This article was written by Cate Macintosh, for Stuff.co.nz National. Published July 8, 2022. To access the original article, click here.
Thousands of people in need of a hip or knee replacement and other elective surgeries are languishing in pain on waiting lists for longer than 12 months, with one surgeon saying they feel like the “living dead”.
Hospitals around the country have slashed elective surgery theatre “lists” they would have scheduled prior to the Omicron outbreak this year, adding to the already burgeoning waiting list.
Of those to be scheduled, many are cancelled or deferred at the last minute as a result of staff illness or hospital bed shortages, as the country grapples with Covid-19 and the first influenza season since 2019.
But surgeons say “chronic, institutional vacancies” are the main reason for the problem.
In early May the wait list had grown to 27,000 for planned, non-acute treatment, up from 8000 in February 2020, before the pandemic took hold.
Minister of Health Andrew Little announced a taskforce to address the issue on May 4, with a report due in September.
But surgeons say the issue needs action now and some have put forward ideas to help.
New Zealand Orthopaedic Association president and Christchurch surgeon John McKie said there were about 6600 people waiting for elective hip, knee and spine surgery.
The group has proposed a plan to add 4000 publicly funded surgeries to their private theatre lists over a two-year period.
McKie said 200 surgeons who work “for public and private services…will undertake to do one extra person on their private list per month for 10 months of the year”.
The plan would require Government funding of $80 million to $100m over two years.
“Now that’s not the whole answer, but it’s something that can start straight away, and it means within the existing infrastructure and private hospitals we could all do an additional case a month without unduly burdening that.”
McKie said people with joints severely damaged by arthritis would be living with severe pain and, often unable to walk, or work.
“No-one is going to die of hip arthritis, but sometimes they say they feel like the living dead because of their pain and disability,” McKie said.
“We don’t operate for fun.”
He said “morphine-based drugs” for pain management often had significant side effects including gut ulcers, constipation, “or they get fuzzy in the head”.
“So, in essence they suffer in silence, or not in silence, out in the community, and they are increasingly debilitated.”
The surgeon said there had always been waiting lists, but the situation over the past three months was the worst he’d seen in his nearly 30 years on the job.
Over a recent eight-week period, instead of completing a usual quota of 16 hip or knee operations, he performed just one.
Where he and his colleagues would have been doing electives, they were instead operating on trauma patients who had “come in through the front door”.
Christchurch Hospital was only completing “emergency and non-deferable surgery” and staff were “reviewing and reprioritising patients who have had surgeries deferred”, Te Whatu Ora – Waitaha/Canterbury senior responsible officer for winter planning Becky Hickmott.
Burwood Hospital had dropped its theatre capacity by 40%, she said.
A Te Whatu Ora – Waitaha/Canterbury spokesperson could not say how many surgeries had been deferred, because “some that would normally be scheduled, haven’t been scheduled, so we can’t just count cancelled surgeries in the system”.
New Zealand Association of General Surgeons president and Waikato surgeon Rowan French said most hospitals had cut scheduled surgery by at least a quarter.
He said severe staffing shortages, rather than illness, were behind the cuts to elective surgery theatre lists, which were done up to six months ahead of time.
“Where I work we have 40 to 45 theatre nurse vacancies and what I hear … is they would often get 50 to 60 applications for a role [last year], but now they’re lucky to get a couple and those people won’t be qualified for the job.”
French said the situation needed urgent attention now.
“What we’ve been trying to convey is that it’s a really urgent problem, it can’t wait another six months because at the rate we’re losing staff we’ll be down another 10-15%…it’s a haemorrhage of staff.
“So we want them to put things in place. Sort out the nurse’s [pay equity deal], the residency for nurses, sort that out, and do it under Covid-like urgency.”
A Te Whatu Ora – Health New Zealand spokesperson said as of June 26, about 6358 planned care surgeries had been cancelled or deferred since January 23, 2022. This compared to the previous five-month period when 7052 elective surgeries were cancelled or deferred.
“It is significant to note the number of patients deferred or cancelled hasn’t significantly changed in recent months.”
Stuff asked Te Whatu Ora – Health New Zealand to explain this claim as the data excluded surgeries that had not been scheduled due to cuts. The health authority did not provide a response in time for publication.
McKie said the situation was the worst he’d seen in his 28-year career.
“Anyone working in the public hospitals would know that we have done negligible elective surgeries [this year].
“From time to time we have peaks and troughs with the trauma service which impacts on the ability to deliver elective care but at the moment this is unprecedented.”