Heart bypass numbers decline

The number of heart bypass operations done at Auckland City Hospital dropped by more than 20 per cent last year.

Its surgeons did 394 of these operations, compared with 504 the year before - and 813 in 2002.

National associate health spokesman Jonathan Coleman, who had obtained the figures from Health Minister Pete Hodgson, used them in Parliament yesterday in the party's ongoing attempts to embarrass the Government over hospital productivity and patients' access to elective surgery.

They show that the number of angioplasty procedures declined significantly last year, to 1080. In the previous two years the number had risen by virtually the same amount as the reduction in bypasses.

Dr Coleman highlighted that the hospital in January had 133 cardiothoracic patients waiting without a commitment to treatment, despite having scored above the "treatment threshold" in the elective services rationing system. And 140 had been waiting more than six months for treatment despite having been told they would receive it.

Mr Hodgson said he could only guess at the reasons for the decline in bypass operations, because Dr Coleman had not said he would be seeking an explanation in the House yesterday.

"All I can say is that around the country, and therefore, I assume, in Auckland as well, coronary artery bypass grafts are giving way to another form of surgery, an earlier intervention known as angioplasty, which reduces the need for ... bypass grafts ..."

The medical director of the hospital's adult health services, Dr Margaret Wilsher, said last night this was one of the reasons. Others were:

* Shortages of theatre and intensive-care staff, although the hospital had a full complement of heart surgeons,

* More complex heart surgery was now possible and it took longer to perform, reducing throughput, and

* Problems with the instrument sterilisation service and other "bedding-down" issues after the heart and respiratory units moved from Green Lane Hospital.

Dr Wilsher emphasised that the heart unit also did lung surgery. "Thoracic surgery volumes have almost doubled over the last two years and it's the same workforce."

The Auckland District Health Board, which runs the hospital, said its current elective heart surgery waiting list and waiting times were unacceptable.

It had introduced Saturday surgery, improved theatre-nurse recruitment and had contracted out 20 bypass operations to private hospitals.