REGINA – Huge debate has ensued following word that the Saskatchewan Health Authority is moving all surgeries for infants born at full term up to eight weeks of age, or infants born premature up to 48 weeks post date of conception, to Jim Pattison Children's Hospital in Saskatoon.
At a SHA news conference at Regina General Hospital, Dr. Michael Kelly, their Provincial Head of Surgery at the University of Saskatchewan, said those cases where surgery would previously be performed in Regina will now see those completed at Jim Pattison Children's Hospital. He said this move will have Saskatchewan aligning with national best practices.
“Very young and medically complex infants as a group face a higher risk during surgery and anesthesia,” Dr. Kelly said. “These patients require highly specialized teams to provide their care, and much care must be delivered frequently enough to maintain skills and expertise in the best interest of patient safety and quality of care.”
But Opposition Health critic Meara Conway has slammed the move, which took effect April 1. She pointed to the internal SHA memo outlining the change, and claimed that what she heard from health care workers is this move will put babies lives at risk.
“We’ve heard that this will cost lives, that some babies will not make it,” said Conway. “These babies are just a few days old, many of them are fighting for their lives and every minute counts, I myself had a child at Regina General just earlier this year, and I can’t imagine not having access to the surgeries that needed. It will be hard on the families who are already dealing with some of the hardest moments of their lives having to be uprooted and go to Saskatoon.”
Conway also said the memo from the SHA insisted the change has been made to the low volume procedure, “however that was disputed by many of the healthcare workers we spoke to.
She called the move “clearly the result of a lack of ability to recruit and retain an anaesthesiologist in this domain.”
“At the end of this day, this comes down to priorities — priorities of a government that has now been in power for two decades, but it appears has given up on improving healthcare. They are content to pay lip service. They are content to slap a new cover on an old plan as we continue this slow march into further healthcare chaos.”
But while shortages of anesthesiologists across Canada was a concern cited, officials say there are other reasons for the move.
Dr. Kelly noted that when case volumes are low, it “becomes difficult for providers to maintain the exposure and skills required to safely manage these patients.” He said this has led to consolidation of surgical care for such infants at specialized children's hospitals across Canada.
He also noted that this is a proactive decision, and that they have been no safety events related to this.
Dr. Mateen Raazi, provincial head of anesthesiology, said that only one or two of these surgeries were being done a month in Regina. He said over a 20-month period, about 25 cases have been done in Saskatoon and roughly around 7 or 8 cases in Regina.
“And because of that inadequate exposure, I would say, the request came from our Regina colleagues here practicing within Regina to say it is very difficult now to maintain the skills that are needed to safely look after these babies. And when we contrast that with the pattern in all other Canadian jurisdictions, it's exactly the same pattern.”
At the SHA news conference the officials stressed they believed safety was not being jeopardized by transporting babies from other communities to Saskatoon. They pointed to their pediatric transport teams as having acquired the expertise and processes over time to do this safely.
Cockrill responds
In speaking to reporters at the Legislature, Health Minister Jeremy Cockrill gave his response to the concerns raised by the NDP.
“The reality is our specialized children’s hospital is in Saskatoon,” Cockrill said. He noted there are 2000 paediatric surgeries a year in Regina, but the “specific subset that we were talking about in this case, though you know about one, maybe two cases a month.”
“And when you’re talking about very specialized anaesthesiologist specialist that’s very challenging. That’s a very challenging to maintain a program, maintain a team that really has the expertise and really the comfort level in performing very challenging operations on very young vulnerable patients. And so the decision was made in concert with the Saskatchewan Health Authority in the provincial Department of Anaesthesiology, provincial Department of Surgery, provincial department of Pediatrics to say hey, we can better handle these one or two cases a month in Saskatoon with our team at JPCH — our team at JPCH does about six, seven maybe eight cases a month.”
Cockrill said the province was “very lucky” to have the Children’s Hospital in Saskatoon.
“Before that, you know situations like this would be going much further whether that’s Toronto, Edmonton, or Winnipeg or Calgary Vancouver, You know, obviously you know, I think when we talk about ensuring that all patients receive the right care at the right time in the right place, really from the right professional as well, for these patients that’s Jim Pattison Children’s Hospital.”
Cockrill also pointed to a “very good transfer team transfer team” to transfer those patients. He said he had “a high level of confidence that we will continue to be able to offer really a high-level quality care for these patients.”
