Attack renewed on Government elective surgery record

Despite population growth, fewer people in Auckland are receiving state-funded elective surgery than in 2001 for hernias, varicose veins and inflamed tonsils.

National MP Jonathan Coleman, quoting Government answers to his parliamentary questions, said yesterday that the region's health boards performed 23 per cent fewer elective hernia repairs, 24 per cent fewer elective tonsillectomies and 45 per cent fewer elective varicose vein operations.

But the tables he used show a more variable picture over the past five years at the three health boards. One statistic - of Counties Manukau's inguinal hernia numbers - showed an increase.

Using the figures, National renewed its attack on the Government yesterday, trying to establish that elective services are in a crisis, an assertion Health Minister Pete Hodgson rejects.

Dr Coleman, a GP, said a hernia could put a patient at risk of gangrene if it became "strangulated" - when the blood supply to the affected part of the bowel was cut off. Varicose veins could be painful, and untreated tonsillitis could leave a patient at risk of rheumatic fever and kidney disease.

Mr Hodgson told the House that antibiotics were increasingly used to treat tonsillitis, rather than removing the tonsils, and compression treatment was now used more widely than before for varicose veins.

Dr Coleman said later that the three boards' collective reduction in tonsillectomies, to 782 operations in 2005, was a dramatic change. It could not be explained by variations in clinical practice or changes in demand in the local populations.

He was certain it was due to increases in the clinical access thresholds applied by the boards - meaning patients now had to be sicker.

Counties' general manager of surgical and ambulatory care, Chris Fleming, said hernia patients were given surgery if the symptoms were severe enough to affect their daily life, especially the ability of physical workers to do their job.

Varicose veins patients qualified for surgery only if in severe pain or if the condition was causing skin ulcers.

Mr Fleming was unable to discuss tonsillectomies, as the relevant clinician was unavailable, but said the board's overall elective surgery volume had increased last year.

The general manager of the Waitemata board's hospitals, Rachel Haggerty, said its elective hernia numbers were fairly stable but had spiked up in 2001 because of one-off funding to deal with an accumulation of patients.

The Auckland board could not offer detailed comment last night, but said surgical volumes this year were exceeding predictions and the high numbers of acute patients had affected provision of lower-priority elective surgery.

Mr Hodgson's defences of elective surgery performance yesterday included figures showing big increases in hip and knee replacements - following specific cash injections - and in the number of heart-artery-expanding angioplasties.