Patients wait as operating theatres lie idle

By REBECCA WALSH and MARTIN JOHNSTON

Two operating theatres at Middlemore Hospital's new surgery centre are sitting unused - even though thousands of people have been dumped from the centre's waiting lists.

Meanwhile, more than 300 patients in the hospital's catchment area - some so disabled they are unable to walk to their gate - can expect to wait up to a year for knee or hip-replacement surgery.

Hospital managers say the hospital has the facilities but not the money to meet demand.

Chris Fleming, general manager surgical and ambulatory care services, said only two of the four in-patient theatres at the Manukau Surgery Centre had been used since the theatres opened in November 2001.

"It's simply a prioritising of resourcing. The Government's given us about $570 million as a district health board for next year ...

"When you look at mental health, primary care and medicine, the amount of funding we can afford to dedicate to elective surgery means we still have spare capacity."

Dr Garnet Tregonning, Counties Manukau's clinical head of orthopaedic surgery, said about 350 patients in south, east and west Auckland could expect to wait up to a year to have an artificial hip or knee fitted. He did not expect any improvement in the next year.

Until the patients had been treated and had recovered, they would be unable to walk to their gate or even bend to put on socks or stockings. They would need crutches or walking sticks and be in constant pain.

Surgeons had given all these patients at least 90 out of a maximum 100 points under the Government's elective surgery rationing system.

Those considered in the greatest need of surgery required two joints replaced or were waiting for a repeat joint replacement after the surrounding bone had started to crumble. Their scores would be at least 95.

That is the score needed by Counties Manukau hip or knee-replacement patients to be assured of receiving surgery within the Government's benchmark of six months.

Others with lower scores, down to 78 points, were put on the waiting list but could not be guaranteed surgery within six months.

"It's demoralising having to say that to patients," Dr Tregonning said.

They would receive treatment if in the private system.

One of those taken off the waiting list was 81-year-old Jack Power. He was told by a specialist in February 2001 that he urgently needed a knee replacement.

When he did not get a surgery date his daughter Mary Clist started ringing the hospital every month and contacted National MP Judith Collins.

In October last year, Mr Power was told he had been taken off the waiting list because the hospital did not have "sufficient resources to provide this service".

Mrs Clist said her father's condition had deteriorated so much that he no longer took part in activities at the resthome where he lives because he was in too much pain. She did not know if he might get surgery.

"He is a World War II vet, he supported himself all his life ... When he needs help it's not there."

Ministry of Health policy is that the cut-off point to get state-financed surgery, based on severity of symptoms, should be the same nationwide.

Andrew Holmes, manager of clinical services, said the problem of South Auckland not being equal to the rest of the country was being addressed.

The greatest variation between health boards was probably in orthopaedics, especially major joint replacement.

"In Auckland we have some shared concern that the level of access for major joint replacements is not as good in South Auckland as in the rest of the country," he told Auckland health board members.

"That's being addressed at the moment between the ministry and Counties Manukau and it has a knock-on effect to the rest of the region."

The Manukau Surgery Centre, which includes six day theatres, four in-patient theatres, two procedure rooms and 75 beds, was built to handle the needs of a growing South Auckland population.

Waiting lists:

Of 18,571 South Aucklanders who needed surgery

9458 have received an operation.

7260 are still on the waiting list.

1853 have been sent back to their GPs.


In south, east and west Auckland

350 people who cannot walk are waiting up to a year for an artificial hip or knee.