Budget cuts pushing MUHC doctors to the limit, top surgeon says

The surgeon-in-chief at the McGill University Health Centre (MUHC) says a funding shortfall is likely to increase wait times for elective surgery at the MUHC, but the Quebec government is denying the problem has anything to do with budget cuts.  

Dr. Gerald Fried has written a letter to hospital staff in which he estimates that the number of scheduled surgeries will have to be cut by between 1,000 and 1,500 because of "significant cuts" by the government.

Quebec determines its funding of the MUHC based on an 85 per cent occupancy rate. However, the hospital says its average occupancy rate is closer to 91 per cent.

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Efforts by the hospital to have the government review its funding levels have so far fallen on deaf ears, Fried said in the letter. 

"The [MUHC] administration made a strong argument to the Ministry to reconsider our funding, based on the impact on patient care, access to timely surgery and the complexity of the work we do," Fried said. "This was essentially refused."

In order to make up the funding shortfall, Fried said the hospital would be forced to close its elective operating rooms for as many as 30 days of the year. This represents a 20 to 30 per cent reduction and will likely have a significant impact on wait times at the hospital. 

"Sometimes we get to the point where we feel that this has pushed us to the limit of what we feel comfortable with professionally," Fried told CBC News. 

"There are compromises that need to be made that are sometimes quite difficult for us and difficult for the patient."

​Barrette denies budget cuts to blame

Health Minister Gaétan Barrette acknowledged there will be a reduction in day surgeries, however, he denied that budget cuts were to blame.  

The minister attributed the drop to a scheduled reduction, as well as to the transition to the hospital's new Glen site.

"The rate at which the hospital is working today is not necessarily where it should be at the end, but that's normal," Barrette told reporters in Montreal.   

"It's a transition period, and it will get there."

He added that the superhospital's doctors had previously agreed to the transition plan, which included reductions in elective surgeries. Barrette said he couldn't understand why the doctors were blaming budget cuts.

"They approved it. They signed it: The MUHC has been built and designed accordingly," he said of the transition plan.  

"So it's very surprising to me to come out today and say, 'Well, this is because this and that'. It has no relationship at all."

Surgery 'time sensitive'

The transition plan Barrette refers to dates back to 2007.

Since then, said Fried, the MUHC's care mandate has changed. 

For instance, it now devotes roughly 30 beds to chronic care, while the 2007 clinical plan envisioned relieving the hospital of chronic care altogether.

By failing to accommodate for the MUHC's evolving mandate and its higher occupancy rates, the Quebec government is limiting the hospital's ability to provide timely care, Fried said, adding that will ultimately impact the quality of care for patients.

"Surgery is generally a time-sensitive act," he said. "The longer you delay people, the longer they are with their disease."