The provincial government won't come close to fulfilling its pledge to meet the national standard for hip and knee replacement wait times by the end of March.
The Nova Scotia Health Authority said in October 2017 it would ensure patients waited no longer than six months for hip or knee replacement surgery and that the benchmark would be met by April 1, 2020.
NSHA-supplied data shows that more than half of all knee replacement patients still wait longer than that. From April of last year, only 47.8 per cent had their knee operations within six months. In the same time period, just 61.6 per cent of hip surgeries were done within the six-month target.
Both are improvements, but miss the mark by a wide margin.
On Thursday, Health Minister Randy Delorey wouldn't give a new date to meet the target. Nor was Delorey prepared to set a different benchmark for hip and knee replacement wait times.
“We will continue to strive toward the national benchmark and we will do that by continuing to listen to our frontlines,” said Delorey. “This was a very new program that was announced in fall 2017.”
He said more Nova Scotians are getting the surgery now than ever before but the demand for both procedures continues to be high.
“We're not where we want to be on the wait list side,” said Delorey.
While half or better are now having their surgeries within six months, many are waiting longer.
The NSHA website shows some on the knee replacement surgery list are waiting as long as 601 days, while those on the list for hip replacements can wait up to 433 days. Ninety per cent of surgeries happen within those time frames.
These waits are after the patients’ first pre-surgery consultation. In 90 per cent of cases, replacement surgery candidates see a doctor for their consultation within 154 days.
There has been some improvement. In 2015/16, only 38.9 per cent of knee replacements and 54.3 per cent of hip replacements were done within the six month target.
Brendan Carr, NSHA president and chief executive officer, also declined to offer a target date to meet the six month benchmark.
"It's hard to pick a date and say we're going to achieve it at this point in time," said Carr.
He said the problem of ongoing wait times is largely a result of limited hospital operating room beds and anesthetists needed to perform the surgeries.
He also said the procedures are just a few of several surgeries that the NSHA perioperative program has to manage.
"The province is doing everything from cancer surgeries, to hernia repairs, cardiovascular surgeries and neurosurgeries. ... One of the problems is balancing those priorities."
Carr was reluctant to say whether the national benchmark is a realistic goal for the province, but said that targets are important because they give “a sense of direction to the health system."
"It is essential to have targets," he said.
It takes longer to get hip and knee replacements in Nova Scotia than in most other provinces, according to the Canadian Institute for Health Information. Less than half of Nova Scotians waiting for surgery in 2018 had it within six months.
Nationally, 69 per cent of knee operations and 75 per cent of hip operations are done within the recommended six months.
None of Nova Scotia’s five provincial hospitals offering both procedures are close to meeting the national benchmark.
Tory health critic Karla MacFarlane said the wait times are unacceptable. MacFarlane said she was informed by one of her constituents on Wednesday that his knee replacement surgery had been cancelled at the Aberdeen Hospital in New Glasgow after waiting two years for the procedure.
"He is now extremely frustrated because he doesn't know when he'll be put back on the list," said MacFarlane.
She said cancellations for both hip and knee replacements aren't uncommon. With each cancellation, patients are required to go through a new screening process, a waste of taxpayers' money, she said.
MacFarlane admits that the problem is complicated but one of the major factors is a lack of open beds. Four of 10 intensive care unit beds were recently removed from the Aberdeen Hospital.
She said the absence of new targets for surgeries allows the status quo to continue.
"We have an aging population. This is an opportunity to collect the data and make new targets."
The NSHA has made investments in recent months in an attempt to alleviate wait times. Over the summer it announced four additional surgeons, three anesthesiologists, new technology and equipment, and more than 80 additional full-time equivalent roles in nursing, physiotherapy and occupational therapy.
Delorey also said the health authority recently expanded its rehabilitation programs, resulting in more successful surgeries and shorter recovery times.
(This article has been amended.)