Doctors list risks with theatre cuts

By MARTIN JOHNSTON

Senior doctors fear a planned cut in the number of operating theatres at what will be New Zealand's leading hospital will increase the risks to caesarean deliveries.

They are also worried it will force patients to wait longer for non-urgent surgery.

The 710-bed Auckland City Hospital, the centrepiece of the Auckland District Health Board's $450 million rebuilding plan, is expected to open in October next year.

It will combine emergency and acute services from Auckland, Green Lane and National Women's Hospitals in a new building next to Starship children's hospital, which is being expanded.

The new hospital and Starship had been intended to have 37 theatres, compared with 29 at the board's four existing hospitals.

But the financially troubled board is now considering commissioning only 33 of them, saving about $4 million by not fitting out the other four.

The Government has ordered the board to slice $25 million off its $86 million deficit.

The women's health part of the new hospital would have three theatres, compared with four under the previous plan and four at National Women's Hospital in Epsom.

National Women's Hospital clinical leader Dr David Knight said yesterday that there would be the option of sending women needing emergency caesarean operations at the new hospital to one of the general theatres on the floor below the women's health division.

But that would be riskier than using one of the women's health theatres because precious extra minutes would be needed to set up the general theatre for a caesarean.

"I'm fairly confident we will get four. If we don't, we will have to ensure we have a watertight procedure [for using a general theatre]."

Other senior National Women's doctors predict that if they are restricted to three theatres, waiting lists for women needing non-urgent treatment will inevitably grow as operations are cancelled to make way for emergency caesareans.

"We've tried very hard to keep waiting lists under six months and we don't want to blow out on that," said one.

But the board's chief executive, Graeme Edmond, rejected talk of lengthening waiting times. He said the spare theatres could be equipped and commissioned if needed.

He said the integration of services possible by having one adult hospital would make it more efficient, and some services were being decentralised to hospitals in north, west and south Auckland.

"The theatres on the women's level will be by and large for women. If capacity dictates we have to operate on a woman in the general surgical area, that would be looked at. That's a sensible use of scarce resources.

"The board's direction is to integrate and consolidate its activities."

But Sandra Coney, executive director of Women's Health Action, said treating women in general theatres was a further dilution of a separate hospital specialising in women's health.

"The bottom line is that women will be getting a worse service than now.

"Currently women go into a women's hospital with dedicated women's health staff that are sensitive to women's needs. It's a very women-friendly environment.

"What they are going to get is a bit of a lottery as to whether they get that or they get just a general medical service where the staff are not dedicated women's health staff."