Surgeons ranks critically thin

By GREG ANSLEY Herald correspondent

New Zealand's groaning health system is heading for a new crisis as a growing and ageing population outstrips the number of surgeons needed to care for it, a report warns.

The report, presented at a Royal Australasian College of Surgeons forum in Melbourne yesterday, says public hospitals risk reversion to a role as charitable carers for the poor.

And it warns that unless more surgical training starts immediately, patients will face greater suffering in the next two decades.

"If we don't act now a lot more people are going to be in pain waiting for elective surgery that this report says they may never get," said college president Anne Kolbe.

"For people in regional New Zealand there will be no surgeons at all."

The report, which predicts similar dire problems for Australia's also-ailing health system, was prepared by Professor Bob Birrell, director of Monash University's Centre for Population and Urban Research, and Professor Lesleyanne Hawthorne, of Melbourne University Medical School.

It concludes that a 30 per cent increase in surgical training positions in public hospitals is needed by the middle of the decade just to keep pace with forecast demand.

Without this boost New Zealand will not have enough surgeons to cope with the 50 per cent or more rise in demand for surgical services by 2021.

Professors Birrell and Hawthorne say access to surgical services has already been severely constrained by the Government's determination to limit public hospital spending.

Public hospitals tend to focus on relief of acute, life-threatening or debilitating conditions.

Waiting lists for non-urgent surgery are often closed at six months and elective surgery moved to private hospitals.

The report notes the recent decision to add 40 subsidised first-year places in the nation's two medical schools. But it says New Zealand still depends heavily on overseas-trained doctors - 2491 were in the system in 2001.

The number of doctors recruited on temporary entry visas has risen significantly and, during the past two years, 900 doctors crossed the Tasman to live. But only a handful were Kiwi-born.

New surgical techniques and greater health fund membership is expected to add to demand.

People over 75 have the greatest need for surgery, but fewer than half of people now aged 65 and over have private health insurance cover.

Mrs Kolbe said if the Government did not act, surgeons would not stay in the public system and it would be unable to attract replacements because there would be absolutely no financial incentive in it for doctors.