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Home / New Zealand

Coronavirus: Private hospitals to help Covid-19 patient overflow

Nicholas Jones
By Nicholas Jones
Investigative Reporter·NZ Herald·
18 Mar, 2020 02:55 AM5 mins to read

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There are 8 new cases of Covid-19 in New Zealand - one in Christchurch, two in Waikato and another in Invercargill, Director-General of Health Dr Ashley Bloomfield says.

Private hospitals across the country have been asked by health authorities for intensive care bed and staffing capacity - and are ready to take patients should the public system hit capacity.

The Private Surgical Hospitals Association represents 39 facilities and has answered an urgent Ministry of Health request for information on resources and staffing.

READ MORE:
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Association president Richard Whitney, also chief executive of Mercy Hospital Dunedin, said his members were ready to help if Covid-19 began to overwhelm the public system's capacity.

"The private sector is assessing its capabilities and looking at how it can free up those capabilities," he told the Herald.

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"The word private doesn't remove any social responsibilities or those of a health professional. It's not a debate of whether we are in this or not - we are in this.

"What our role is will be dependent on what we are capable of doing. For example, for us in Dunedin [Mercy] we have onsite CT, MRI and the like, and an ICU [intensive care] capability. We are as useful as the public hospital a kilometre away."

There are nine private hospitals with intensive care units, with a total of 37 ICU beds (one-to-one nursing). Across all 39 private hospitals there are 1269 inpatient beds, and 44 high-dependency unit (HDU) beds, which allow more extensive treatment but at a level below intensive care.

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The private hospitals have a total of 174 operating theatres and 31 procedure rooms. They employ 2661 registered nurses. Doctors usually also work in the public system.

Whitney said how those resources might be made available would be on a case-by-case basis, and local District Health Boards would be having those conversations.

"It's a moving feast. To the best of my knowledge right now no private hospital has had a determination of what its role will be. But they are certainly active in their conversations with their local DHBs about how best they can support the DHBs."

The number of New Zealand cases of Covid-19 is ticking upwards, although there's no confirmed community transmission. That could change when more testing is carried out.

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The world has watched in horror as some hospitals in northern Italy become overwhelmed with the number of patients needing specialised care. Doctors there have spoken of having to decide what patients to treat.

New Zealand is aiming to avoid such a scenario by controlling the spread of the disease through measures including border controls, social distancing and contact tracing. This avoids the number of sick people quickly rising - something that could overwhelm hospitals, given about one in 20 people could end up in intensive care.

New Zealand's public system has a total of 176 ICU beds, across 20 DHBs. Authorities are currently collecting other information including the number of ventilators available.

Director-General of Health Dr Ashley Bloomfield has said stopping elective surgery was a way to make sure there's flexibility in the system, and enable more acute Covid-19 patients to be cared for.

The private sector is often used by DHBs to carry out some elective surgeries to keep waiting lists and times manageable. Whitney said any reimbursement for a pandemic response and equipment including protective masks, goggles and gowns was something yet to be looked at.

"That will have to be worked through on a case-by-case basis, or after the fact ... that won't be a predetermined conversation which will then determine whether we do or don't engage. Engagement is a given, it's a matter of how it pans out."

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The private sector wasn't looking to make money out of the pandemic, he said.

"It is the opposite of that. In fact, there will be costs that will not be recouped. The extent of that, well, who knows until the end of the day."

If the health system's capacity was reached by the spread of coronavirus then Whitney expected elective surgeries in public hospitals to "slow down or stop". Theatre lists would also reduce in the private system to free-up capacity needed to help the Covid-19 response.

"It's not that [DHBs] are going to just be flicking us surgery to do. They will be scaling down what they do, and, by default, we will have to scale down what we do to allow capacity to actually deal with the acutes and stuff that they can no longer deal with, because they've been so overwhelmed.

"My local view is it wouldn't be unreasonable for the DHB to look at us to do urgent cancer surgeries, and perhaps trauma surgery of things like fixation of fractured bones. They sort of have to happen. But someone's knee or hip replacement, if it's another two months before they get it, then so be it - they have been living with the condition for 12 or 24 months now."

Private hospitals with ICU facilities

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Mercy Hospital – Auckland (part of the MercyAscot group)

Ascot Hospital – Auckland (part of the MercyAscot group)

Southern Cross Hospital Hamilton

Braemar Hospital – Hamilton

Wakefield Hospital – Wellington (part of the Acurity Group)

Southern Cross Hospital – Wellington

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St George's Hospital – Christchurch

Southern Cross Hospital – Christchurch

Mercy Hospital – Dunedin

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