Govt report damns heart surgery rate

Access to heart surgery in Otago is equal to that of other first world countries - but at other New Zealand health boards is far worse, a new Ministry of Health report shows.

The goal is to get the rest of the country up to Otago's standards, the draft report says.

The report highlighted the gravity of the situation in New Zealand, saying the "critical failing" was in a high-mortality field.

"The consequences of a lower provision of services are more serious than for most other specialties, because there is a greater likelihood of death if surgery cannot be accessed by a patient who needs it."

New Zealand was bottom of the seven countries included in the draft report.

Canada and Northern Ireland both had access rates more than 50% better than New Zealand. England's rate was nearly 40% better. The report said New Zealand fared worse than Australia, but did not include comparative figures.

Cardiac surgery rates also fluctuated widely around the country, it said.

National Party health spokesman Tony Ryall slammed the revelations as "healthcare by post-code".

Staff shortages in the health sector, especially in intensive care unit nursing, were seen as a major factor in the country's poor performance nationally.

Nurses involved in cardiac surgery tended to work more night-shifts than their colleagues, but did not feel adequately compensated. The shift work resulted in burnout and staff retention problems.

"Whether it is in the pre-assessment clinic, the inpatient ward, the theatre or the intensive care, the role of the nurse is pivotal to achieving the best outcome for the patient undergoing cardiothoracic surgery," the Cardiac Surgery Service Development Working Group report said.

Anaesthetists were also in short supply. The time commitment required for anaesthetists to undertake cardiac surgical work was greater than other surgical work, but was not always paid accordingly, it said.

Cancellations were also a significant drain on public health money, the report said - the cost of lost theatre time estimated at more than $25 a minute.

Mr Ryall said the findings were "virtually the same" as those in another report received by the Government in 2003.

Health Minister David Cunliffe said he met the Cardiac Service Group last week and expected to see its final report as soon as it was completed.


Cardio surgery facts

Cardiac surgery rates in comparable countries, relative to New Zealand.
• Canada +78%
• Northern Ireland +52%
• England +38%
• Scotland +29%
• Wales +27%

Cardiac surgery rates per 100,000 population for people 15 years and older (Region: Total between 2002-07; average per year).
• Auckland 281; 56
• Waikato 259; 52
• Capital & Coast 254; 51
• Canterbury 284; 57
• Otago 376; 75

The report
• The report noted international comparisons were complex as it was not explicit whether international rates included private activity or not.

What the report recommends

• A "planned and continued" increase in resourcing over the next five years.
• A nationally agreed "prioritisation score" for patients for cardiac surgery.
• Categories of urgency and maximum time-frames for surgery established.
• Weekly reporting of cardiac surgery volumes by providers.
• A Ministry of Health-sponsored task force be established to make sure the recommendations are carried out.

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