College of surgeons goes quiet

The Royal Australasian College of Surgeons will not elaborate on its claim last weekend that it would be better for patients if the South Island's six neurosurgeons were based in one place.

The original comment has already drawn criticism from Dunedin Hospital's emergency department clinical leader Dr John Chambers, who is in the United Kingdom.

The comment, in a Radio New Zealand report, came from the college's New Zealand national chairman John Kyngdon, the college's Australian media office said yesterday.

Mr Kyngdon had said that, as with all issues, the college was concerned primarily with patient safety.

This required consideration to be given to such factors as caseload, the incidence of emergency and planned surgery, and striking a balance between rostered and on-call work.

These considerations had all been raised in earlier inquiries into South Island neurosurgical services, the media office stated.

In a posting on the "Keep Neurosurgery in Dunedin" Facebook site, commenting on the report, Dr Chambers said it was a "sad day" when colleges were put forward as professional bodies which supported services for patients being centralised with the acceptance "some will die as a result".

He hoped he would have the opportunity to put his views to expert-panel chairwoman Anne Kolbe, in person, on his return from the UK soon.

Dr Chambers, who is a New Zealand faculty board member of the Australasian College for Emergency Medicine, in an email response to Otago Daily Times questions yesterday referred to the "hassle, expense and danger" of relying on regular helicopter retrieval from Otago and Southland to Christchurch.

"Christchurch neurosurgeons clearly assume that this will simply happen and patients will be taken to them. Who are the doctors who will man such a [helicopter-transfer] service? Who will pay their life insurance?"While the helicopter retrieval service in Otago-Southland did a great job of bringing patients to Dunedin, it was "always a balance of benefit versus risk".

Adding regular transfers to Christchurch "could well tip the balance".

There was also no doubt that even if it was funded and staffed, some patients would deteriorate and die during the process, he said.

When the ODT sought elaboration on the comments about patient safety and other matters raised, the college of surgeons yesterday advised it would be inappropriate to comment further on the issue.

To do so would be to pre-empt the work of the expert panel looking into the future configuration of the South Island service, it said.

The findings of the panel were awaited by the college and those findings would "obviously inform the views of the college on this matter".

The questions posed by the ODT asked whether the concerns raised by the college could be addressed by a two-site proposal where Dunedin and Christchurch had a joint specialist staff working a joint roster across both sites.

Comment was also sought on the claims of Southern clinicians that the safety of some Southern patients would be compromised by a one-site model.

The expert panel considering the future configuration of neurosurgery in the South is expected to give some details of its schedule later this week.

The panel comprises Mrs Kolbe, a paediatric surgeon and head of the clinical school at Auckland University, Adelaide neurosurgeon and councillor of the Royal Australasian College of Surgeons Glenn McCulloch, and consumer rights advocate and former head of Consumer New Zealand David Russell.

Canterbury District Health Board chief executive David Meates advised, through his communications office, that he would not be commenting on any issues involving the panel or its work.

elspeth.mclean@odt.co.nz

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