SMH cap on glaucoma cases means no surgeries until next
While funding remains in place for 186 more cataract procedures to take
place at Stevenson Memorial Hospital (SMH) within the current fiscal
year, for the first time, a hard cap of 45 glaucoma cases has been
implemented, and that was reached in mid-September. That means no
further surgeries will take place until at least April 2014, when "it
is anticipated that Stevenson will be able to allocate global
dollars to perform another 45 glaucoma cases in the new fiscal year."
The Central LHIN, which is the Ministry of Health's clearing house for
operating grants to hospitals, only funded up to 300 cataract cases in
Alliston, down from 419 in 2012-13. Those are divided between
Stevenson's two Ophthalmologists including Dr. Baseer Khan, who also
performs the complex glaucoma surgeries that SMH is no longer going to
fund beyond the cap.
Dr. Khan, whose arrival at SMH in 2006 ushered in a growing focus on
ophthalmology services in Alliston, is now facing a 50 per cent
reduction in operating room access which has shifted mostly to urology
cases. In 2012-13 he performed about 190 glaucoma surgeries, of which
about 15 per cent were local patients, 60 per cent from the broader
Central LHIN area, and the rest from outside referrals. Each case costs
approximately $1,000 and SMH has determined there are other priorities
to spend on.
He told Free Press Online this afternoon that he understands the
hospital's reluctance to fund a program that includes patients from
outside its catchment area, but SMH is only one of about three
hospitals in the province that are equipped to handle the specialized
eye surgeries. In 2008,
Dr. Khan led a team at which was only the third one in Canada to
perform a Canaloplasty, a
minimally invasive procedure, which provides the hope of managing
glaucoma without medication or major surgery.
"We can do these at SMH. The nurses, some who've been with me
from the start, have the expertise to do these cases, they're
excellent. I think it puts Alliston on the map," he said. "At the end
of the day we're talking about $150,000. It's good for the hospital, we
don't burden the in-patient unit."
SMH CEO Annette Jones, in an email reply to Free Press Online, called
Opthalmology "a valued program."
"Stevenson is always looking for ways to better meet the needs of our
community while remaining fiscally responsible, as we know that running
a deficit is not an option," said Ms. Jones. "While we continue to
support our robust and excellent Ophthalmology program, we must monitor
the number of eye surgeries so that our volumes and costs do not exceed
the funding cap. (...) In the future, as our community grows, this
funding cap could mean that patients may need to travel to hospitals
outside this community for eye surgery once our physicians reach their
And that's a prospect local patient Ursula Martin is dreading.
"I wonder if other illnesses/services are budgeted the same way? For
example, do they allow for 100 Heart Attacks per year, and if you are
unlucky enough to be number 101 they say 'Oh, so sorry, we reached our
funding limit for that yesterday,'" said Ms. Martin. "The news is
filled with complaints that we don't have enough doctors to provide
services to patients, especially north of Toronto. Here we have a
highly skilled Doctor who isn't being given the Operating Room time to
service his patients."
Ms. Martin fears her eyesight will deteriorate because her only option
is through a clinic in Toronto, which already has a year long waiting
"I will go Blind before their next fiscal year begins, and so likely
will some others, since Stevenson is the only place the surgery was
offered north of Toronto, I know that people from as far north as North
Bay came there to see Dr. Kahn," she said. "45 Patients for all of
Ontario North of Toronto is shameful, don't you think?"