The VCHC's caseload

With the arrival of Duncan, the number of children who were being referred out of province began to decline dramatically. By 1987 the VCHC's patient volume was double what it had been in 1984. This increase levelled off by 1988, which was seen by Collins as an indication that the centre was treating all Manitoba children with heart conditions. By 1988, the Manitoba government required that no child could be sent out of province for heart surgery unless Collins had stated the operation could not be done in Manitoba.

There were times, however, when the pediatric cardiac surgical program did slow down. After experiencing poor results with a number of Norwood operations, the approach was to encourage parents to consider comfort care as opposed to having their children undergo the high-risk Norwood.

In addition, Collins had always hoped to see the program expand its outreach to patients from Northwestern Ontario, North Dakota and even the Third World. After the program had been in place for a decade, 12 per cent of its patient caseload came from out of province.

By 1993 the VCHC had, besides Collins, three academic pediatric cardiology positions, four cardiovascular technologist positions, three nurse-clinician positions, three secretarial positions and one database manager/computer consultant. However, from 1990 onwards, the program was hit with ongoing funding cuts that affected all of the HSC. It proved to be difficult to keep all these positions filled.