People with broken bones are facing agonising delays to have surgery because of an unprecedented number of patients, potentially putting some at risk of serious complications.

The number of seriously injured or sick people needing orthopaedic surgery has leapt by 80 per cent in 11 months at Middlemore Hospital, forcing the postponement of some elective surgery to make way for the acute cases.

The Auckland District Health Board (DHB) weekly tally has risen by 10 per cent in a year, and Waitemata's monthly count for January was up 11 per cent on December.

Hospitals aren't sure of all the reasons but say it's partly a growing and ageing population; Middlemore has seen more road-crash victims along with an increase in the complexity of cases, requiring longer operations.

The difficulty is that we have had unprecedented demand for acute services ... It's got a little bit crazy

Myrie Edwards lay for five days in a Middlemore bed waiting for the swelling to go down before surgery could be considered for her right ankle, which had been dislocated and broken by an off-balance moment on steps.

Then a six-day wait ensued in which she was repeatedly told she would get the operation, only to be bumped off the theatre list by the arrival of patients deemed in greater medical need.

"Its debilitating. I'm normally a happy-go-lucky person but I got really, really depressed since I was here. All day Monday I was in tears.

"You get your hopes up when they say, 'You're top of the list', [but then they say] they've got other acute patients who need to go in first," said Edwards, 47, a mother and part-time cleaner from Mangatawhiri, southeast of Auckland.

To prepare for surgery, she couldn't eat or drink after 2am, only to be told at around 7.30pm, more than 17 hours later, that the operation wouldn't happen that day and she could have a meal and drink.

She had trouble eating, initially suffering nausea and vomiting from the pain medication which wasn't properly controlling her pain.

Edwards received her operation, in which a metal plate was screwed into her ankle, on Tuesday and wonders if the Weekend Herald's involvement played a role.

"I told them I was talking to the Herald and I went straight in."


However, the Counties Manukau DHB said treatment timing was based on patients' clinical risk and the availability of staff and theatres.

Edwards and her husband, Tony, are speaking out to help prevent others suffering the same fate.

"They need to get ... sorted. We hope we can get the DHB to pull their finger and do something, because it's ridiculous," Myrie Edwards said.

But she praised her nurses and said the deputy head of orthopaedic surgery, Richard Street, had visited her to deliver a personal apology for her wait.

Richard Street, deputy head of orthopaedic surgery at Middlemore Hospital.
Richard Street, deputy head of orthopaedic surgery at Middlemore Hospital.

"We like to do better than that," Street said, "but there have been special reasons. Fortunately she hasn't suffered, apart from starving. Her outcome wasn't compromised."

He attributed her delay partly to elderly patients needing to be treated first because of their risk of death if they had to wait.

"We endeavour, particularly with fractured neck-of-femur [near the top of the thigh bone] to get those patients to theatre within two days and hopefully quicker than that."

Long delays could drag out the recovery of these typically elderly, infirm patients. The risk of death was even greater with open wounds caused by bone fractures, which could allow a major infection to take hold.

"The difficulty is that we have had unprecedented demand for acute services ... It's got a little bit crazy."

The peak came last weekend, with more than 30 patients waiting for acute surgery on Monday.

"Fortunately we have been able to get many of those people treated, but at the cost of elective surgery. Over this time many lists have been cancelled and that has made access to elective surgery more demanding."

Middlemore treated around 180 acute orthopaedic surgery patients in January, up from 100 last February.

Hospital services director Phillip Balmer said the demand for all types of acute surgery rose by 20 per cent from September to January, measured by theatre time. This was driven mainly by an increase in the number of orthopaedic cases and their seriousness.

The orthopaedic increase hadn't been fully analysed, but the known reasons were an increase in road crash cases and the referral from outside Counties Manukau of more patients needing both orthopaedic and plastic surgery.

To meet the increased demand, the number of theatres at Middlemore had risen to 14, from 11, more staff had been hired and extra evening and weekend theatre sessions had been scheduled.

Waitemata DHB said that in December, it introduced a second all-day, Monday-to-Friday acute orthopaedic theatre, "to ensure patients continue to receive timely access to surgery".

Auckland DHB said, "Considerable work is under way to identify both short- and long-term solutions to the impact of population growth ..."

"Our clinicians prioritise acute procedures on a daily basis, and work hard to ensure our acute patients receive the surgery they require in a timely manner."