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Abacus Values
Sep 4, 2015

The need for elective surgery increase


 King obtained numbers under the Official Information Act that revealed 730 people in Taranaki  had elective orthopaedic surgery, including hip and knee operations, in the 2014/15 year.

But  a further 675 people  were referred to the hospital for surgery by their GP only to be sent back without a consultation, because they didn't meet the threshold, 

King said there were figures missing - those showing how many people were accepted for the first assessment and were then turned away without an operation.

Taranaki DHB hospital services manager (surgical) Lee McManus, said all patient referrals to the DHB were looked at and prioritised by senior doctors. 

"While our focus is on providing assessment and/or treatment for patients with the highest clinical need first, and within the resources we have available, we understand it is disappointing for those patients not accepted for further assessment.

"We always recommend that the patient go back to their GP and for them to refer should they have any concerns or if a patient's condition deteriorates."   

Earlier this year highlighted the case of Graeme Jury, a security guard at Taranaki Base Hospital, whose GP referred him for a hip operation three times. Each time he was refused an appointment because he didn't meet the threshold.

By then he was in such pain he was barely able to walk and was using a scooter to do his rounds, he said.

"They said that wasn't a good look. I could get attacked. But it wasn't as if I could run away, anyway," he said.

So, he had to stop working. His GP again referred him to the hospital and this time he got a first surgical assessment and has since had his operation.

King said the elective surgery problem was going to get worse as the number of people needing orthopaedic surgery and cataracts was growing and would continue to grow, because the population was ageing.  

The threshold had more to do with the money available as opposed to how disabled someone was. If someone was unable to walk, or couldn't drive a car because they couldn't see and still didn't meet the threshold, then the threshold couldn't be based on clinical need, she said.   

"These people didn't even get an appointment, so you wouldn't know if they should have got an operation or not. They didn't make the cut. They didn't get an appointment to be assessed."  

Since 2010, 9393 people in Taranaki have had elective surgery in the areas of ENT, orthopaedics and ophthalmology, for issues such as cataracts, while 4397 didn't even get as far as their first surgical assessment. 

The biggest problems seemed to be in orthopaedics. In 2013/14, 639 people received operations while 726 were sent back to their GP without an appointment with a specialist. This figure would include people, like Jury, who were referred more than once.

Research commissioned in 2014 by the Health Funds Association of New Zealand and the Private Surgical Hospitals Association found 280,000 people nationally were told they required some form of elective surgery in 2013.

But 170,000 of those patients were not on a waiting list.

New Plymouth MP Jonathan Young said he recognised there was some unmet need.  

"From time to time people come to see me. We do our best in representing their needs if that is a possibility," he said.

But the figures show that since 2008 there had been a 41 per cent increase in elective surgery across the board, he said.

"And since 2008 we have increased the DHB's budget by $65 million. So, essentially the bottom line for us is we are working very hard to get as many elective surgeries to people as possible." 

 - Stuff

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