Photo by Martin van den Hemel
If you’re young and healthy, or your parents are young and healthy, it probably doesn’t affect you.
But for one person in eight in Richmond who is over 65, the sudden move of cataract surgery from Richmond Hospital to East Vancouver’s Mount St. Joseph Hospital by Vancouver Coastal Health Authority is a catastrophic upheaval.
And the doctors who care for them are saying the same, as is Richmond South Centre MLA Linda Reid.
“This is an issue that affects seniors,” Reid says.
Cataracts often come with age, gradually clouding vision, like growing blotches of yellow Vaseline on the lenses of your glasses, making clear vision increasingly difficult. Making driving at night stressful and dangerous.
The 10-minute surgery that removes your cataract, replacing it with a clear human-made lens inside your eye, offers startlingly-good vision. It makes everything sharper, brighter, and colours more vivid. The surgery is covered by the provincial medical services plan.
Seniors who need this surgery waited months at Richmond Hospital. Now the 500 on the waiting list will join the 5,000 cataract surgeries per year at Mount St. Joseph Hospital in East Vancouver.
While the health authority assures that no one will wait longer, with the Richmond eye surgeons having their number of days to operate reduced—not everyone is reassured.
The longer older adults wait for eye surgery, the greater their risk of falling, and therefore injuries. While the cost at Richmond Hospital is not clear, a sign posted in the waiting room at St. Paul’s Hospital says a trip to emergency is worth a minimum of $1,600.
Timely, close-to-home cataract surgery saves lives and dollars as well. In a June 2018 article from the Journal of the American Medical Association that studied over 500,000 patients, “a nine-per-cent reduction in serious traffic crashes” was found after cataract surgery. A serious car crash is classified as one that resulted in death or serious injury requiring hospitalization.
Falls and serious car crashes that don’t result in a death can mean a trip to the hospital, and can precipitate a move to a care facility.
The provincial government announced, in the spring of 2018, an additional $240 million to improve care for seniors. The B.C. government has also moved to have the cost of cataract surgery to the Medicare system reduced by cutting the surgeons’ fees to $350 from $425.
Patients are not allowed to drive themselves home after their cataract operation and they cannot go home alone. While patients can take the bus to the hospital, they have to cab or ride home in a car by doctor’s orders. Richmond Taxi says the average ride home from our local hospital is about $15. They say the average ride to and from Mount St. Joseph’s is about $100. For most people, seniors included, $100 for cab fare is hard to come by especially for those living on the national average of $1,115 for CPP and OAS.
While no one responsible for the decision was available to speak, the health authority’s communications department suggests people without someone to drive them could get a social worker who can arrange to put them onto the Handy Dart system if eligible. The spokesperson also suggested that seniors be in touch with Richmond Cares, Richmond Gives to access their volunteer driver program. He also said a social worker might be able, in dire financial situations, to arrange for the cost of the cab fare home.
In their letter announcing this move, the health authority said: “This decision (to move cataract surgery) was made in the best interest of the patients, and patient care.”
A reporter met with eight people over coffee, a sampling of those who contacted MLA Linda Reid with their concerns.
“I had both eyes done this summer in Richmond. I live on my own, my husband died 22 years ago. I have to look after myself,” said Richmond’s Elaine Graham.
Reid says she asked the province’s health minister to reconsider the move and is awaiting a response.
“But I’m not that patient so I’ll be phoning him again today.”
She’d like to know who requested the move and the rationale behind it.
“I didn’t hear anything about why it was done. Was it Richmond Hospital that requested it?”
The health authority says the operating rooms at Richmond Hospital have been repurposed.
But Reid wonders why the new use takes priority over these cataract surgeries.
Former Richmond councillor Cynthia Chen says she wants answers.
“If they really care about people, how come they implemented something with no consultation with the people at all? I spoke with the doctors and they knew nothing about it.”
This move affects not only those waiting for much-needed cataract surgery. It affects family members as well. Oscar, another person at the table but who asked that his last name not be published, said: “I’m here to support my wife because without her I cannot survive.”
Also at the table was Hyacinth, who asked for anonymity and was expecting a surgery date in January or February.
After news of the move, she called her ophthalmologist’s office. “They haven’t got any information at all, no scheduling or anything. I’ve been waiting nine months. I was supposed to be happening in the New Year. Now, I don’t know. In the mean time my eyes are getting worse.”
While she enjoys reading, she can’t any longer.
“For us to be having to go over there (Mount St. Joseph) is going to cost us, so Vancouver Coastal Health should be paying our fare,” she said.
All said that there was no consultation before the decision was made.
“What bothers me, as you get older, you are seeing less,” said Dawn, who asked to remain anonymous. “It’s a shame that you are being deprived of that.”
Another reason given by the health authority for the move is that it frees up operating rooms at Richmond Hospital, moving cataract surgery into smaller, simpler procedure rooms at the East Vancouver facility.
Reid said that the health authority is clear that cataract surgery does not need a full operating room like the ones used at Richmond Hospital: “If it only requires a procedure room like those at Mount St. Joseph, surely we can accommodate that here.”
The physicians contacted said they would be willing to use procedure rooms at Richmond Hospital, saving the $50 fee for an anaesthetist in an operating room, even if that meant operating evenings and weekends. This could open up even more time to do the sight-sparing, cost-saving, and life-enriching surgery for seniors.
One medical office manager said evening and weekend appointments fill up first because those with jobs prefer those hours and those who need a ride find it easier to arrange when their younger friends or offspring aren’t working. A similar solution was used for increasing access to medical imaging at Richmond Hospital, when weekend and evening appointments were made available.
Richmond is already down one ophthalmologist due to retirement, from the four the city had for decades. In those same decades, our population has grown two-and-half times, from 80,000 to 200,000 people. The Richmond doctors are facing fewer operating hours after the move.
Coun. Bill McNulty, a former Richmond Hospital board member, said: “It’s unfortunate that Richmond continues to lose its services for the public, especially when we are trying to build a new hospital.”
Richmond Mayor Malcolm
Brodie said of the move: “With an aging population and a growing need, the
elimination of the cataract surgeries at Richmond Hospital is most unfortunate.
We must confirm to Vancouver Coastal Health that this change is unacceptable
and pressure them to immediately reinstate this important Richmondprogram.”