Neurosurgery should be here to stay: report

A draft report reviewing South Island neurosurgery services will affirm a commitment to offering neurosurgery in Dunedin.

The service being under review had raised questions about the future of neurosurgery in the South, but those familiar with the contents of the report said it recommends neurosurgery continue to be offered in both Dunedin and Christchurch.

A massive public campaign, spearheaded by the Otago Daily Times, in 2010 led to neurosurgery services, under threat of centralisation in Christchurch, being maintained in Dunedin.

A subsequent fundraising campaign resulted in $3million raised to fund a chair in neurosurgery at the University of Otago.

However, the service has remained on wobbly foundations.

There were reports in 2016 of a lack of co-operation between the Christchurch and Dunedin surgeons.

All South Island DHBs are members of the South Island Alliance, which commissioned the new independent report into neurosurgery services.

Southern DHB chief executive Chris Fleming, also chairman of the South Island Neurosurgery Service, said the alliance would be happy to share the final report "in due course".

"We can't speak to the final outcome but the spirit of reviewing the implementation of the 2010 report is to find sustainable ways of continuing to deliver services here.

"The South Island district health boards remain committed to the one-service, two-sites model. However, recruitment and retention of the staff we need remains the biggest challenge."

In 2016, it was decided Dunedin would have four resident neurosurgeons, three of them with academic duties, and recruitment for two academic neurosurgeons had begun.

The SDHB was unable to provide up-to-date figures on Dunedin Hospital staff vacancies in neurosurgery before deadline.

Members of Parliament asked the SDHB about long-term staff vacancies as part of the health select committee's 2018 annual review of the organisation.

At that time, there was a sole neurosurgery staff member, and two vacancies equivalent to one full-time role.

Those positions had been vacant for a combined 1041 days.

MPs did not ask the same question during this year's annual review.

Mr Fleming said the purpose of the review had been to look at the recommendations made in a 2010 critique of neurosurgery services and whether they had been carried through.

"We need to identify where we are at with them, identify what is working well, areas where there are challenges, and to make recommendations centred around how we can further strengthen the South Island neurosurgical services in the coming months and years."

The South Island Alliance leadership team would formally consider the review's findings and recommendations when the report had been finalised, Mr Fleming said.

Both former health minister Pete Hodgson, who is chairing the committee overseeing the building of the new Dunedin hospital, and current health minister David Clark played roles in the earlier Save Neurosurgery campaign.

When the new hospital site was announced last year, documentation stated neurosurgery services would not be lost, but how all services would be delivered "continues to evolve".

The most recent hospital master plan said neurological procedures were "suitable for inclusion" in the planned Same Day Surgery Centre.


I once again feel obliged to comment on this article to put the Dunedin Neurosurgery situation in perspective. The recent review of the implementation of the 2010 Kolbe report seems an inevitable consequence of a largely failed implementation. Despite reporting to the contrary, we as Neurosurgeons in Christchurch have actively supported the clinical needs of the people of Southland as the Dunedin Unit has repeatedly collapsed since 2010. The unrealistic idea of an academic Neurosurgery Department supporting the clinical needs of the local patients has in fact totally sabotaged the process with all new staff resigning leaving a sole Dunedin Neurosurgeon supported by Christchurch to pick up the slack. The resignation of the widely announced Professor of Neurosurgery that came with a big price tag also deprived the clinical need of the department. Subsequent irresponsible appointment of poorly skilled locum surgeons have resulted in many adverse outcomes that go totally unreported. We have pointed this out to senior administration and feel that the general public needs to be made aware of a system that is constanty in crisis and is unfair on the staff involved and the public served.

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