5 May 2020

Criticism of deferred non-urgent surgery, but support for holding off continues

9:51 am on 5 May 2020

Frustration is growing among people stuck on surgery wait lists due to their age or weight.

Public hospitals reported more than 500 adverse events or failures in the past year.

File image. Photo: 123RF

Elective surgeries and specialist appointments are restarting under alert level 3, but the Ministry of Health has told DHBs to consider deferring non-urgent treatments for people who are over 70, have a BMI over 40, or have heart, lung or kidney disease.

Among those people is Hamilton man Graham McCready, who describes himself as a fit, active 75 year old with the body of a 45 year old.

The keen cyclist and tax accountant said he only has one problem: a cataract in his eye which was meant to be operated on six weeks ago.

It was cancelled due to the lockdown and the Waikato District Health Board has told McCready his appointment is on hold indefinitely.

"They didn't look at me in terms of my fairly active physical condition. They just arbitrarily said 'you're over 70, now 75. See you later'," he said.

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Most health boards have told RNZ they will be following the ministry's guidelines to postpone surgery for elderly or obese people unless it's urgent.

But McCready said he didn't understand why he had to keep waiting.

"I think it's pretty well safe now. I went to have a blood test today and the person taking the blood had his personal [protective] equipment and facemask and everything else and I felt very safe going in there. Then the eye clinic - that's not really related to any issues or symptoms of the virus," he said.

A doctor in Christchurch, who didn't want to be named, said the guidelines could stir up more anxiety among health professionals and members of the public.

"With the very low levels of Covid around it seems unlikely that you're going to be more susceptible to catching Covid in a hospital. So therefore it doesn't seem logical to keep people out that you're screening for Covid before they even get in. And if the hospital's got no cases within it, then it doesn't seem to add anything," he said.

"I think there's a lot of fear and confusion around Covid. This doesn't seem to address that. It may make it worse."

But Christchurch researcher and geriatrician Hamish Jamieson said health boards were taking the right approach, because major surgeries like hip replacements could leave people more vulnerable to illness for weeks afterwards.

"Having an operation and then getting Covid - either during the operation or in the six weeks afterwards - could lead to worse outcomes for them. So it does seem reasonable, the Ministry of Health having a policy not to do surgery on people who are high-risk at the moment," he said.

The chair of the Pasifika Medical Association, Kiki Maoate, also agreed it was a rational approach which would prevent hospitals from being overloaded.

"If you do get complications and you're holding up an acute bed, or a ventilator or human resources, that will reduce the ability to respond when there's an acute emergency in a Covid situation."

The Director-General of Health Dr Ashley Bloomfield said it was likely the ministry's advice would change when the country moved to a lower alert level.

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