Neurosurgery row must be resolved - surgeons

The southern neurosurgery row needs to be resolved quickly and with common sense, two senior orthopaedic surgeons say.

Southland Hospital's acting chief medical officer, Murray Fosbender, said yesterday if there was not a speedy resolution the two neurosurgery appointees expected to start in January might get cold feet and start to look elsewhere.

Dunedin consultant orthopaedic surgeon John Matheson has also called for an end to the impasse, warning the Government in a recent letter that significant delays and a decision to remove neurosurgery from the Southern region would "induce a huge public backlash".

Mr Fosbender said the two-site service with four neurosurgeons in Christchurch and two in Dunedin needed to be integrated so it could be "business as usual" for Southland patients.

In the hiatus of the last few years over the service, Southland Hospital had "got through" with support from the locums in Dunedin and Christchurch staff.

"What we want is basically what we had. It was a good service which was responsive to acute and elective needs. Dunedin was able to provide that with two neurosurgeons."

He was concerned that if acute patients had to travel to Christchurch essential time would be lost in some cases.

While it was a fact of life that for some specialties patients had to travel outside the Southern region for treatment, that was not the case with neurosurgery, as there was already a unit in Dunedin.

The region, with more than 300,000 people, had the critical mass to support the unit, he said.

Mr Matheson, in his letter to Director-general of Health Stephen McKernan, which is also copied to Health Minister Tony Ryall, said he wanted to emphasise the importance to orthopaedic surgery of retaining neurosurgery in Dunedin.

Neurosurgeons worked on the central nervous system and also on the spine and there was a merging of clinical practice between neurosurgeons and his specialty, especially in deformities of the spine.

Traditionally, there had been a close liaison between both departments in Dunedin.

The world-class work being done by the South Island regional spinal service for spinal deformities by Bruce Hodgson and Alan Carstens in Dunedin was complex and involved close clinical liaison between the two specialties on difficult cases.

Often these were children with severe and congenital and acquired defects.

This close liaison had suffered since the retirement of Sam Bishara.

"A viable neurosurgical service in Dunedin with two neurosurgeons being able to consult and operate with the orthopaedic surgeons on some occasions is highly desirable."

Mr Matheson was also concerned that the dislocation of neurology and neurosurgery following from the one-site model was "fraught with difficulties".

The model which would see two neurosurgeons retained in Dunedin would "certainly be the best outcome for the population south of the Waitaki River".

Mr Matheson said last night he applauded chief executive Brian Rousseau's action in appointing two neurosurgeons.

"We feel very passionate about retaining the service."

In his letter, he said the delays risked the Christchurch-only solution being achieved by default.

Canterbury District Health Board chief executive David Meates, asked for comment, referred to the agreed process being worked through in a brief email statement yesterday.

"It is important that the recently appointed independent expert panel is able to work through all of the issues relating to neurosurgery to ensure that a robust and sustainable service is put into place."

elspeth.mclean@odt.co.nz

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