No neurosurgeon over long weekend

Photo: ODT files
Photo: ODT files
Dunedin Hospital will have no neurosurgeon all weekend, a situation which will recur over the next six to eight weeks.

The Otago Daily Times understands no neurosurgeon will be available at Dunedin Hospital over the long weekend, a situation confirmed by a Southern District Health Board spokeswoman.

Over the next six to eight weeks, one third of the weekend and after-hours roster, or an average of one weekend in three, will be provided by full-time Dunedin neurosurgeon Ahmad Taha, the spokeswoman said.

There will be periods over that time when after-hours on-call support will be provided from Christchurch.

Southern DHB chief executive Chris Fleming said in an emailed statement the neurosurgery service at Dunedin Hospital continued to support round-the-clock elective and acute care as part of the "one-service, two-site model with Canterbury DHB".

"Southern DHB's neurosurgeon continues to work in a full-time capacity five days a week, plus will be on call out of hours approximately one-third of the time, with Canterbury DHB covering the remainder of on-call hours."

Mr Fleming said active recruitment for neurosurgeons was ongoing and the DHB was recruiting locums to cover the gap in rosters in the meantime.

"We expect to appoint a locum in approximately the next 6-8 weeks, at which time more of the on-call roster will be able to be covered on the Dunedin site."

The ODT understands staff have been emailed to advise of the situation.

Mr Fleming said Dunedin Hospital had just one neurosurgeon, Mr Taha.

"... and his being on 24/7 call is neither reasonable nor sustainable.

"The two-site model means we are able to call upon our colleagues in Christchurch for back-up support.

"While we are in the process of appointing locums to fill the roster, we are needing to find ways to draw upon the Christchurch team to support us."

Since 2010, neurosurgery in the South Island has been organised as a single service spread across Dunedin and Christchurch.

"As has been reported periodically in recent years, Southern DHB has been challenged in recruiting and retaining enough neurosurgeons to sustain an appropriate roster.

"This is made even more difficult as a result of the lack of New Zealanders training in neurosurgery in New Zealand, and the very different clinical environment in New Zealand compared to other countries."

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

Comments

Medivac to Christchurch in 'The Golden Hour' doesn't seem practicable.

The fragmented Neurosurgical Service at Dunedin Hospital continues to be in need of resuscitation. At least six locally registered neurosurgeons have started and resigned from the unit in the last two decades. On top of this numerous locums have come and gone. This is largely due to the fact that the unit does not have enough work to keep three surgeons occupied. A unit needs at least three surgeons to run a legal and workable call roster. Recruitment and retention of neurosurgeons in the larger units around New Zealand with ample workload is already a challenge. Unfortunately Dunedin will never be able to provide the patient numbers to recruit and retain quality neurosurgeons that have an Australasian equivalent training. Short term employment inevitably result in resignation once the nitty gritty of service provision is stared in the face. No surgeons employed after the 2010 Kolbe report, including the much announced Professor of Neurosurgery for which a large amount of money was fund raised, have maintained employment. Reliance on random locums is short sighted and could be dangerous as they may not be screened with the same intensity as potential full time employees.

Continued; . A locum is not scrutinised as to skill and training like a surgeon that wishes to be registered in New Zealand as vocationally trained. As such, patients rely on the flip of a coin as to whether their treatment is sub standard, at the level or above the level expected. We as neurosurgeons in Christchurch have seen what this can result in and the administration in the Health Board at the highest level is well aware of this. I think that the patients in the Dunedin need to insist on being fully informed as to the quality of surgeon that is looking after them or their loved ones. It is more appropriate for a patient to travel to a busy quality unit with the experience to match to have their complex surgery rather than to rely on an unknown entity to complicate matters further. Neurosurgery is already a high risk surgical discipline that has know serious complications. There is no need to bring additional factors into the equation. Patients from the West Coast, Nelson, Malbourough, North and South Canterbury as well as some Dunedin, Southland and Otago patients requiring paediatric, endovascular aneurysm and skull base surgery already travel to Christchurch for treatment.