Orthopedic, gynecological and general operations must wait after Interior Health ends contract with private facility

More than 1,000 orthopedic, gynecological and general surgery patients in Kelowna have been left wondering when their operations will take place because Interior Health has ended its contract with the private operating facility that was to do the procedures.

Okanagan Health Surgical Centre took on day surgery cases for 3½ years to alleviate the backlog at Kelowna General Hospital. The centre's six surgeons treated 914 orthopedic patients in 2007, and several hundred more gynecological and general surgery patients.

The original arrangement between OHSC and Interior Health was brokered because the private facility, which primarily does plastic surgery, had extra time and space, said the general hospital's head of orthopedic surgery, Terry O'Farrell.

"The hospital was jammed up and we were cancelling elective cases there on a regular basis," said Dr. O'Farrell, who also operates at the clinic. "They have three well-equipped operating rooms, which is why we did this deal, and it has worked out very well."

Interior Health decided to put the operation services out to tender in 2006 and selected a new private company, Kelowna Surgery Centre, whose facility that hasn't been built yet. It is due to open in April, 2009.

Joanne Konnert, Interior Health's chief operating officer for the Okanagan, said it had hoped OHSC would continue to be used by Kelowna patients for the next year, but decided to end the arrangement on March 31 because OHSC had increased its fees for 2008 by about 20 per cent. This, she said, was significantly higher than other private facilities offering similar operations.

Most patients on the waiting list will now be treated at Kelowna General Hospital. However, Dr. O'Farrell estimated that around 1,200 orthopedic patients could be forced to wait a year or more for the new private surgery centre to open.

He is concerned about Kelowna General's ability to cope with the added patients.

"The operating room facilities probably haven't changed since the 1970s, and the population of the Okanagan has exploded and we just can't accommodate all the patients that need surgery [in the hospital]," he said.

Dr. O'Farrell added they would not be able to take any more referrals, and has written to his patients to urge them to write to Interior Health voicing their concerns.

This was the first time the fees OHSC charged Interior Health had gone up since OHSC got the contract, he said.

Lorne Aston, one of Dr. O'Farrell's patients, was on the waiting list at OHSC for surgery to correct a torn shoulder muscle until last week. The 74-year-old retiree has had heart bypass surgery in the past and was forced to stop the exercising he is supposed to do as part of his recovery.

"If it takes a year to get in there, I will be really frustrated, that's for sure. I thought I'd get in in two or three months," he said.

"It's all going to be held up because it is going to be done at the hospital and everything is so darned crammed there."

He said he had previously waited more than five months for an MRI on his shoulder, even when the OHSC was taking patients.

Ms. Konnert called the new charge rates at OHSC significantly higher than at other private centres for similar procedures.

She said the operating theatre at Kelowna General Hospital is to be opened for 50 weeks a year, up from the current 40 weeks, in order to accommodate orthopedic patients.

Some of the cases could be taken to the University of British Columbia's Department of Orthopedics in Vancouver.

Ms. Konnert said that she believes the situation would affect no more than 800 patients, 500 of whom would be operated on at the general hospital.

This, she said, would not place any extra burden on Vancouver Coastal Health.

Brian Peterson, who oversees the operating theatres for OHSC, said that if Okanagan orthopedic patients end up in Vancouver, follow-up care may be a problem.

"If someone from Kelowna goes to Vancouver to get a procedure done, they could come back home and have a complication and who's going to take care of them if the surgeon is in Vancouver?" he asked.

Ms. Konnert said Interior Health is open to further dialogue with OHSC.

"We are hopeful that we would be able to have that conversation, and move forward again and work with them," she said.

"We have been very disappointed to be going through this. We had a good partnership with them. And they certainly helped us create some capacity in Kelowna General."

A spokeswoman for B.C. Health Minister George Abbott said officials are aware of the situation and are "working on it."