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The board instituted a neurosurgery contingency plan in June last year to manage the workload of Dunedin Hospital’s sole neurosurgeon, who has worked solo for months due to the SDHB’s inability to hire extra clinicians in an internationally scarce specialty.
That resulted in a system being introduced where surgeons based in Christchurch were contacted if the Dunedin doctor was on leave, off sick or off shift, with patients meeting a range of criteria being transferred north for treatment.
In response to an Official Information Act request, SDHB chief executive Chris Fleming said from January 1, 2019, to January 30 this year there were 32 transfers to Christchurch directly funded by the board.
"There has been a combination of helicopter flights and fixed-wing flights, the total cost for these flights has been $487,541," Mr Fleming said.
"The cost of treatment in Canterbury is billed on top of this through inter-district flows."
The SDHB did not monitor whether any patient transfers had been delayed due to weather or transport availability issues, or whether that had had any adverse impact on patient health, Mr Fleming said.
"Southern District Health Board is not aware of any patient dying whilst awaiting neurosurgery operations.
"We do not keep information on patients that choose to utilise the private healthcare sector."
Despite having just one surgeon, the SDHB had adhered to the Government timeframe of four months for anyone wait-listed for a neurosurgery operation, Mr Fleming said.
The SDHB has identified a candidate for a neurosurgery position, and is waiting credentialling procedures to be done by the Medical Council.
In the financial report provided to the most recent SDHB meeting, air ambulance costs were cited as one of three major reasons why the clinical supplies budget was $5.3million unfavourable in the year to date.
"Air ambulance activity has increased significantly with neurosurgery patients being transported from/to Dunedin," the report said.
Soaring air travel costs have led the SDHB to review how it procures fixed-wing air travel in general.
Southern has the largest geographic area of all New Zealand DHBs, and that meant air transport was an important part of service provision, strategic project manager Megan Boivin said.
"This includes using air travel to transport patients to and from treatment in a clinically safe way, and transporting clinicians and staff between SDHB facilities, although most staff use motor vehicles for transport."
The board’s contract for staff travel, generally between Dunedin and Invercargill, is due for renewal. For fixed-wing patient transport, the SDHB used several providers and had previously not had a single contract, Ms Boivin said.
Earlier this month the SDHB posted a request for proposal on the Government tender website for the provision of both a fixed-wing air ambulance and for patient and staff transfers.
The tender deadline is the end of March.