Deal no drain on resources, CEO says
Hospital boss refutes claim oncology surgery blitz was curtailed due to lack of nurses
The head of the Ottawa Hospital on Wednesday defended a controversial arrangement in which operating and recovery rooms are being rented to a private corporation on weekends, saying the partnership has shortened orthopedic wait-lists and improved the efficiency of weekday procedures.
Hospital CEO Cameron Love, who has not previously addressed questions about the new “publicprivate partnership” publicly, moved to downplay allegations that the agreement is draining resources from the rest of the hospital. He further denied accusations that a planned oncology surgery blitz at the hospital this spring had to be curtailed because of a lack of recovery-room nurses.
However, sources that spoke to the Star insisted that the early days of the partnership are having negative impacts.
Love said the deal to rent public operating space at the hospital’s Riverside Campus to a private group of 26 surgeons known as the Academic Orthopedic Surgical Associates of Ottawa Inc. (AOAO) has created capacity to allow the hospital to more quickly tackle complex operations, such as spinal and cancer surgeries and neurosurgery. AOAO is renting two operating rooms and a recovery room every Saturday, a day on which these spaces typically go unused.
The agreement between the Ottawa Hospital and AOAO began in late February and has faced criticism from health policy experts, politicians and unions for a lack of transparency on the part of hospital officials and the provincial government concerning the use of public health infrastructure by a private entity and the cost to the public purse, if any. Hospital employees charge that the deal is using up public resources for private gain, while unions say enticing paycheques offered by AOAO have the potential to poach staff from regular weekday shifts.
Love said such concerns are unfounded and that the “innovative” model used by AOAO has not only resulted in more orthopedic surgeries being completed faster, but also “significant” financial gains to the hospital to the tune of $1,600 per procedure — money he says is reinvested for other surgical procedures.
“Pulling (patients) out of the main OR and doing these cases in a straightforward fashion as opposed to having emergency cases and complex cases all mixed in, you become more efficient,” Love said. He noted that before the COVID-19 pandemic, the hospital’s three campuses and 11 surgical specialties conducted about 50,000 surgeries a year. That number fell during the pandemic, creating a backlog, he said. “The growth and the aging of the population and the demand for surgery is going to do nothing but increase. And our biggest challenge has been capacity … we need to get more capacity to get more people surgery.”
In a statement released Wednesday, the hospital said AOAO physicians and staff have performed 40 surgeries to date.
“That’s 40 people in need of hip and knee surgeries who are no longer on the waiting list, living and waiting in pain, where the average wait time is 250 days for hip surgery and 209 for knee surgery. This partnership has led to a 20 per cent increase in surgical productivity for the hospital.”
The hospital said it had not issued many public statements about the partnership because it needed to see whether the “pilot project” would result in shortening wait times and it did not want to “overpromise” to patients before knowing it could deliver. It also said it wanted to “ensure this model does not have an impact on our already under-resourced staffing levels.”
“In fact, less than half of AOAO’s staff are TOH employees, and they work in a variety of roles at the hospital (registered nurses (RNs), registered practical nurses (RPNs), attendants and clerks) with a mix of full-time, part-time and casual staff,” the hospital said.
But according to hospital employees who spoke to the Star on the condition of anonymity for fear of workplace repercussions, the new arrangement is negatively affecting staffing — and potentially patients — a charge the hospital denies.
Sources who have directly witnessed how the partnership has played out over the past month say a plan by the hospital to conduct an oncology surgery “blitz” over four weekend days at its General campus this spring had to be reduced to three days because recovery room staff could not be found. One staff member said they were told by their supervisor that recovery room staff could not be found because they were “otherwise engaged doing private work.”
Love told the Star that is “not an accurate statement” and that there are multiple reasons why schedules are adjusted or surgeries postponed “but it has nothing to do with what’s happening with AOAO.”
The Star has previously reported that AOAO is offering RNs a flat rate of $750 a day, while RPNs are being offered $550 — rates that are close to double what an average RN or RPN would make on a regular eight-hour shift at the hospital during the week.
“This is not what medicare is supposed to do,” said New Democrat MPP Joel Harden, in whose riding the Ottawa Hospital is situated (Ottawa Centre). “The government said they were going to put up guardrails to make sure that the quality care in the public system would not be impacted by this and this was ‘innovation.’ Well it’s not innovation to make a cancer patient wait a minute longer for something they urgently need. Anybody who’s been through that, a family member or friend who’s been through that, know that every minute counts.”
Hannah Jensen, a spokesperson for Health Minister Sylvia Jones, told the Star that the Riverside Campus’s efforts to reduce the surgical backlog for those waiting for joint surgeries “has no impact on other surgical activity nor the hospital’s health human resource capacity.” She added that “for the NDP MPP to suggest that oncology surgical procedures are being delayed and health human resources are being impacted is blatant misinformation.”
The Star’s sources also say that hospital staff are being asked to conduct preadmission clinics during the week for patients bound for the private AOAO surgeries. All patients undergoing surgery must attend the hospital’s pre-admission unit (PAU) for a consultation with nurses, a pharmacy technician and occasionally an anesthesiologist. At these sessions, the patient is briefed about what to expect and can undergo blood work and cardiac testing to ensure surgery goes smoothly. “Despite AOAO being allegedly private, those patients are going through the hospital’s preadmission unit. They’re kind of taking up slots that would be available for other patients,” said one hospital employee, noting that the preadmission unit is always full at the best of times. “It sometimes happens that a surgeon’s office will call and say ‘Can you fit this patient in?’ and we can’t. We’re just so stretched.”
Love told the Star the hospital has “no issues” in managing activity in its PAU and that there is capacity.
A lawyer representing AOAO did not respond to the Star’s request for comment Wednesday.
Love said it’s important to remember that his hospital’s partnership with AOAO is fully funded and paid for through the Ottawa Hospital with public dollars.