The Kia Manawanui Trust has shone a shocking spotlight on the roadblocks to timely cardiac care in New Zealand, but members are optimistic things can be fixed.
Cardiac care in New Zealand is in trouble. There are extensive delays for surgery, a shortage of specialists, long waits for scans, and lack of access to drugs that would help heart patients. Two years ago, officials considered sending patients to Australia for treatment because the situation here was so dire, and not for the first time.
The Kia Manawanui Trust (it means “the heart of Aotearoa”) is out to try to make a difference. A sister charity to the Asthma and Respiratory Foundation, it set out in 2018 to identify the problems and find ways to fix them.
“This is a major killer in New Zealand,” says CEO Letitia Harding. “We’re going to find out where the bottlenecks are, what lobbying needs to be done, why we don’t have devices and medical interventions you can get overseas that we know save lives, and we’re going to start raising awareness and pushing for change.”
One of the trust’s first successes was to raise funds for portable electrocardiogram (ECG) machines to be sent to under-served communities.
It has also run a certified course in intravascular imaging, a technique that can significantly reduce cardiac death as it allows doctors to see inside blood vessels to assess the severity of disease.
Now, it has funded research by Otago University which has pinpointed just how badly heart care in New Zealand is lagging. Almost half of all heart attack patients are not being treated within internationally accepted timeframes, the “Heart Disease in Aotearoa” report found.
Areas with the fewest cardiac specialists – Tairāwhiti, Whanganui and the central North Island – have the highest death rates. Māori and Pasifika are hospitalised or die from heart disease on average a decade earlier than the population as a whole. Auckland is the only region where the number of specialists per head of population is comparable to European countries. The study put the total cost of heart disease deaths in 2020 at $13.09 billion.
“The lack of investment in the cardiac space has been going on for many, many years,” says Harding. “I don’t blame one government or the other, this has been decades.
“We’re going to make some noise and come up with solutions.”
Harding says it isn’t such a stretch for a charity focused on respiratory health to become involved with cardiac care, too.
“The heart and lungs are related,” she points out. “We know that COPD [chronic obstructive pulmonary disease] can lead to heart failure, for instance. And when the Asthma and Respiratory Foundation was talking about vaping issues, more and more literature was coming out on how it affects not just the lungs but the heart.”
In a bid to tackle the shortage of cardiac sonographers, Te Whatu Ora Health New Zealand has already partnered with the University of Auckland to launch a training programme for at least 15 students per year. However, during their studies they need to train in a cardiology department, and Harding says there’s no budget for that.
Ringfencing funding is among a list of solutions the trust has suggested to Health Minister Simeon Brown.
Kia Manawanui also wants to see more funding for dedicated cardiac beds at hospitals in main centres, an end to delays in hiring new medical staff when someone leaves a hospital position, and a commitment to tackling the waitlist for ECGs.
The trust estimates at least 15,000 patients are waiting for heart scans to diagnose potentially life-threatening conditions and has called for locum staff to be used to run extra clinics to clear the backlog.
Particularly in rural areas, there are delays for patients who need heart scans that could detect atrial fibrillation early. The condition can lead to heart failure and affects about one in 35 Kiwis.
Te Whatu Ora has announced plans to shorten hospital waiting lists by outsourcing simpler “elective” procedures to private surgeons.
Harding agrees this could ease the pressure on the health system. “But private hospitals don’t do acute services. They aren’t going to be seeing the heart attack patients at 3am – they go to the public hospital.
“There is a place for the public-private partnership model this government is obviously very keen on. But you still have to invest in secondary hospitals that are screaming out for more beds.”
Harding is optimistic that the trust can make a difference.
“There was a need for someone to speak out about the issues going on in the cardiac space. Heart disease affects so many lives and we’re really excited to get into this new area.”
