Ear, nose and throat patients must wait

By MARTIN JOHNSTON health reporter

Green Lane Hospital in Auckland has cut non-urgent surgery to cope with a heavy workload that some staff believe has compromised safety.

Senior doctors and other staff in the ear, nose and throat department have sent hospital chiefs an urgent notice saying services must be restricted in their area to ensure safety.

But the management says safety has not been compromised.

The department sees about 13,000 outpatients a year and about 2400 inpatients. The cases range from inflamed sinuses and the removal of adults' tonsils, through to cancer in the mouth and throat.

The urgent notice, obtained by the Herald, says staff at a meeting last month agreed on measures including that patients referred from outside central Auckland with acute conditions should not be accepted during normal working hours.

The memo also said that no new patients should be booked for clinics or operating lists unless they needed urgent attention for a seriously disabling or life-threatening condition.

" ... planned admissions may be cancelled without notice if the situation is deemed by senior ward staff to be unsafe.

"These measures will remain in place until necessary remedial steps have been taken to ensure patient safety.

"Such steps will involve those issues that have been raised by [ear, nose and throat] staff with management in the past year but remain unresolved."

The hospital's general manager, Carol Ramage, is playing down the "very emotional" memo, which she said had used unfortunate wording.

"We haven't turned away patients but we've probably slowed our elective [non-urgent] admissions," she said.

That had increased the department's waiting list, which previously had been virtually nonexistent.

Staff were very concerned about the high workload in the department, she said. Before the staff memo was issued, the hospital had addressed the problem by cutting department beds from 29 to 20.

Its workload had increased in January and February because of some difficult cases compounding the nursing shortage at the hospital. More than 40 positions were now vacant, said Carol Ramage.

She expected the ear, nose and throat department to be back to normal in a few weeks.

But Ian Powell, executive director of the Association of Salaried Medical Specialists, said the hospital's chiefs were overriding the judgment of clinical experts. "That tells me that management at Green Lane is on a completely different planet from those at the coalface."

Also in January, the ear, nose and throat clinical director, Dr Nick McIvor, resigned. He has not yet been replaced, although he remains a surgeon at the hospital.

The management would not say why he had resigned, and were seeking a replacement.