General surgery closure in Flin Flon leaves residents in precarious situation, surgeon says

A surgeon who used to work at Flin Flon's hospital says residents in the northwestern Manitoba city have been left in a precarious situation after more than five years without general surgery services.

General surgery services at the Flin Flon General Hospital closed in March 2020, after the hospital's general surgeon left.

Dr. Gerry Clayden, who served as a general surgeon at the Flin Flon General Hospital from 1988 to 1999, said he was "astonished" that the hospital could go from a 24/7 operating room staffed by four general surgeons during his tenure to nothing at all.

Clayden and his colleagues regularly performed C-sections, cancer surgeries and a wide range of emergency operations, he said.

"It's quite telling to think that the busy surgical practice that we had in Flin Flon has just disappeared and gone. It's just crazy," said Clayden, who now practises in Carman, Man.

If local patients need surgery, the Northern Health Region suggests they head to The Pas — about 110 kilometres away — where obstetrics, gynecology, orthopedics and general surgery services are available.

But it's a "long, long journey in a snowstorm," Clayden said.

"I think it's precarious for the people who live there, quite frankly. I mean, this is not really 21st-century medical care, is it?" he said, adding that there's a "clear and present danger that people will die for lack of services" if patients can't be medically evacuated elsewhere.

A spokesperson for Shared Health, the provincial health agency, said air ambulance pilots can't take off, land or continue flying if weather conditions exceed Transport Canada-mandated weather thresholds for visibility and cloud clearance.

That means medical evacuation responses could be delayed, diverted or even cancelled if weather conditions fall below the threshold, the spokesperson said.

The Northern Health Region said it's monitoring patient volumes and needs in the Flin Flon area to ensure access to "safe, appropriate care."

However, it said patient demand for obstetric and surgical services currently "remains low," and it is "not actively recruiting for a general surgeon position at the Flin Flon General Hospital at this time."

But Health Minister Uzoma Asagwara said in a statement to CBC that recruitment for a general surgeon in Flin Flon is "active and ongoing."

No one should have to leave their community to access medical care "that should be available closer to home," their statement said.

City is a medical hub: deputy mayor

Flin Flon Deputy Mayor Alison Dallas-Funk says that the border city is a "medical hub" for the surrounding communities in both Manitoba and Saskatchewan. She estimates the hospital serves more than 20,000 people — four times the population of Flin Flon itself.

But she worries that the population will dwindle if access to medical services like surgery isn't restored.

"Retaining community members that require health services is really an issue here," said Dallas-Funk, and the lack of services also presents "a problem advocating to get people to move here."

Dallas-Funk said the hospital has struggled to retain doctors as well, due to the lack of services. Even the emergency room doctors are largely flown in from Winnipeg on a two-weeks-on/two-weeks-off rotation, she said.

Doctors Manitoba, which represents more than 4,000 physicians across the province, said in a statement it has seen access to medical services decline in northern communities due to a "severe physician shortage" and a "lack of more advanced equipment and techniques."

Doctors are "deeply concerned about the lack of surgical and other services available to patients in Flin Flon," the statement said, and the organization said it's working to support recruitment and retention in rural and northern Manitoba.

Dallas-Funk said it's unfair that community members have to leave the city for medical care, often travelling for hours and sometimes staying overnight at a hotel. Some people will skip necessary appointments because they can't afford to travel, she said.

"The idea that people are … having to make the choice between paying rent or going to a medical appointment, to me, is frankly ridiculous," said Dallas-Funk, who is also the director of the local food bank.

Flin Flon resident Helga Wiens travelled in November to the Morden-Winkler area — about 670 kilometres to the south — for a knee replacement surgery.

But "I know people personally that keep living with the pain, because they don't want to fly out of town," Wiens said.

"They'll just keep going without having the surgery, because it's so hard to get to a surgeon."

The health region said its northern patient transportation program does subsidize medical transportation costs, covering travel by air, bus or train and reimbursing patients who choose to drive.

However, patients' food and accommodation costs are not covered, which could create a financial burden, Dallas-Funk said.

"Being ill when you don't have access to health [care] is costly," she said.

"I don't want to see people missing appointments and I don't want to see people not having health care based on … if they can afford to drive somewhere, can they afford to sleep somewhere?" she said.

A spokesperson for Asagwara said the government is working to "reduce the need for people to leave their communities" by expanding team-based primary care in the north and putting money toward staffing.