Regina newborns to be sent to Saskatoon for surgeries

The youngest patients in Regina will no longer be able to get surgery in the Queen City and will instead have to be transported to the Jim Pattison Children’s Hospital in Saskatoon.

As of April 1, a new policy is in place for the Saskatchewan Health Authority (SHA). Neonates, Premature infants, and medically complex young babies up to eight weeks old or premature babies at an eight-week developmental age, will have to be transferred to Saskatoon if they need surgery.

This came out in a memo sent to SHA staff that was leaked to the Sask. NDP. The memo said the change is being made due to a low volume of such procedures.

Read more:

• Sask. makes headway in ongoing struggle to recruit medical specialists
• ‘Very disappointed’: Union head frustrated with new health-care plan
• Regina Urgent Care Centre shortened hours on 11 of 15 weeks this year, minister admits challenges

A number of doctors in the leadership team were made available to answer questions on Tuesday.

Dr. Michael Kelly, a neurosurgeon and provincial head of surgery for the SHA, explained that very young and medically complex infants have a higher risk during surgery and anesthesia – that, as well as their size, means their care – and particularly their anesthetization – is a very specific specialty.

One or two of these procedures were being done a month in Regina, according to Dr. Mateen Raazi, the provincial head of anesthesiology and a pediatric anesthesiologist.

“Because of that inadequate exposure, the request came from our Regina colleagues here to say it is very difficult now to maintain the skills that are needed to safely look after these babies,” said Raazi.

The doctors were very clear: there weren’t any precipitating events or safety concerns that prompted this change. They said the health authority is always looking at their procedures and where there might be gaps.

Few procedures

Raazi said over the past 20 months, there have been about 25 cases of a surgery being performed on a child this young in Saskatoon, while there were seven or eight in Regina.

He said the concentration of such specialty, and therefore such procedures in children’s hospitals has been happening across the country

“We’ve looked at the pattern across Canada, we’ve looked at the evolution of trends across Canada for all children’s hospitals, and this is the direction where all of it is headed,” Raazi said.

However, Regina Deputy Chief Medical Officer Dr. Alan Beggs, who is also a practising orthopedic surgeon, said that doesn’t mean the pediatric care in Regina is shrinking; he said with the province’s surgical plan, it’s actually broadening.

“This is a very isolated, very small number of children who are best served and safest served in a super specialized centre like the Jim Pattison Children’s Hospital,” Beggs said.

Kelly said two more pediatric surgeons have been hired in Regina – one has already started working and another will start this summer. He said it’s just that the majority of pediatric surgeries are done on much older children.

The Sask. NDP has put forward that this change is due to a shortage of anesthesiologists, disputing the explanation of a low volume of procedures given by the SHA. A news release blames it on a lack of planning to recruit and retain the specialists on the part of the provincial government.

Dr. Mateen Raazi, pediatric anesthesiologist and provincial head of anesthesiology (Lisa Schick/980 CJME)

Raazi said there has been a shortage of anesthesiologists in Saskatchewan and across Canada, but he said Regina has put measures to address that which have been “quite successful.” He said Regina is well on its way to a full complement.

He said a shortage is not the reason this pediatric policy has changed.

Concerns and cost

The babies needing surgery will be moved via medical transport – by air or on the highway. All three of the doctors talked about the pediatric transport teams, characterizing the care they give as excellent, and saying this is something that’s already being done from hospitals outside Regina and Saskatoon.

“We have acquired the expertise over time, the personnel, the processes, to do this safely,” said Raazi.

Kelly was sympathetic to the concerns around medical transportation – he said it’s hard taking someone from their home and family.

“That patient matters the most, and certainly the emotional aspects and the difficulty of transitions matter to families, but it really is important – especially when you get into rare very complex surgeries – that those patients’ care is provided in a centre where that’s the case,” said Kelly.

He said it’s about giving the patient the best standard of care, and once that’s explained to patients and families, they’re usually very accepting.

Dr. Mike Kelly, neurosurgeon and provincial head of surgery (Lisa Schick/980 CJME)

Kelly did say those families who do have to be moved to Saskatoon could incur costs – medical transportation can end with a bill, plus the cost of staying in Saskatoon for an extended period when your home is elsewhere.

Begg said women who are pregnant and whose babies have been identified as possibly needing this kind of early intervention will be given a preferential delivery in Saskatoon to make sure they’re closest to the care they might need.

When asked whether this change will be permanent, Kelly said the population in Saskatchewan is changing so it could be revisited somewhere down the line. However he said he expects the new policy to stay in place for months or even years to come.