Extra patients travelling to Christchurch for neurosurgery could put pressure on ambulance resources, St John southern region operations manager Doug Third says.
While it was not the place of the service to give an opinion on where neurosurgery services should be sited, having more patients travelling to Christchurch would have an impact on the service in the South.
One of the concerns would be that the Otago Regional Rescue Helicopter service would be more heavily used to ferry patients to and from Christchurch, meaning it would be less available for other uses.
More people would have to travel long distances by road, which could increase risk for some patients and cause considerable logistical staffing issues.
Mr Third said the situation had been well put by Otago Rescue Helicopter Trust chairman Ross Black, who raised concerns this week about its resources to fly acute patients to Christchurch regularly, suggesting this could adversely affect the service provided in Otago and Southland.
Mr Black warned that getting the injured and ill in the region to hospital within the "golden hour" could become more difficult if neurosurgery services were moved to Christchurch.
Mr Third said ambulance officers were only allowed to work for five and a-half hours without a compulsory half-hour break.
If a patient was being transferred from Dunedin to Christchurch at the start of an officer's shift, at say 7am, it could be possible to do the trip in the time without a break.
But if the transfer was called for at 9am, it might make more sense to recall an off-duty officer. However, that person was also required to have a 10-hour break between shifts. No officers could work more than 14 hours in any 24-hour period (with required breaks).
The situation could be more marked in areas such as Central Otago and further afield.
If a helicopter was not available for an injury on Treble Cone, for instance, it would take an ambulance 90 minutes for the return trip to Wanaka. If it was determined there the patient needed treatment at Dunedin Hospital, it could take several ambulances meeting each other on the way to ensure officers did not work too long without a break.
This was "business as usual" for the service, but it would be compounded if "a lot more neurosurgery people [had to be moved] to Christchurch".
Invercargill to Christchurch by road could take about nine hours.
Hopefully, many Southland patients would be flown, but flying was not always possible out of Invercargill or Dunedin.
The service had 90 paid staff in the southern region and about 450 volunteers, but Mr Third said the volunteers were also subject to strict rules.
If they had done an eight-hour shift in their "day" job, they would be restricted to a further six hours' work in that 24-hour period.
Another concern was that Dunedin, at times, could be isolated because of the weather.
During the recent flooding, Dunedin effectively had been cut off, with helicopter conditions "very marginal" for a couple of days.
A patient had been flown from Oamaru Hospital to Dunedin where a helicopter had travelled up the coast and back in conditions which were less than desirable.
If all neurosurgery was based in Christchurch and Dunedin was cut off by road, Mr Third said he would hate to think of a situation in which an urgent neurosurgery case "could not get out of Dunedin".
He knew ofthree or four recent instances when Dunedin had been cut off from northern centres, because of weather, for anywhere between eight and 18 hours.
Mr Third hoped all these aspects would be taken into account by the panel reviewing the configuration of neuro-surgery services.
"We'll always strive to provide the best possible service within the funding available," he said.
