Dunedin Hospital. Photo: ODT Files The new Dunedin hospital will have a neurosurgery-equipped operating theatre and the city’s neurosurgery services will remain unchanged, Health New Zealand Te Whatu Ora (HNZ) says. HNZ South Island executive regional director Dr Pete Watson rejected a report the city could lose its prized neurosurgery department. A letter supposedly sent to HNZ’s national office from a representative of the Association of Salaried Medical Specialists, warning of the consequences of regionalising neurosurgery departments, was never received, he said. The ODT understands much of the letter’s concerns have been aired to HNZ representatives on more than one occasion. Dr Watson said the new Dunedin hospital inpatient building, which opens in 2031, had been designed to accommodate neurosurgery cases, with a neurosurgery-equipped operating theatre. ‘‘This reinforces Dunedin Hospital’s ongoing role in delivering specialist neurosurgical services for the lower South Island as part of the Te Waipounamu regional neurosurgery service.’’ HNZ remained committed to ‘‘ensuring people across the lower South Island have access to safe, high-quality neurosurgical care’’. The reality was that, despite many years of effort, sustaining a standalone Dunedin service had been difficult, he said. ‘‘For many years, Christchurch has provided support to the Dunedin service as part of the South Island neurosurgery service.’’ The remarks from HNZ come as representatives of the Dunedin department expressed concern the body’s new ‘‘regional focus’’ approach to health funding could lead to fewer services in the South. If that should happen, clinicians have warned HNZ there could be more deaths due to the time-pressured nature of the services, and the increased travel time to Christchurch. HNZ Southern group director of operations Craig Ashton said last week as part of the Te Waipounamu regional neurosurgery service, ‘‘Dunedin Hospital continued to deliver neurosurgical services to the lower South Island’’. But he did not indicate in what form the department would remain. There is one specialist neurosurgeon, supported by three resident medical officers (two registrars and one house officer) at Dunedin Hospital. A 2019 report delivered to the then-Southern District Health Board suggested best practice for a hospital catchment of Dunedin’s size would be a neurosurgery department with three neurosurgeons. Taieri MP Ingrid Leary said while HNZ’s comments might sound reassuring, the key details remained unanswered. ‘‘Southern communities still need transparency about what is continuing to change. ‘‘The question of collaboration is whether in reality decisions about Dunedin’s neurosurgical service are being made in Christchurch, with Dunedin expected to follow.’’ There were also questions about how many neurosurgeons would be based in Dunedin, what local and after-hours coverage would remain, which acute procedures would be performed here and when patients would be transferred to Christchurch. ‘‘These questions matter, particularly for patients in Southland, Central Otago and rural communities, where distance can have serious consequences.’’ Labour leader Chris Hipkins said the situation reflected a lack of communication from HNZ. ‘‘I think when it comes to the provision of healthcare, there needs to be a lot of transparency. ‘‘New Zealanders will accept that not every hospital will be able to deliver every potential health service, and so sometimes we do need to travel to access specialist expertise. ‘‘But when [HNZ is] proposing to move that around and shift focus, they need to be transparent and upfront about that.’’ Dr Pete Watson, Executive Regional Director, Health New Zealand. PHOTO: SUPPLIED This service development was not about removing neurosurgery from Dunedin, Dr Watson said. ‘‘It is about ensuring the service remains clinically safe, sustainable and available when patients need it most.’’ Regionalisation was designed to make the best use of specialist expertise across the South Island while ensuring patients received the right care, in the right place, at the right time. ‘‘In practical terms, Dunedin Hospital would continue to provide neurosurgical assessment, treatment, surgery, inpatient care and follow-up services for patients. ‘‘The service would operate as part of an integrated South Island network, with clinicians working collaboratively to ensure patients can access specialist care when required. ‘‘Importantly, the regionalisation approach does not represent a reduction in neurosurgical services at Dunedin Hospital and access to urgent and lifesaving neurosurgical care is unchanged.’’ Ms Leary said regional collaboration could strengthen services. ‘‘But regionalisation cannot become a euphemism for shifting decision-making or capability to Christchurch without clearly explaining what is changing and what it means for patients.’’
