Saturday, August 1, 2015


Nearly one in five cancer patients is waiting longer than the medically acceptable limit of one month for radiotherapy at the Jewish General Hospital — the worst showing of all cancer centres in Quebec, newly-compiled government figures reveal.
The Jewish General has gone from reporting among the best results for access to life-saving radiotherapy to the worst in less than two years. How did this happen? The answer to that question is that government meddling and underfunding are to blame, say critics, raising concerns about whether the Quebec Health Department is managing cancer care properly.
The government chopped the radiotherapy budget of the Côte-des-Neiges hospital by 40 per cent in April 2014, far more than any other health centre in Montreal. And the cuts are continuing: the Jewish General's radiation oncology budget will be slashed by nearly $600,000 this year to $3.9 million.
The Jewish General founded the province's first truly comprehensive cancer centre in 2005. Known as the Segal Cancer Centre, it was the first in the province to acquire a rapid arc linear accelerator to zap a patient's tumours while sparing healthy tissue.
The facility houses the McGill Centre for Translational Research in Cancer, focusing on cancer genetics and radio-pharmaceutical chemistry, among other fields. The Jewish General is one of the few hospitals in North America to run a geriatric oncology program.
Dr. Té Vuong, who was appointed director of the radiation oncology clinic in 2009, is a pioneer in a highly targeted form of radiotherapy — called brachytherapy — for cancer of the rectum.
"There are more opportunities for cancer patients to participate in clinical trials at the Segal Centre than most other places in the province," said Barry Stein, president of the Colorectal Cancer Association of Canada.
"I would venture to say that any comprehensive cancer centre that has such a gathering of expertise and experience will have patients who fare better."
Word of the centre's advances and superior outcomes spread quickly and cancer patients from the South Shore, Laval and as far west as the Ontario border began seeking care at the Jewish General. The annual volume of patient visits to the Segal Centre skyrocketed from 55,000 in 2009 to 90,000 last year.
So what was the government's reaction?
"They thought that the Jewish General was trying to attract these patients on purpose," Stein said. "But that wasn't the case. The patients just came on their own."
In addition to cutting its budget, the Health Department established what came to be known as the "postal code policy," ordering the Jewish General to start "repatriating" off-island cancer patients to hospitals near where they live.
"The hospital was made out to be the bad guy when it was the government doing it indirectly by cutting budgets that led to depriving people of their individual rights of where they wanted to go to receive care," Stein said.
Health Minister Gaétan Barrette justified the repatriation policy as providing "proximity" of cancer care to residents of Laval and the South Shore, noting that those regions have hospitals with excellent cancer departments.
Much of the Segal Centre and its equipment were funded through private donations. Today, a concrete bunker that was built at great expense sits empty waiting for another linear accelerator that the government has yet to approve. In the meantime, the hospital makes do with the shrinking resources it has, which might shed light on why some cancer patients are not able to undergo radiotherapy within the ideal period of 28 days.
As of June 27, 82 per cent of patients in need of radiotherapy got it done in that time frame at the Jewish General in contrast with a 100-per-cent rate at Maisonneuve-Rosemont Hospital, where Barrette once practised as a radiologist. The rate at the McGill University Health Centre was 93 per cent and 96 per cent for the Centre hospitalier de l'Université de Montréal.
In its 2013-2014 annual report, the Jewish General noted that 93.7 per cent of cancer patients underwent radiotherapy within the four-week benchmark.
Joanne Beauvais, Barrette's press attaché, declined to comment on the latest figures.
"As you may know, the minister does not micromanage institutions," Beauvais said on Thursday.
Officials at the Jewish General were unavailable for comment. But in the past, they have said that one set of statistics is not enough to confirm a trend, and might be unreliable.
Stein agreed that one can't jump to conclusions from one set of stats. But he did suggest that there are lessons to be drawn from the Jewish General's experience.
"There is a plan to reorganize cancer care in the province," Stein said. "And I hope it will lead to a better integration of services not just at the Jewish General, but throughout the province. It's a big task."

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