Support for uni's role in recruiting neurosurgeons

The university should continue to play a role in recruiting neurosurgeons for Dunedin Hospital, the South Island Neurosurgery Service and the University of Otago say.

An independent report into the service, released this week, said recruitment of clinical staff should prioritise clinical needs and be "uncoupled" from university recruitment.

The University of Otago's chair in neurosurgery was established in 2012, following a successful $3million fundraising campaign significantly supported by the Otago Daily Times.

However, the new review questioned how effective the well-intentioned plan for combined appointments of academic and clinical neurosurgeons had been.

"Quite evidently, successful achievement has been intermittent at best over the past nine years," it said.

"While the review team is in no way against the development of academic neurosurgery in any of the New Zealand universities, it believes the use of appointees to academic roles in provision of clinical service of limited value, particular in a centre with a limited clinical load."

Numerous appointments at senior lecturer level had been made since 2010, but none were retained for more than a year or two.

"It would appear that the idea that academics would be attracted and retained in clinical posts where high acuity, low complexity work represents the greatest service need was never realistic," the report said.

Otago neurosurgery professor Dirk De Ridder does not practise clinically in Dunedin.

The "uncoupling" suggestion was the sole recommendation from the report rejected by its commissioners, the chief executives of the five South Island district health boards.

SDHB chief executive Chris Fleming, who is also the South Island Neurosurgery Service chief executive, said if clinical work was separated from the academic side of neurosurgery, it would not be viable to have a service.

"It's not so much about the workload, it's about the regularity of being on-call."

School of Medicine dean Barry Taylor said the university supported the Alliance's rejection of the report's recommendation.

"[It was] somewhat surprised by the recommendation as the two roles enable an effective roster to function," he said.

It was important that researchers were able to work with someone who was clinically active, Prof Taylor said.

He supported the report's recommendation of creating a national neurosurgery service.

"We are only a small country, and to function effectively, academic neurosurgery in Dunedin needs to have linkages and acceptance across the country so that they can recruit and be involved with the different patients that would participate in clinical research trials."

Way forward

The report made 13 recommendations, which included.—
, Reconstituting the South Island Neurosurgery Service board and making it independent of South Island health boards.
, Restricting on-call hours to assist patient and clinician safety.
, Instituting a standardised reporting structure.
, Ongoing monitoring of complaints about behaviour adversely affecting teamwork.
, Reassessment of the current funding model.



The idea of triage is that the neurosurgeon doing clinical research is on call, surely?