Patients to be told of delays to heart operations

Some heart patients judged by surgeons to need an operation will be told they don't qualify to have it any time soon in the public health system.

Auckland City Hospital, already struggling with heart bypass and angioplasty procedure numbers caused mainly by a shortage of nurses, says it is planning letters to send to new patients "to provide them with clarity".

In effect, the letters will tell patients either that:

* They qualify for surgery and can expect to have it within six months, or

* They do not qualify, given the financial threshold for treatment, even though a clinician has said they need surgery. These people will be put on "active review".

The hospital does not have enough money to treat everyone whom a surgeon deems in need of surgery.

It intends posting the letters in about three weeks, but first needs Health Ministry approval.

"There has been a lot of clinical and political concern about getting the wording right," an Auckland District Health Board meeting was told by an official.

Her presentation on elective services performance referred to "active review letters" for cardiac surgery, to be followed by a "roll-out to remaining services by June".

Asked if the letters would be sent to patients who had been promised an operation, a spokeswoman later said letters giving heart patients certainty of treatment within six months or assigning them to regular "active" review of their priority would at this stage go to new patients on the list.

"Once this process is under way we will revisit the existing list and look to ways of managing those who do not reach the clinical priority assessment criteria for certainty of treatment."

About 100 patients a month were added to the list, mainly from the Auckland region and Northland.

The letters follow the release of figures last month showing the hospital did 22 per cent fewer heart-artery bypass operations last year than the year before and 13 per cent fewer heart-artery-expanding angioplasties.

As at January, the hospital had 133 cardiothoracic patients waiting without a commitment to treatment, despite having scored above the "treatment threshold" in the priority scoring system.

And 140 had been waiting more than six months for treatment despite having been told they would receive it.

Board papers also reveal problems in coping with the number of eye patients.

Officials say "agreement needs to be reached" to reject referrals of patients whose eyesight is not threatened by their condition, to meet Government requirements on timeliness of care "and a significant lift in the access threshold".

National Party health spokesman Tony Ryall said developments at the health board were further proof that elective services were in a crisis nationally.

Lifting the access bar to treatment meant patients needed to be sicker to receive state care.