Half of the children in Canada who need surgery are facing waiting times that far exceed clinical recommendations for treatment, a situation experts say could have serious, lifelong consequences for young patients’ development.
The waiting-time numbers, collected from children’s hospitals across the country by the Pediatric Surgical Chiefs of Canada, highlight the immense strain pediatric facilities are under. The burden has also led to overcrowded hospitals, record emergency-room waits and delayed diagnosis and treatment of developmental conditions.
Emily Gruenwoldt, the president and chief executive of Children’s Healthcare Canada and executive director of Pediatric Chairs of Canada, said children are being left in pain for months as they wait for surgeries, and parents are having to give up their jobs to care for them.
“When you’re waiting for a life-changing surgery, everything else stands still,” she said.
Among the children whose diagnoses have been delayed are tens of thousands facing waits of months or even years for assessment of conditions that require early intervention and treatment, such as autism spectrum disorder.
At McMaster Children’s Hospital in Hamilton, 62 per cent of patients in need of surgery are being forced to wait beyond the recommended timelines. At the same time, the hospital is operating at 120-per-cent capacity for inpatients, according to Bruce Squires, the hospital’s president.
Mr. Squires said that, before the pandemic, less than one-quarter of children in need of surgery faced delays longer than the recommended treatment windows.
“The impact of a child waiting too long for their particular medical treatment – whether it is a surgery, or mental-health care, or a cancer therapy or any other type of treatment – is significant,” he said. “It also can have lifelong impacts.”
Timely pediatric health care is critically important because early diagnosis and treatment are the most effective ways of minimizing the long-term effects of health conditions and helping children reach their full potential.
Pediatric surgeries are performed in order of how urgent they are, but even urgent procedures are being delayed beyond the recommended windows of time. Pediatric orthopedic surgeries are among the procedures most commonly subject to lengthy delays.
In an e-mailed statement, Ontario Health wrote that, as of Aug. 1, 55 per cent of those on the pediatric surgical waiting list had waited beyond the recommended timelines for their procedures.
Mr. Squires said the most recent Ontario data he has seen show that about 40 per cent of adult patients are waiting beyond the recommended timelines for surgeries.
“The kids who need our services the most are waiting too long,” said Julia Hanigsberg, the president and CEO of Holland Bloorview Kids Rehabilitation Hospital in Toronto. “That means they are deteriorating while they are waiting, so their conditions are more serious, harder to treat, with more complications and perhaps not as good a long-term prognosis.”
Like the rest of the Canadian health care system, pediatric health care is facing a series of pandemic-related issues, including worker shortages because of burnout and exhaustion. At least some of the backlogs in medical procedures are related to restrictions and shutdowns during earlier waves of COVID-19.
On top of that, many pediatric facilities are contending with an unusual surge in viral illnesses among young people, said Karen Gripp, the child health medical director at the emergency department of the Health Sciences Centre Children’s Hospital in Winnipeg. This is adding significant pressure to the system, she said.
Before the pandemic, viruses were seasonal, so clinicians knew to prepare for increases in demand, such as a spike in patients seeking treatment for asthma in the fall. But the lifting of pandemic restrictions and reduced use of masks has changed that predictable cycle, Dr. Gripp said.
“What we see now, everything is coming at the same time. All of the seasonality is gone.”
Tammy DeGiovanni, the senior vice-president of clinical services and chief nurse executive at the Children’s Hospital of Eastern Ontario in Ottawa, said 2021 was a record-breaking year for the facility’s emergency department, but that this year has been even busier. The hospital is contending with a high admission rate from the emergency room and a busy critical-care unit. And, like other facilities, its waiting lists for surgery, MRIs and a host of other services continue to grow.
Making children wait so long for important medical treatments carries significant risks, Ms. DeGiovanni said. She added that these lengthy waits require urgent attention from governments.
Ms. Gruenwoldt, of Children’s Healthcare Canada, said her organization is calling for a national strategy to help ensure timely, equitable access to pediatric health care across the country. Among the priorities she hopes to see included in that strategy are increased funding for youth mental-health treatment and improvements to the way data on pediatric health outcomes are monitored and collected.
The organization is also calling for new funding to reduce the backlog of childhood surgeries, and improved focus on training health professionals to work in pediatric surgery.
“That overarching strategy is overdue for Canada,” she said.
Carly Weeks