Doctors' group proposes Ontario fund new surgical centres to catch up on backlog

A professional group representing Ontario doctors is recommending that the province fund a new model of outpatient health-care centres to help tackle a growing backlog of surgeries and other procedures.

A report from the Ontario Medical Association published Wednesday outlined a proposal to create Integrated Ambulatory Centres across the province.

The group said the centres would work with local hospitals to perform medical services insured by the province, of which thousands have been postponed during COVID-19 at various points as the health system responded to surges in virus cases.

"The need to address both the pandemic backlog and wait times is urgent," Dr. Adam Kassam, president of the group, said at a Wednesday news conference.

"That's why Ontario's doctors are calling on the provincial and federal governments to act immediately and provide the necessary funding to clear the backlog now, while they work to implement the new integrated ambulatory center model."

The medical association said its plan would free up hospital beds so hospitals can focus on responding to acute and emergency patients without sacrificing non-acute care. It also made the case that patients would have faster access to procedures with the model and spend less time in hospitals, reducing the risk of acquiring other infections while hospitalized.

It said the current hospital-based delivery model for health care "creates constant and inevitable competition between acute and non-acute care."

Ontario currently has more than 1,000 independent health facilities, but the report said most of those are not licensed to deliver publicly funded surgeries and instead focus on diagnostic services like ultrasounds and x-rays.

Integrated Ambulatory Centres, as proposed by the medical group, could focus on outpatient surgeries and procedures in orthopaedics, gynecology, urology, plastics, otolaryngology or ophthalmology. It said the process of opening new care centres could take up to eight years, and the total cost will depend on various factors, including how many new spaces need to built and how many can be renovated.

Dr. Jim Wright, a surgeon with the group's policy and research division, said the group hasn't set a number of clinics, as some could be transitioned out of existing facilities and some regions might continue running procedures out of hospitals depending on resources available.

The report also noted that wait times for surgeries and other procedures was an issue before the pandemic, though the backlog has only grown from health system disruptions over the past two years.

Analysis in the report found a backlog of more than one million surgeries in Ontario by the end of last year. On top of that, the group said the pandemic has created a backlog of more than 21 million patient services, such as MRIs and cancer screenings, that may take years to clear.

Those figures don't account for procedures that were cancelled during the recent Omicron wave of COVID-19 and people who need services but didn't engage with the health system during the pandemic.

The OMA said doctors are reporting that patients "who would have been diagnosed and treated sooner are coming in later and sicker" because of the pandemic.

Dr. Mary-Anne Aarts, chief of the surgery department at St. Joseph's Health Centre in Toronto, said the health system is preparing for backlogs and waitlists to grow in the coming months as more people seek out treatment now that the Omicron wave of infections is subsiding.

"We're going to have increased demand on our services for diagnostic reasons and also for surgery," she said. "That's what we're trying to brace ourselves for and what we're most concerned about."

A spokeswoman for Health Minister Christine Elliott didn't rule out looking into the new funding model in the future, while also calling on the federal government to give the provinces more money for health care.

"The ministry continues to review opportunities to leverage ambulatory surgical models to help create additional surgical capacity in the province," Alexandra Hilkene said in an emailed statement.

She also pointed to the existing range of surgical models in Ontario and $300 million in funding announced last summer to help hospitals catch up on surgeries and other services.

This report by The Canadian Press was first published Feb. 16, 2021.