Emergencies put heat on Counties Manukau surgeons

By ANGELA GREGORY health reporter

People waiting for surgery in the Counties Manukau District Health Board region continue to fall off lists as surgeons deal with emergency cases.

Surgeons are publicly complaining that they continue to be hampered in achieving the number of elective (non-urgent) operations needed because of the pressure of urgent operations, which take priority.

A Middlemore Hospital plastic surgeon, Alessandra Canal, told the Herald that even some relatively urgent surgery was not being performed in ideal timeframes.

Chris Fleming, surgical and ambulatory care services general manager, confirmed yesterday that some acute cases were having to wait.

Mr Fleming said the public needed to be aware of the impact major incidents like last month's sword attack and the spate of dog bites had on the system.

He likened the problems with delayed surgery and long waiting lists to a large crash on the motorway.

"Even though the wreckage may be cleaned up in short order, the backlog of traffic can take many more hours to clear."

Mr Fleming said the level of elective surgery at the Manukau Surgery Centre needed to be increased to free Middlemore theatres for more urgent surgery.

"We also need to be more realistic when scheduling elective surgery to ensure that the instances of last-minute cancellations become the exception, not the norm, whereby people are given reasonable expectations of when they can have their surgery."



Head of orthopaedics Garnet Tregonning was concerned patients did not understand the constraints that both the surgeons and the board worked under.

"For some years we have been performing a lower proportion of elective surgery than the rest of New Zealand."

Counties Manukau performs 31 per cent elective surgery with the balance being urgent cases. That compares to the national average of 41 per cent elective surgery.



Mr Tregonning said the problem had been happening for some time and was directly related to the region's high population growth rate and an ageing population.

"Unfortunately, this growth rate has exceeded the increase in funding," he said.

A number of patients had already been removed from the waiting list and returned to the care of their general practitioners.

But despite this the waiting list was still extensive.

Chief executive Stephen McKernan acknowledged the frustrations felt by the surgeons and the patients.

"The Ministry of Health is attempting, with population based funding, to bring us to a more equitable situation," he said.

"However, the years of under-funding are now being felt."

Mr McKernan said the board needed to find a way with the surgeons of balancing the urgent surgery so that people on waiting lists had some certainty about when they would get their operations.

He said that even people booked with certainty were vulnerable to being pushed off the lists as more urgent cases came in.