The number of West Coast people waiting for surgery or a specialist's assessment has soared in recent weeks because of Covid constraints, the vaccine mandate and staff shortages.
In his report to the DHB's Health Advisory Committee, operations manager Phil Wheble said 135 patients had been waiting more than four months for their first specialist appointment by the end of September. That compares to just seven in October 2020, and the numbers have been creeping up month by month ever since.
Most were orthopaedic cases (90) along wth plastic surgery (25) and respiratory patients (13), Wheble reported.
There were 116 patients waiting over four months for surgery they needed, 63 of them orthopaedic cases.
Others had been waiting longer than they were supposed to for dental and plastic surgery, and operations involving gynaecology, urology and other areas.
The waiting times for orthopaedics and plastic surgery were growing even before Covid took its toll, because of staffing problems, Wheble said.
"Even after travel and distancing restrictions were eased, Air New Zealand was not operating twice-daily flights in to the West Coast until September 22, which impacted on visiting specialists' ability to travel to undertake surgery and a range of surgical and medical clinics."
Telehealth appointments had been used wherever possible, Wheble said.
The DHB was making a concerted effort to catch up, but was hampered by staff shortages.
The good news was that the DHB had been able to fill five nusing vacancies, one in paediatrics and four in the short-stay unit, and one surgical vacancy.
"Our general surgery team is almost fully staffed. Dr Black, our full-time general surgeon and his family arrived in New Zealand in late October from Colorado. Dr Black is an experienced endoscopist and a surgeon with a passion for rural communities."
The DHB was also recruiting a Canterbury-based surgeon for regular pattern part-time work on the Coast, Wheble reported.
Committee member Edie Moke said: "Thirty-two percent is just terrible. I get your point about Covid and clinical input that's not available at the moment, but at what point do you think we will see a reduction in those statistics?" Wheble said there was no one answer for all the services.
"For example, orthopaedics will continue to be a challenge. It is a constrained resource with plastics ... but what we've done is trained up one of our rural generalists to do some of that work in primary care."
The DHB was talking to plastic surgery specialists about moving some of that work from the operating theatre in the minor operations room.
"What that does is give a little more throughput in that space when they come across (from Christchurch)."
Dental surgery lists had been set back both by Covid and the Westport floods, but there would be a chance to catch up on the backlog in December, Wheble said.
"It won't eliminate the total but it will dent it."
Prior to Christmas the other waiting lists would continue to be problematic, he said.
"Some of the workforce issues we're facing are because of the mandatory vaccination order; and that has impacted on us without anaesthetists - not our staff - but locums that were about to cover various leave (gaps) and so it limits how much we can do during this period."
The DHB's new permanent anaesthetist would be arriving in New Zealand just before Christmas, and that issue would be resolved in January, when she began work, Wheble said.
But across the DHB services, the impact of Covid and the need to resource a national response would still be making itself felt in the months to come, he said.
Committee chairman Peter Neame said he believed it would take several years for the impact of the pandemic to subside.
"Things won't be right for three to five years, in my opinion. If you look back at history pandemics have a course. It doesn't matter what we do … we just have to live through it, and get on with it.'"
DHB chairman Rick Barker said on the positive side, the staff appointments were great news.
"On the plastics I have been assailed on a number of occasions by people who are concerned about getting minor things chopped off them - because of sun damage and so on. If we can make some advances in this area with plastic surgery, it would be a really good thing."
Not everyone needed a triple bypass but most people need some minor (skin) problems attended to, Barker said.
"This seems to be a surgery or process a lot of people would need and it would make it a very useful health service - strengthening our plastics (service) would be a very good thing."
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