5 May 2022

Surgeon urges use of private sector to tackle waiting list crisis

12:07 pm on 5 May 2022

An experienced orthopaedic surgeon says redirecting public patients to private hospitals could help the massive backlog of people waiting for operations.

Counties Manukau DHB says all non-urgent planned care that has been postponed due to Omicron will now be rescheduled as quickly as resources allow.

People are waiting even longer for operations due to Covid-19 backlogs. Photo: Supplied / LDR

Geoffrey Horne, a semi-retired Wellington-based orthopaedic surgeon, said people sitting on waiting lists requiring surgery were in a dire situation. He believed bringing private hospitals into the mix was a good idea because they were more efficient at getting the work done.

"The public sector is about half as efficient as the private sector at performing operative procedures," Dr Horne told Morning Report.

"Generally speaking the costing systems in the public sector are not very robust, whereas in the private sector every cent is accounted for."

The government announced yesterday that public hospital waiting lists will be managed nationally in the face of soaring unmet demand.

Horne questioned whether the government's plan to tackle waiting lists from a nationwide perspective would have much impact on the situation.

"Patients already do move around the country now to various tertiary centres," Dr Horne told Morning Report .

"I don't think that will be a widespread thing. If you get offered to have a knee replacement in Whangārei tomorrow, you're not likely to fly from Wellington or Christchurch to get a knee done in Whangārei. I think it's unlikely that is ever going to happen."

The combination of severe underfunding for surgery over the past decade and pent-up demand due to Covid-19 were factors, he said.

"The concept of matching capacity with the needs of patients led to a lot of patients being sent home and being told to go back to their GPs and being told to take some more aspirin," he said.

"There is a vast pool of patients whose needs have not been met."

Health Minister Andrew Little has set up a taskforce to help hospitals take whatever short-term measures they can to reduce waiting times. It will be responsible for delivering a national plan by September.

All but one of the country's DHBs operated at a loss this financial year.

A new taskforce is looking to reduce waiting times for patients. Photo: 123rf

The government said that in March, nearly 36,000 people had been waiting longer than four months for their first appointment with a specialist.

Those waiting more than four months for treatment had also more than trebled, from 8000 in February 2020 to nearly 27,000 in March this year.

The taskforce will be led by the chief medical officer at Counties Manukau, colorectal surgeon Andrew Connolly.

"What we are doing is looking at how to be in a more co-operative model rather than competitive," Connolly said.

Connolly said the taskforce would look closely at using private hospitals for operations.

"What we are doing in terms of private is looking at how to be in a far more co-operative model, rather than competitive.

"Are there conditions where we could enter into long-term contracts that are efficient, that help create capacity in the public hospitals for some of the more complex work?"

He said increasing access to surgery was vital.

"This is not about denying access at all, this is about increasing access," he said.

"We have to look where we can grow access."

Ah-Leen Rayner, the Breast Cancer Foundation NZ chief executive, told First Up the new taskforce to tackle waiting times was a good idea if proposed changes mean people can be treated in a more timely manner.

"A national approach is a good idea - if travelling to another region can actually get you diagnosed and treated more quickly we are supportive of the idea," she said.

The foundation was hearing from some doctors who are seeing women who have waited six months for their first appointment.

"That is not ok with a breast cancer diagnosis - it is the biggest killer for women under 65," she said.

"Breast cancer won't wait."

Rayner said the government would have to keep looking at ways to ensure women with breast cancer can get timely treatment. She also raised concerns about the added stress associated with treating patients away from home.

"One of the things that does concern us is that people will be away from their support networks."

Reports suggest the Covid-19 pandemic has meant over 50,000 mammograms have been pushed back and the foundation has launched a campaign called #GiveUsOurMammograms, demanding action.

"Breast cancer is entirely survivable if it's caught early," she said.

"We will continue to campaign for women to have their mammograms in a timely process because we know they save lives."

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