PLANNED operations in Scotland were slashed by more than 180,000 during the first 12 months of the pandemic, with some areas seeing waiting lists for orthopaedic procedures grow nearly ten-fold.
Routine surgeries such as hip and knee replacements or cataracts removals were put on hold in March last year to free up theatre and hospital space for an influx on coronavirus patients.
After returning to nearly two thirds of capacity by October, the second wave saw turnover cut back again to around 40 per cent by January this year.
It comes amid criticism that the Scottish Government has been slow to establish promised new elective centres, and reports last week of a Highland patient told she faces waiting six years for a double hip replacement.
An analysis of data from Public Health Scotland shows that a total of 153,775 operations were scheduled for theatres between March 2020 and February 2021, compared to 337,295 in the same 12 month period from 2019 to 2020.
A further 3,511 of the operations booked to take place during the 12 months to the end of February were cancelled also for "non-clinical/capacity" reasons, such as lack of beds or surgical staff.
Separate data from PHS shows that by the end of December last year, the number of patients who had been waiting more than 12 weeks from referral to treatment for orthopaedic surgery had doubled year-on-year from 8,390 to 17,912.
In Lothian, this had ballooned from 417 to 2,186, and in Borders from 48 to 406.
NHS Highland said last week that its orthopaedic service had been "particularly impacted" by the pandemic after patient Janice Dunlop, from Lochaber, revealed that she had been told by her consultant that she could wait six years for her double hip replacement.
"It's like a sentence, it's not a wait," she said.
Other specialties have seen similar spikes in lengthy waits, with the number of children waiting more than 12 weeks for paediatric surgery doubling year-on-year from 633 to 1,130 , and number of adults waiting more than 12 weeks for elective heart surgery going from 405 to 810 by December 2020.
In its 2016 manifesto, the SNP pledged to create five new elective surgery suites in Edinburgh, Livingstone, Dundee, Inverness and Aberdeen, later revising this to six plus expansion of the Golden Jubilee service.
To date only the Golden Jubilee's new Eye Centre is up and running, with new facilities in Forth Valley, Highland, and Fife expected to begin treating patients in 2022, followed by Grampian in 2023, and Tayside and Lothian's centres timetabled to open in 2024.
Professor Mike Griffin, president of the Royal College of Surgeons Edinburgh, said last week that had the sites been available by the time Covid struck they would have helped to mitigate the waiting times backlog "because we would have had Covid-free sites which we were all struggling to try to develop during the pandemic".
READ MORE: Orthopaedic surgeon warns it will 'take years' to clear Covid backlog
Private hospitals and the Golden Jubilee have been designated 'green' sites, without Covid admissions, but most hospitals have tried to manage Covid and non-Covid care under one roof.
"If we had more of the American model, where we had elective and acute services separate, we would never have had the horrific pause or shutdown that we had in the first wave, and the situation would be a lot better," added Prof Griffin.
Professor Rowan Parks, Vice President of the RCSE, said waiting list have been "exceptionally hard hit by the pandemic".
He added: “The impact on patients whose surgery has been postponed is immense, and more patients are being added to waiting lists every day, not to mention the many more patients who have yet to be referred owing to late presentation and diagnosis as a result of the pandemic.
“The next Scottish Government must urgently address this backlog and ensure our valued NHS is fit for purpose for the future – we must redesign to recover. More pandemics may come and so it is essential that we think differently and are better prepared.
“We must also consider our healthcare workforce, from trainees to consultants, nurses and support staff, across theatres, wards and clinics; many are burnt out and in need of support.
"Not only have they given their all during the pandemic, but the recovery very much depends on them so their wellbeing must be an absolute priority.
“Crucially, we must ensure that in future, cancellation of essential elective surgical services is avoided.”
Dealing with the NHS waiting lists has been a key focus ahead of the election on Thursday.
Donald Cameron Scottish Conservative Shadow Health Secretary said: “While there was an understandable focus on tackling Covid in our NHS, it is hugely concerning to see the ever growing number of patients waiting months on end for treatment.
“Even prior to the pandemic, the SNP were routinely failing to hit their own targets. They cannot hide from their woeful record in charge of Scotland’s health service over the last 14 years.
“Thousands of patients have no idea when critical treatments or procedures will be carried out.
“The Scottish Conservatives will inject £600 million to specifically tackle the backlog in our health service, giving clinicians the resources they need to carry out treatments seven days a week.
"That is on top of our pledge to increase funding for the NHS by £2 billion over the course of the next Parliament."
READ MORE: Scottish Tory, Labour and SNP manifestos 'disconnected' from reality, says top economic think tank
Scottish Labour health spokeswoman Jackie Baillie promises investment "to upgrade NHS systems and facilities, establish designated outpatient and elective centres in each health board area, and increase staff and processing capacity in cancer screening centres to clear the backlog of appointments and find those with a missing cancer diagnosis".
Ms Baillie added: "These figures show the devastating knock-on impact of Covid-19 on our NHS. But the pandemic only made an existing problem worse.
“Fourteen years of SNP mismanagement have left our NHS in a precarious state before the pandemic, having failed to ever reach their own waiting time targets.
"The SNP failed patients who are waiting anxiously, and in pain, for much delayed treatment, and cannot be trusted to deliver an NHS recovery."
Mairi Gougeon, the SNP's Public Health minister, pledged a "full-scale post-pandemic remobilisation" including a commitment to increase inpatient, day-case and outpatient treatment activity by 10% compared to pre-pandemic activity levels within the first year of the new parliament.
She added: "Our NHS has been nothing short of heroic in the fight against Covid, but as we are seeing across all parts of the UK the pandemic has had a terrible toll on our NHS's ability to treat patients as quickly as it would want to.
"That is why the SNP is committed to strengthening our national health service as we aim to recover from this crisis.
"At this election, we have pledged to increase frontline NHS spending by at least 20% to support and renew our NHS as it recovers from Covid-19. This will increase funding of frontline services by over £2.5 billion."
However, the Institute for Fiscal Studies (IFS) last week described the public spending plans set out by the SNP, Conservatives and Labour in their manifestos as unrealistic and "disconnected" from fiscal reality.
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