Orthopedist: Surgical Waiting Lists for Children “Unacceptable”

Press photo of the year 2020

An orthopedist at Landspítalinn hospital has told the Minister of Health that surgical waiting lists for children are unacceptable. “I can’t get them into surgery within an acceptable time frame,” Sigurveig Pétursdóttir told Willum Þór Þórsson during an annual meeting of the Icelandic Medical Association in October.

“I’m on my knees”

Sigurveig Pétursdóttir, 64, has been employed as a doctor for 38 years. She’s spent 30 years working with disabled children as a paediatric orthopedist. At an annual meeting of the Icelandic Medical Association, held on October 14, Sigurveig told Minister of Health Willum Þór Þórsson that the state of the hospital “has never been worse.”

Read More: Mass Resignations at the University Hospital

“I’ve got children who’ve waited a year,” she called out from the assembly hall, according to a transcript of the meeting published by the Icelandic Medical Journal: “A disabled child who walks with one leg crooked for an entire year because there’s no space in the operating room. And why is there no space? Well, because the staff has quit. It’s not a matter of not having the staff. They quit. The hospital’s a mess. It’s a mess right now. It’s not going to become a mess tomorrow. It didn’t happen yesterday.”

Sigurveig preempted familiar bureaucratic talking points with the statement that all talk of analysis and assessment was unacceptable: “I’ve heard it a hundred times, but the situation has never been worse than now,” she stated. “It means nothing to me, being told that I did so well during the pandemic, not having missed a day of work.”

“I’m on my knees,” she continued. “I’m giving up, and I’m not the kind of person who gives up when things get rough. But no one will be able to walk in my shoes. No one!”

Increased funding required

Those present at the annual meeting urged the government to heed the will of the public and to increase healthcare funding. They also announced their disappointment in next year’s budget bill, urged healthcare institutions to ensure the safety of their staff, and called for actions to be taken to deal with the failing health of doctors and the growing number of healthcare professionals who are resigning from their jobs.

In late October, sixteen middle managers employed at the National University Hospital of Iceland received letters of termination. The terminations stemmed from the adoption of a new organisational chart intended to improve the hospital’s operations.

“The main purpose is to get a handle on the hospital’s management and operations, to strengthen our clinical services, and to harmonise other key services,” Runólfur remarked in an interview with RÚV.

City Council Introduces Proposals to Address Preschool Crisis

In the wake of parent-led protests, Reykjavík’s City Council has introduced proposals to expedite the admission of preschoolers. As reported last week, hundreds of children are currently waitlisted for preschools around Reykjavík.

A press conference at City Hall

Last Friday, parents of waitlisted children gathered at Reykjavík City Hall to protest; nearly 700 hundred children aged 12 months and older are waiting to be admitted to preschools around Reykjavík.

In response to the growing crisis, members of the council held a townhall meeting yesterday morning, introducing six proposals to expedite the admissions of waitlisted preschoolers. The proposals, approved of by City Council prior to the meeting, are as follows, RÚV reports:

  • Expediting the opening of Ævintýraborg

The Ævintýraborg preschool on Nauthólsvegur is to be opened ahead of schedule, or in early September. While the school’s playground and outdoor area are being finalised – expected to be complete in early October – Ævintýraborg will emphasise “diverse outdoor activities” in Öskjuhlíð, Nauthólsvík and near-lying areas. Once completed, Ævintýraborg will admit 100 children.

  • Utilising city-owned housing

Available housing owned by the city is to be utilised to meet preschool shortages this fall. Work has already begun to evaluate whether Korpuskóli school can serve as temporary facilities for preschoolers. Two additional departments are to be opened at the Bakki preschool, in the Staðarhverfi neighbourhood, in the hopes of accepting up to 160-200 additional preschoolers. Furthermore, community centres, along with other housing owned by the city and its collaborators, is to be utilised for preschoolers. This proposal is made on the condition of the parents’ interest in agreeing to these proposals and on the condition that these facilities can be staffed.

  • A new preschool in Fossvogur

Reykjavík will take advantage of an option-to-buy clause in order to purchase land in the Fossvogsdalur valley, adjacent to the city’s Cultivation Centre (Ræktunarstöð Reykjavíkur). The council will request the reclassification of the lot, and if said request is granted, an additional Ævintýraborg, capable of accommodating 100 preschoolers, will be opened next year.

  • Expansion of Steinahlíð

The Steinahlíð preschool is one of the city’s oldest preschools, currently accommodating 55 children. The council will enter into talks with Barnavinafélagið Sumargjöf, the school’s proprietor and landowner, with the aim of expanding the school, whether temporarily or for the foreseeable future. The will of the two parties to consider this expansion was addressed in an agreement regarding possible reclassification changes with regard to the Borgarlína transit system, which was approved June 18th.

  • Increased subsidies to daycare

Subsidies to daycare providers will be increased in order to strengthen their operational conditions, lower the cost of parents, and increase the number of daycare providers. Base subsidies will also be increased and further avenues to improvements, i.e. instructional or housing subsidies, will be explored.

  • Application protocols

Preschool admission protocols will be reviewed with a view to improve the dissemination of information to parents, simplify the application process, and work toward greater transparency. It is also necessary to review the possibility of integrating the application process between Reykjavík preschools and independently-operated preschools.

“Their disappointment has not escaped our notice”

Einar Þorsteinsson, City Council Chairman, and acting Mayor in the absence of Dagur B. Eggertsson, conducted the town-hall meeting, which was well attended by parents of waitlisted children.

According to Einar, the parents’ disappointment had “not escaped the council’s notice.” “I’m happy that there was a consensus among council members regarding the proposals … everyone’s doing their best to ensure adequate accommodation.”

Parents are not “systems enthusiasts”

Kristín Tómasdóttir, who has organised the protests at City Hall, took to the podium after the proposals had been introduced. Kristín stated that while she welcomed the meeting, and the fact that city council had finally introduced their proposals, she expressed the parents’ dismay that they’d been forced to expend energy  ensuring that city council do its job.

“You’re here to introduce proposals that you never intended to introduce,” she said, suggesting that if it weren’t for the protests, the proposals would never have seen the light of day.

“We were simply supposed to be understanding of the fact that you didn’t intend to keep your promises,” Kristín remarked.

Up to Four-Year Wait for ADHD Diagnosis

The current wait time for an ADHD diagnosis could be up to four years, RÚV reports. This per a new report issued by Iceland’s ADHD Association. According Vilhjálmur Hjálmarsson, the association’s chairperson, there are currently well over 3,000 people on the waitlist, 800 of whom are children.

“It’s really simple,” said Vilhjálmur. “Nothing’s been done about adults. You’d probably need four times as much funding to get this enormous waitlist down to a year. If we look at the children, then we see what has been a growing problem—additional funding was provided just before the election, but by no means enough.”

The ADHD Association says that the waitlist for a diagnosis has never been as long as it is now and wait times have increased over the years. And with no additional funding earmarked for ADHD diagnoses on the horizon, it’s expected that long waitlists will continue to be a reality. At the current rate of diagnosis, even if no additional individuals were added to the waitlist, it would take four years for everyone already on it to be assessed for ADHD.

Long Waiting Lists for Most Elective Surgical Procedures

According to a newly-published report by the Directorate of Health, waiting lists for most elective surgical procedures are too long. Individuals electing for knee-replacement surgery, for example, must wait for 12 months on average. The COVID-19 pandemic has had a significant impact on waiting lists.

Supervising healthcare in Iceland

Last month, the Directorate of Health published a report on the state of waiting lists at the National University Hospital. The report is based on data from the beginning of the year.

As noted in the introduction, the Directorate of Health is legally obligated to supervise the healthcare system in Iceland. In its fulfillment of this role, the Directorate calls for data on elective-surgery waiting lists at the National University Hospital of Iceland twice a year.

The Directorate of Health’s guidelines state that 80% of elective surgical operations should be scheduled within 90 days, RÚV reported. According to the report, however, this aim is met in only 4 out of the 18 types of surgical procedures. (The wait is acceptable with regards to cardiac valve replacements, coronary angioplasties, and prostate operations).

The majority of individuals on waiting lists, or around 80%, have waited too long for ablations (a procedure to treat atrial fibrillation), pupilloplasty, acid-reflux surgery, bariatric surgery, and knee-replacement surgery. The wait lists for most surgical categories has lengthened or stayed the same since the publication of the previous report.

A near twelve-month wait for knee-replacement surgery

Over 1,700 people are waiting for knee or hip replacement surgery, with the average wait for knee-replacement surgery at the National University Hospital being 49 weeks. The wait for pupilloplasty is also long, with approximately half of those 2,600 individuals who underwent the operation last year having waited for seven months.

As noted in the report, the COVID-19 pandemic has had a significant impact on waiting lists. Special measures must be taken to increase the number of operations once the effects of the pandemic subside.

“Previous reports have indicated that a shortage of staff and hospital beds has had a negative impact on waiting lists at the National University Hospital. There are indications that this is still the case.”

As reported by Iceland Review last week, even with a new hospital to open in Reykjavík in 2026, the healthcare system is expected to be significantly short of hospital beds in 2040, i.e. if drastic measures aren’t taken.