Long wait times for urological surgeries and procedures in the Cowichan Valley are among concerns being raised by Dr. William Nielsen.
Nielsen, the Valley’s only urologist, said urology services in the area are currently funded for just about 50 per cent per person of what is available in Vancouver and Victoria.
He said the situation is only getting worse as the local population grows, and what was once a six-month wait for a prostate resection procedure in the Valley is now two years.
Nielsen said waiting times for urological elective surgeries in Victoria are currently between six and eight months.
He said the Cowichan District Hospital had 140 beds when it was first constructed in the 1960s, but that has since dropped to about 113 fully funded beds, which is adding to the backlog.
Nielsen said approximately 200 beds are needed to meet local needs, including urology procedures, in the planned new hospital that will eventually be built in the Valley, but health authorities in Cowichan are dealing with rigid financial formulas from the government that are difficult to change.
“The health administrators in the Valley inherited an archaic funding formula in which we’ve been designated a ‘have-not’ area and don’t receive as much funding as more populated centres,” he said.
“The Valley has one-quarter the population of Victoria, but just one-eighth of the operating room time for urological surgeries. We’re handicapped here, so our days are stressful trying to get people basic care. We can’t respond properly to local needs because we just don’t have the money. We have to try and find a political solution to this.”
The Cowichan Valley Division of Family Practice, which represents family doctors in the Valley, recently sent a letter to Island health officials supporting more funding and medical personnel for local urology programs.
The letter, written by board co-chairman Dr. Jim Broere, said the general practitioner community in the Valley has become increasingly aware that the Cowichan urology program is significantly under-resourced, resulting in “frequent and considerable delays in patient care”.
“As the only urologist in the community, Dr. Nielson continues to provide exemplary care to the patients in Cowichan,” Broere said.
“However, with upward of 100,000 patients in our catchment area, it seems unrealistic that Dr. Nielsen alone can keep up with the care demands of this growing population. An adequately resourced urology program should result in fewer out-of-town hospital stays and decreased morbidity in our local population.”
Dr. David Robertson, executive medical director for the Valley with Island Health, said the main strategy currently to deal with long waiting times for urological procedures in the area is the construction of a new hospital.
Plans are for a a new $350-million Cowichan District Hospital to be built on three properties on Bell McKinnon Road in North Cowichan.
While still in the early planning phases, Robertson said the construction of the hospital is now Island Health’s number one capital priority.
“It’s still early in the process and we’re not at the stage at this time to determine just how many beds the new hospital will have, although 200 may be a pie in the sky number,” Robertson said.
“We have to look ahead through the next 25 years, about the life span of the new hospital, to determine population numbers, disease patterns and other issues in that time period to determine how many hospital beds will be available.”
As for Nielsen’s assertions that the Cowichan Valley is considered a ‘have-not’ area by Island Health and doesn’t receive as much funding as larger centres, Robertson said it’s a fact that some procedures and medical specialties in rural areas don’t receive as much funding as major centres.
“Some procedures are not appropriate for some hospitals; Port Alberni doesn’t do heart transplants for example, and that affects funding levels,” he said.
“We have to look at what’s realistic in the new facility in the Valley.”
While Robertson acknowledged wait times for urological procedures may be longer in the Cowichan Valley than in larger centres, he said they are comparable to similar-sized communities in the province.
But he said the hope and expectation is that the new hospital will see those wait times decrease.
“We know the process of building the new hospital is slow and frustrating, but we’ve already been at it a long time,” he said.
“There’s already more than 80,000 people in the Valley, and that means the area already has the population to support at least one more urologist.”
Nielsen said he’s encouraged that more space for urological procedures in the new hospital is being considered.
“But retirees are coming here all the time,” he said.
“We have a responsibility to keep up with the medical demands of the grey tsunami that is coming from the east.”