Number of patients culled from surgery list doubles

By Audrey Young

The number of patients dropped from waiting lists after being assessed by a specialist as needing surgery has more than doubled in the past five years.

In the year to January, 8108 patients were referred back to their general practitioner after either having been promised surgery within six months or been classed as needing surgery and put on "active review".

In the five years before that, only 4292 patients at a similar stage of the waiting list and booking system had been discharged back to their GP.

The figures were supplied by Health Minister Pete Hodgson to National health spokesman Tony Ryall in answer to written parliamentary questions.

Mr Ryall says it's a case of making waiting lists look shorter by culling people.

Mr Hodgson says it might reflect better management of the system by district health boards because they are being more direct with people about what they can give them.

Managing waiting lists around the country has become a political headache for the Government, highlighted last week when Hawke's Bay District Health Board referred 1800 in one go - though in that instance, the patients were in the category that had not yet seen a specialist before being referred back to their GP.

Mr Ryall says the figures show that "a cull" has been going on at the second stage.

"This is the cruellest cut of all. These patients have survived the first cull, see a specialist and find that surgery is needed, and then fall victim to the second cull.

"It seems patients now have to be within sight of the pearly gates before they get elective surgery," he said.

Of the 8018 dumped in the year to January, 1400 were from Counties-Manukau, 2400 from Canterbury, 750 from Otago, 630 from Bay of Plenty and 500 from Nelson.

The number of discharges represents a significant increase when compared with the number of elective procedures performed at the same time, which figures suggest has not changed much from year to year.

The discharges compared with the the procedures in the year to January 2002 was about 4 per cent; but January this year was equivalent to about 7.5 per cent of all procedures in the previous year.

Mr Hodgson said he did not know why but it could be that district health health boards had been "quietly getting on top of their [electives services patient information] and that they have been gradually getting on top of the need to refer people back [to their GP] on a regular basis, daily, weekly monthly."

The Government was trying to give people clarity, fairness and timeliness in regard to elective surgery.

Prime Minister Helen Clark said the collection of health data was not yet picking up day surgery and procedures performed in mobile bus clinics such as cataract operations.

She disagreed with Mr Ryall's claims that patients were being culled because of a lack of funding.

In the last six Budgets, health spending had increased more that 60 per cent.

"So I don't think it's about money. I think it's about management; its about prioritisation. It's also about recognising that demand is infinite and you have to manage demand and the point at which people come through to hospital."

She said that about two-thirds of the district health boards "appear to be managing their waiting lists in a way that doesn't attract headlines".


Assessed as needing surgery then removed from waiting lists - all DHBs:
* 8108 in the year to January 2006.
* 4230 to January 2005.
* 5625 to January 2004.
* 3793 to January 2003.
* 4292 to January 2002.

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