Northern Health failed to meet wait-times targets for three key surgeries in 2010-2011, and as a result lost out on $790,000 in extra incentive funding offered by Victoria.

That is less than a tenth of a per cent of Northern Health's total revenues last year, which came to $650 million.

But spokesperson Jessica Quinn said the incentive funding will keep Northern Health focused on cutting down surgical wait times.

"We're constantly working on improving access and shortening wait lists wherever we can," she said. "This is an area of focus for us, and we're striving to meet the targets that the government set out for us."

The targets apply to cataract surgery, knee and hip replacements鈥攖hree surgeries for which wait lists have been a well-known problem in B.C., says health ministry spokesperson Ryan Jabs.

"In the past, we've basically just given the health authorities their funding allocations and left it at that," he said. "But there was no real incentive tied to whether they did meet their goals."

Specifically, the targets require that 90 per cent of patients who need a hip or knee replacement get it done with six and a half months of being ready for surgery.

That time window shrinks to four months for patients who need cataracts removed.

Northern Health performed the worst on those targets among all B.C. health authorities last year, with more than a third of hip replacement patients waiting too long and nearly half of knee and cataract surgeries exceeding the target.

Sixty-five of Northern Health cataract patients waited longer than a year.

By contrast, just one per cent of Vancouver Coastal patients waited longer than 26 weeks for hip or knee surgeries, and just four per cent waited longer than the target for cataracts. As a result, that region lost no money.

A draft report on surgeries in the Northern Health area, which runs across B.C. from Valemount to Atlin, said the region is characterized by relatively low patient volumes, hospitals that are far apart, and a limited number of specialists.

Quinn said recruiting and retaining surgeons has also been a challenge to Northern Health.

For example, staff at Bulkley Valley District Hospital struggled for years to replace a general surgeon. The hospital has since moved to a visiting surgeon model, a system that has worked well and may be adopted by other rural hospitals.

This is the third year that B.C.'s health ministry has held back funding when wait times for knee, hip and cataract surgeries aren't met.

That represents the ministry's stick approach, one that Jabs said is balanced by the carrot of the ministry's new patient-focused funding arm.

Under that program, Northern Health got  an extra $2.2 million to expand hip replacement and other hip surgeries. That meant 740 hip surgeries were done in the north last year, a 44 per cent increase from 2010.

"The big reason why we're doing this is because there's increased volume," said Jabs. "There's a continual increased demand."

In a province that is quickly ageing, demand for knee, hip and cataract surgeries is expected to keep rising, and Northern Health has the highest project growth rate for seniors among all B.C. health authorities.

Jabs cautioned that the wait-times targets are based on averages鈥攑atients who require surgeries right away can be treated in a few weeks or days.

For northerners, that can mean a trip to hospitals in other parts of B.C.

About a third of Northern Health patients who had hip replacements and 15 per cent of patients who had knee replacements last year went to hospitals in and around Vancouver.

With files from Jeff Nagel