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opinion

Newfoundland Premier Danny Williams speaks in St. John's on January 28, 2009.Paul Daly

Newfoundland and Labrador Premier Danny Williams misrepresented Canadian health care this week in explaining why he went to Miami for mitral-valve surgery. With his statements, whether inaccurate or simply incomplete, he made Canadian medicine look second-rate.

His doctors in Canada, he said, told him he would need a full or partial sternotomy, either of which would have required breaking his chest bones. At Miami's Mount Sinai Medical Center, by contrast, he received minimally invasive surgery, no bones broken. "Did some checking, of course, and what was ultimately done to me, the surgery I eventually got… was not offered to me in Canada," he told his province's NTV News.

Minimally invasive mitral-valve surgery is performed at the Montreal Heart Institute and Hôpital du Sacré-Coeur. It is also done at hospitals in Quebec City, London, Ont., Toronto, Ottawa, Edmonton and Vancouver. "You can have all the special care that you need around Canada; we have the same results and the same safety that they offer in Florida, I'm sure," Hugues Jeanmart, a cardiac surgeon at Hôpital du Sacré-Coeur and the Montreal Heart Institute, said yesterday. Patients can return to their regular lifestyle in four to six weeks. He said he has done minimally invasive mitral-valve surgery over 350 times; Dr. Joseph Lamelas of Miami's Mount Sinai has done it 2,000 times. But the technique is available in Canada, contrary to the impression Mr. Williams left.

"It's his body, it's his money, hopefully, but don't tell us the operation cannot be done here," said Arvind Koshal, director of cardiac surgery at the Mazankowski Alberta Heart Institute in Edmonton. "It can be done."

The University of Ottawa Heart Institute issued a statement yesterday from Thierry Mesana, the chief of cardiac surgery, that minimally invasive mitral-valve surgery has a higher rate of complications, including strokes, and "the only real benefit is cosmetic." On the other hand, Bob Kiaii at the London Health Sciences Centre said he does the minimally invasive surgeries routinely, and more safely than when the chest is sawed open.

The impression Mr. Williams left, that the technique he sought in Miami is not available in Canada, is reinforced by his statement that he will consider applying for reimbursement for his medical costs in Florida.

He also said he would inevitably have been seen as a queue-jumper if treated in Canada. But Dr. Jeanmart in Montreal said prompt care is available when the individual case is acute. The Peter Munk Cardiac Centre in Toronto said it has no extensive waiting list for any heart surgery at the moment.

"This is my heart, it's my health, it's my choice," Mr. Williams said. Of course it's his choice, but it reflects on the quality of medicare. The message he has sent by word and deed is that Canadian medicine is stuck in the past century.