Surgery hit by theatre pressure

By ANGELA GREGORY

A study showing unacceptable waiting times for bone surgery at Middlemore Hospital could be replicated at any hospital in the country, says the Orthopaedic Association.

The study by Middlemore consultant Kevin Karpik, released at the association's annual conference, showed that in the second half of last year acute patients faced significant delays in getting orthopaedic surgery they needed.

It echoes a study released by Auckland Hospital's director of orthopaedic trauma, Bruce Twaddle, which showed treatment for broken bones was falling short of guidelines.

Mr Karpik said the cancellation of surgery for sometimes days on end at Middlemore was common and could lead to complications.

Association president Geoffrey Horne said the results would be typical of orthopaedic services around the country.

Professor Horne said the demand for orthopaedic surgery would only increase. For example, the ageing population would lead to more hip replacements.

Professor Horne defended the right of Mr Twaddle to speak out.

Mr Twaddle was last Friday called to account by hospital management for saying restrictions on resources were compromising patient care.

Professor Horne wanted to see targeted funding for orthopaedic surgery with more money from the Government.

Mr Karpik said that Middlemore's orthopaedic service last year had just one dedicated orthopaedic acute theatre available during the day.

"Occasionally this was taken away by other services or stopped for other reasons."

Although there were enough surgeons to staff a number of theatres, it appeared there was not enough theatre time available.

The average delay from admission to surgery was 1.7 days.

Counties Manukau District Health Board spokesman Chris Fleming said the study covered the worst period for acute orthopaedic surgery at Middlemore.

Steps had been taken and had produced a marked improvement in the last six months.

The hospital now had a policy of six acute or arranged theatres for orthopaedic surgery, he said.

The total number of all acute patients waiting for surgery had dropped from an average 30-40 a day to 15-25.

Mr Fleming said Middlemore was also now dedicated to move on surgery where resourcing was the primary reason for a predicted delay.

The Auckland District Health Board is trying to work out a solution with timely access to theatres.

The Ministry of Health has said it knew more work was needed to help ease the effects of orthopaedic surgery waiting times, and significant progress was being made.

The number of patients waiting more than six months after assessment as eligible for publicly funded treatment had fallen from more than 8000 in 1998-1999, to about 2000 in August this year.

However, the ministry acknowledged that not all patients who wanted surgery could currently receive it and there were still long waits.

Surgery delays

* Study shows that in the second half of last year acute patients at Middlemore faced significant delays in getting orthopaedic surgery.

* Consultant says Middlemore had just one dedicated orthopaedic acute theatre available during that period.

* Although surgeons were available to staff several theatres, it appeared there was not enough theatre time available.

* Health board says hospital now has a policy of six acute or arranged theatres for orthopaedic surgery.