters, Island Health’s executive director for surgical services.

The NDP says Island Health’s call for contracts is an entrenchment of stop-gap measures where use of private clinics to reduce wait times drains funding, doctors and nurses from the public to the private system. “It’s a worrisome trend,” said NDP critic Judy Darcy.

The surgeries are publicly funded and patients come from Island Health’s standard wait-lists. The private clinics must be accredited and meet a variety of standards and guidelines, including those set out by the College of Physicians and Surgeons of B.C.

Island Health began awarding contracts for day surgeries to private clinics in 2004 to reduce wait-lists and reserve hospital operating and procedure rooms for more acute and complex cases.

The health authority has been struggling with a backlog of colonoscopies since April 2013, when it spearheaded a provincewide colorectal cancer-screening program, offering screening colonoscopies to people who have a positive stool test or have a family history of the disease.

There are 1,265 people waiting for a colonoscopy, including screening colonoscopies, at Victoria General and Royal Jubilee hospitals.

Island Health said it is looking for a private clinic or clinics to provide day surgeries and/or colonoscopies to improve patients’ timely access to care.

“I want to re-emphasize this is a patient-first approach and the quality of service is going to be our No. 1 priority,” Peters said in an interview.

“While we are looking for the best price to do as many procedures as possible, it won’t come at the cost of quality.

“We recognize there are procedures done in an operating room that could be done in an ambulatory setting outside the hospital.”

Darcy agrees wait times are too long for a number of procedures. But she said public facilities should be used to provide high-volume but low-risk specialized procedures, rather than building up the private system until there is no turning back.

“I think it’s a big issue that we are losing control and handing it over to the private system … to increase prices in the future,” Darcy said.

Island Health has had a multi-year contract with Victoria Surgery Centre, which was extended to Dec. 31, 2015. “This would be the next evolution in that and a longer-term agreement with a larger volume of cases,” Peters said.

Island Health also has contracts with Seafield Surgical Centre in Nanaimo and Comox Valley Surgical Associates.

Over the past three years, those three private clinics have performed 1,328 surgeries for Island Health

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