As spinal surgeries increase, some Manitoba patients refused out-of-province care still feel left 'in limbo'

Manitoba's government appears to be making progress in its commitment to expand spinal care capacity, but it's not happening fast enough for some patients, who want the province to reduce the barriers to getting out-of-province care.

Data provided to CBC News suggests Manitoba has done about 15 per cent more spinal surgeries in 2024 and 2025 compared with 2023. That year, the NDP took power and scaled back the Progressive Conservative's surgery and diagnostic task force's out-of-province program.

Rob Doig feels a byproduct of that shift has left people like him in the lurch.

His cerebrospinal fluid leak (CFS) condition hasn't improved despite numerous procedures in and out of province, and his latest rejection from Manitoba Health this fall has left him "in limbo."

"It just really becomes frustrating because as the patient there's somebody that's living this who is affected, and work, social life, mental and cognitive issues, it just really, really piles on," Doig said. "I really [have] to fight Manitoba Health."

Doig, 48, has lived with debilitating neuro-spinal issues since an injury he suffered in 2016 that have left him unable to be upright for more than an hour at a time.

His Winnipeg surgeon had requested Manitoba Health send Doig to the Mayo Clinic in Minneapolis for a specialized photon CT imaging procedure in the off chance it might reveal tiny fluid leak sites they had missed in conventional CT and MRI scans.

Only two such devices exist in Canada and they're typically reserved for oncology and pediatric patients, which is what Doig says his surgeon told Manitoba Health the first time it denied the request to send him south.

Manitoba Health argued "resources had not been exhausted … in Manitoba or elsewhere in Canada," according to a rejection letter dated Sept. 2 Doig provided to CBC News.

"Having nine surgeries here … five lumbar drains … umpteen blood patches … umpteen imagings … saline intrathecal injections. … If that's not exhausting all of our efforts, I don't really know what is," Doig said.

"And I know [my doctor] has the same belief as well —that it's just mind-blowing that Manitoba Health would deny this, saying that there's other options available."

Capacity growing: spine clinic lead

Dr. Perry Dhaliwal said recent investments — including $12 million last year put toward creating the Manitoba Spine Clinic — are helping to expand patient assessment capacity and reduce wait times in Winnipeg and Brandon.

"We've been able to work down the backlog by more than 50 per cent already in one year," said Dhaliwal, a surgeon and medical director of the Manitoba Spine Clinic.

"Just the sheer throughput of having the patients assessed is far better than it has ever been in the last 10 or so years that I've been here."

Shared Health, which co-ordinates health-care delivery in the province, provided data that suggests Manitoba performed 1,186 spinal surgeries last year and 1,123 in 2025 as of October — representing an increase of roughly 19 per cent and 13 per cent, respectively, over 2023's total of 996.

Dhaliwal says expanding operating times at Concordia and Maples clinics has helped, and that result could be improved if the province is successful in recruiting two to three more spine surgeons.

Dhaliwal also said the spine clinic hopes to open a decant clinic in January that could "decompress" congestion in hospital emergency rooms by diverting spinal patients with urgent care needs straight to the clinic.

Out-of-province claims

Though Manitoba Health still permits some out-of-province procedures, it has scaled them back since 2023.

One of the NDP's first acts that fall was to dissolve the surgical and diagnostic task force formed by the Progressive Conservatives to address ballooning wait-times system-wide, due in part to pandemic-related interruptions.

Health Minister Uzoma Asagwara has previously said the task force was ineffective its programming funds were better off invested in building capacity in Manitoba's system.

In a statement on Friday, the minister said “too many Manitobans have been living in pain while waiting for spinal surgery, and that’s not acceptable. Improving spinal care has been a clear priority for our government. Our focus has been on delivering care here at home."

"Unlike the previous government, which spent tens of millions of dollars sending patients to private, for-profit facilities in the United States, we are investing in Manitoba’s public system and delivering more surgeries than ever before."

Recently, the Manitoba Health Appeal Board sided with a patient fighting to have Manitoba Health reimburse them for an out-of-country spinal stenosis surgery.

The province refused on the basis the patient didn't obtain prior approval, required under provincial health and insurance legislation. But the board pointed to the "extreme deterioration" of the patient's condition — including loss of bladder and bowel control — and administrative errors within the system.

The board asked the health minister to consider reimbursing the patient, and provide a decision by the end of the year.

Questioning appeal process: patients

Marion Kereluk, 65, says he's grateful that patient has the appeal board on their side, though he questions why they refused to take a similar stand for him a year ago.

"I'm happy for him but at the same time, how about the rest of us?" Kereluk said. "I am sure I am not alone [among those] who had to seek surgery on our own and pay for it on our own and not get compensated."

Kereluk had begun losing bladder control. He could hardly walk. His surgeon recommended him for surgery in Fargo in 2023. The NDP folded the task force that fall. His surgery request was rejected, and he was facing a delay of up to two more years before he could expect one in Manitoba.

In desperation, Kereluk got surgery in early 2024 in Calgary at a cost of about $23,000, not including travel and accommodation costs. He did not have pre-approval, and Manitoba Health denied his claim for reimbursement on that basis.

His MLA, PC health critic Kathleen Cook, criticized the NDP a couple times during question period in 2024 over this. Eventually, Manitoba Health reimbursed Kereluk $2,500, about 10 per cent of the bill for the surgery, he said.

Kereluk appealed, but he health appeal board sided with the province, in part because Kereluk got his treatment at a private clinic.

Despite that detail, Kereluk remains confused why the same board sided with a patient this fall who hadn't received prior approval.

"I've never been a burden to the system … and now, here when I needed it, I couldn't get it and that's upsetting."

Doig has similar questions about the board's latest decision.

He was grateful when Manitoba Health sent him to experts at Cedars-Sinai Los Angeles for surgery in April 2023. The procedure alone cost about $365,000 US. Manitoba Health picked up the surgery tab, but refused to cover travel and accommodation.

Doig filed with the Manitoba Health Appeal Board to recoup roughly $8,900 in travel and accommodation costs. The board ruled it didn't have "jurisdiction for decisions" made under the diagnostic and surgical task force after a December 2023 hearing, and so couldn't render an opinion as to whether Doig was entitled to repayment.

Doig's U.S. surgery didn't take, and his condition has worsened in the ensuing 2½ years.

He said Manitoba Health's rejection of his surgeon's request for an out-of-country photon CT this fall was another "gut punch."

"We still aren't any farther ahead than we were from my original injury … we're regressing," he said. "It really makes you re-evaluate everything. … We're kind of up in limbo. I don't know which way this is going.