For the 174 people in Greater Victoria waiting for hip or knee replacements, the lineup is about to get longer.

Last week, the Vancouver Island Health Authority announced a number of changes as it looks to make up a $45-million shortfall in its 2009/10 budget.

Just because a surgery is elective doesn’t mean it’s not critical, said Jill Karleen, South Island co-chair of the B.C. Nurses’ Union.

“People’s lives are on hold.”

But only procedures with lower wait times will be targeted, said VIHA spokesperson Shannon Marshall.

Elective surgeries will receive the same funding as last year. Since costs have gone up, however, the number of procedures will decrease.

Not only could fewer surgeries mean longer waiting lists, Victoria Medical Society president Dr. Gerald Tevaarwerk warns that local surgeons won’t sit around and wait for better days.

Surgeons are already limited to as little as one day per week in the operating room, and if their hours are cut further, they’ll leave for Alberta or Ontario, he said.

Elective surgeries are just one of many areas of cutbacks and savings.

VIHA president/CEO Howard Waldner promised to “aggressively reduce administration, support and other discretionary costs,” as well as increasing health fees and parking fees.

Patients will also be moved around.

The health authority is looking for more beds to make sure recovering patients don’t linger in expensive acute care beds for longer than necessary.

Seniors will also shifted. Smaller, less efficient residential facilities will be closed and patients moved to larger facilities. It’s too early to say which facilities will be closed or what the size threshold is, said Catherine Mackay, VIHA’s executive vice-president.

“We have to look at what the costs are,” she said, adding the authority will have more answers in two weeks.

Karleen said displacing patients can cause instability and lead to more injuries and illness.

VIHA’s commitment to cutting back on overtime also concerns her, she said, noting that nurses are already overworked.

VIHA officials, however, say it’s about making sure nurses use their time efficiently.

“We could bring in different types of workers for non-nursing duties … to free up the nurses’ time,” Mackay said.

Tevaarwerk said the strategy misses a larger opportunity for savings.

He called for an electronic database for patient records so doctors, specialists and pharmacists can communicate.

“We’re 10 to 15 years behind (but) politicians don’t dare make the move for fear of making a mistake,” he said.

In some European countries, a central database tracks a patient history, tests ordered and medications.

Such a system eliminates duplication or the need for paper for referrals, prescriptions or records, Tevaarwerk said. If introduced here, the savings would take up to two years to realize, but would be significant, he added.

rholmen@saanichnews.com