Christchurch neurosurgeon denounces 'propaganda'

Christchurch neurosurgeon Ronald Boet says the South is too small to support neurosurgery and the service should be centralised in Christchurch.

In a comment left on the Otago Daily Times website, Mr Boet accused the newspaper of ''once again maligning neurosurgery in Christchurch''.

''This one-sided propaganda is not helpful,'' he said.

Mr Boet was part of a group of Canterbury neurosurgeons who wanted to centralise neurosurgery in Christchurch in 2010, and lost the argument. His view has not changed.

''It is well known that we are in favour of a single neurosurgical unit for the South Island to service the one million people residing.

''This is without doubt the best solution for the region, providing top-quality care within the resources available and maintaining surgical standards whilst also training new neurosurgeons.

''The fact two neurosurgeons have recently resigned in Dunedin, as have most neurosurgeons before them, shows that the critical mass of neurosurgery is too low in Southland [sic] to keep them busy and maintain their interest,'' Mr Boet said.

Reuben Johnson left early this year, and Prof Dirk De Ridder has scaled down his clinical work, but will continue to perform the surgeries that fall in his area of specific interest.

A locum neurosurgeon is working at Dunedin Hospital alongside neurosurgery clinical leader Ahmad Taha, and two neurosurgeons are being recruited.

The debate about South Island neurosurgery reignited after Prof De Ridder revealed there was ''no real interaction'' between the Christchurch and Dunedin hubs.

Prof De Ridder wanted the hubs to specialise in the work each did best, and build a bigger service involving Wellington. Christchurch was not interested.

''The philosophy from Christchurch is, 'We're five neurosurgeons, we don't need Dunedin, so why would we send anything to Dunedin at all'? Prof De Ridder told the ODT this month.

Mr Boet said the working relationship between Christchurch and Dunedin was good, and it was ''misleading'' to suggest otherwise.

''We have a good working relationship between the units, discussing most cerebrovascular and paediatric neurosurgery/oncology cases and developing suitable management plans.

''The tumour cases that De Ridder is doing is often done in combination with Christchurch surgeons that travel to Dunedin to help him,'' Mr Boet said.

The Ministry of Health appears reluctant to get involved, telling the ODT yesterday that the Canterbury and Southern boards were ''working together on neurosurgery''.

Canterbury DHB chief executive David Meates recently told the ODT that Canterbury had accepted the two-site service and was working to make it a success.

eileen.goodwin@odt.co.nz

Comments

''The fact two neurosurgeons have recently resigned in Dunedin, as have most neurosurgeons before them, shows that the critical mass of neurosurgery is too low in Southland [sic]" - Point one Dunedin is not Southland and is part of Southern DHB

Point Two is the attitude of "''The philosophy from Christchurch is, 'We're five neurosurgeons, we don't need Dunedin, so why would we send anything to Dunedin at all'? Prof De Ridder told the ODT this month." just shows that seeing as they didn't get the result they wanted they are less than inclined to make it work.

Surely the earthquakes have shown that it isn't wise to complete centralise and the fact that Dunedin Hospital is already on limit of the "Golden hour" let alone sending to Chch, The med school is here, and the capacity is here etc, our aging demographic mean it is wise to have a unit here.
As for the "not enough work argument", send people to Dunedin after all they want a single unit so there must be enough work to justify it. Why is it deemed suitable to send people to CHCH but not the other way around? If they want a single base for the SI why not Dunedin instead for the same reasons as above and more.

Interesting also when talking of "workload" it seems as if Chch is referred to as serving the SI as a whole and Dunedin only serves the SDHB which indicate Chch is actually trying to make to 2 centre Fail ie "We're five neurosurgeons, we don't need Dunedin, so why would we send anything to Dunedin at all". It really does seem a double standard the we are expected to be okay with sending patients to Chch but it is not considered a suitable solution to send them the other way

Christchurch Hospital subsided a little at the Gardens end in the quake. You do need a stable surface on which to thread coiling through the femoral, past the aortic chamber into the brain, to coil aneurysm. How many radiologists do they have? Then, of course, we might opt for craniotomy, with the little circular saw removing a skull flap to access.

We might prefer those risky procedures here. Where? Otago.

 

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