Fed-up surgeon quits hospital

By MARTIN JOHNSTON health reporter

One of New Zealand's leading plastic surgeons has quit Middlemore Hospital, saying he is frustrated by the shortage of money in the public health sector.

News of Cary Mellow's resignation last night came as top orthopaedic surgeon Bruce Twaddle was reprimanded by the Auckland District Health Board for his public criticism of bed reductions at its new hospital.

Mr Twaddle, Auckland City Hospital's head of orthopaedic trauma, was told he risked dismissal for any repetition.

Mr Mellow, head of plastic surgery for the Counties Manukau board for six years and a surgeon at Middlemore since 1989, said he was frustrated by patients' unacceptably long waits for surgery in the public sector.

The 46-year-old, who has worked on some of the most complex cases done in this country, including dog bite victims, said: "Many surgeons in the public hospital system are frustrated.

"We've heard it from orthopaedics this week. Certainly in plastic surgery there's a considerable level of frustration at the ongoing problems with funding in public hospitals and the difficulty with treating patients who need to be treated."

More patients were waiting unacceptably long periods for operations or were not being treated at all. People needing operations for non-spreading skin cancers, breast reconstruction or congenital deformities were particularly affected.

A decade ago some skin cancer patients would be treated within a month or two. Now they might wait six months or more, although melanoma and other more aggressively spreading cancers were given good priority.

"It means the skin cancer tends to grow and may need an operation that's bigger," Mr Mellow said.

Board communications manager Lauren Young said Mr Mellow would be a huge loss to the department.

But she brushed off Mr Mellow's funding concerns.

"There are always going to be frustrations over funding. That's the nature of health. The pie is never going to be big enough."

Mr Mellow, who needed facial surgery himself after a 1998 attack by a man wielding a steel-headed mallet at a West Auckland clinic, will finish in January and work more in the private sector.

Mr Twaddle's reprimand follows his comments in the Herald this month, a day before the $200 million Auckland City Hospital opened, criticising its reduction of about 70 beds. The board says greater efficiencies, extra daycare and more beds at Waitemata and Counties Manukau board hospitals make up for the loss. The senior doctors' union last night condemned his warning letter from management, which it considers an attack on a vital right of specialists to speak out about standards of patient care.

The union's executive director, Ian Powell, said it would start personal grievance proceedings in a bid to force the board to revoke the letter.

Mr Twaddle would say only that he was disappointed at the outcome. "I will be trying to get the censure removed from my record."

The board declined to comment on his case.

Surgical skill

* This year Cary Mellow used 200 stitches to repair the face of a 5-year-old boy savaged by a dog. In 1998, Mr Mellow led pioneering surgery to reattach a 2-year-old boy's lip severed in a dog attack.

* At the time there were only 10 documented cases of lips being "replanted" and the boy was the youngest patient.

* In 1994, Mr Mellow took part in a 17-hour operation to reattach a man's arm, severed between the elbow and wrist in an industrial accident.