Your views on retaining neurosurgery services at Dunedin Hospital.
As a clinical psychologist who has worked with head-injured clients for at least 20 years throughout Otago, I can honestly say that it really is a no-brainer to remove tertiary neurosurgery services from the region.
Like many of my colleagues, I have seen countless individuals and their families after a traumatic head injury and all express extreme gratitude for the prompt and efficient service that they received.
Invariably, clients talk of the desperate journey to hospital from the accident site, be it a road crash in South Otago, a logging accident in the Catlins, or a workplace injury in Alexandra. The helicopter, the ambulance or the first-response team are all the key feature in their stories.
The "golden hour" is uppermost in everybody's minds and getting to the operating table as quickly as possible is a key indicator of client satisfaction with the service. For survivors, almost everyone gets to the hospital just in time.
It is disappointing that so much local energy has to be channelled negatively into preventing the implementation of the dumbest of suggestions by centralised healthcare policy analysts.
We should instead be pushing forward collectively towards our own vision of our clinical services, where a vibrant medical school provides a comprehensive regional service that makes us proud of the city where we live.
Warrington
[Abridged]
Until now I believed that this Government, for which I voted, had the people's best interests at heart. I am disappointed that there is a push to centralise neurosurgery in the South Island.
I am a registered nurse and have worked with neurosurgical patients most of my career. In London, I worked at the national hospital for neurology and neurosurgery.
It was here that I heard of the Dunedin unit - it had a solid reputation over there as a leading unit. I worked in both ICU in Dunedin and was the clinical educator in the neurosurgical unit for four years.
The research and world treatment remains unchanged in the care of neurosurgical patients - early intervention improves outcomes. By sending patients to Christchurch, it will delay life-changing treatments.
This will end up costing the taxpayer and ACC huge amounts as the results will be long-term, full-care costs associated with severe brain injury.
Remember the 1980s and early 1990s when we had huge numbers of severely brain injured patients clogging up acute beds and requiring long-term care facility beds?
These numbers have decreased over the years because of the concept of the "golden hour". Rescue helicopters, median barriers, drink-driving and speeding campaigns have all contributed to these improved outcomes.
Take away the services in Dunedin and you will see an increase in these numbers again, essentially costing the Government thousands of dollars.
This loss of service to our area will put all the residents of Otago and Southland at risk and will be a huge safety issue for our community.
Health Minister Tony Ryall needs to take control of this situation and create a two-site service with two neurosurgeons based in Dunedin and four in Christchurch, enabling our community to be safe.
Rebecca Aburn
Dunedin
Having spent more than 20 years investigating and providing centralised or hub-and-spoke IT services in global, national and regional contexts, I believe several of the factors that need to be considered in the neurosurgery case (Christchurch being the hub and Dunedin the spoke) are the same.
Three major factors are services and service levels required by spoke clients, ability to attract and retain skilled staff in the spoke and financial analysis.
There is no compelling case to centralise neurosurgery services in Christchurch. Both Christchurch and Dunedin require full emergency services.
If moving neurosurgery services to Christchurch is part of a broader strategic plan for South Island medical services then the approach taken so far is woeful and damaging to the wellbeing of South Islanders and New Zealand as a whole.
Wanaka
[Abridged]
Perhaps the National Government would like to explain why it is, whenever they get in power, they start taking away disciplines from the Dunedin Public Hospital? Last time it was our heart unit; before that they denied us a scanner; and now the neurosurgery unit.
Why this obsession with our hospital departments and undermining the University Of Otago? Are they jealous of the wonderful hospital we have here?Dunedin Public Hospital has a heart and atmosphere like no other in New Zealand.
Surely, the Government should try to find out why this hospital is so special and then try to get other hospitals to follow.
Mosgiel
[Abridged]
Do you ride a bike, a horse, a motorbike, drive a car or participate in life? Then the prospect of the loss of neurosurgery services in Dunedin affects you.
No-one can guarantee that they, or their family, will be exempt from requiring these services.
We need to know that should we need them, they will be there, not hours away in Christchurch.
Mosgiel
[Abridged]
What I find particularly outrageous about even considering bypassing Dunedin in regard to providing neurosurgery services is the fact that Dunedin was the first hospital to provide these services for the whole of New Zealand.
We were the site for the first pioneers of neurosurgery, leading the way with Prof Murray Falconer and later many others of outstanding stature and knowledge.
It is an insult to their memories that the Government would even consider removing neurosurgery services from the hospital that pioneered this specialty.
Dunedin
[Abridged]
While our highly respected medical and university professionals, civic leaders and countless others are joining together to fight for neurosurgery services to remain in Dunedin, Clutha Southland MP Bill English appears to be conveniently sitting on the fence.
In reply to Arthur Linnell's letter (4.8.10) regarding this, he states "I am concerned that my constituents continue to have good access to this specialised service" but sidesteps answering the crucial question of where he feels this service should be based.
Because of the distance involved in transporting patients needing urgent neurosurgical care, we in the South would be the most at risk should this vital service be shifted to Christchurch.
Mr English seems unmoved by the real concerns expressed by those who returned him to Parliament and those whom he professes to represent.
It is time he listened to his constituents and added his voice in support of our neurosurgery unit remaining in Dunedin.
Owaka Valley
[At Thursday's public protest meeting in Dunedin, a message was read from Mr English and other southern National Party MPs supporting services based in Christchurch and Dunedin. - Ed]
The public of Otago and Southland is indebted to the Otago Daily Times for going in to bat on our behalf in support of the neurosurgery unit.
After the first headline, you would have thought someone would have reassured the southern provinces that closure would never happen, but after a fortnight of these headlines, we are still in the dark.
Please keep slogging on this one until sanity prevails.
Sue McDonnell
Outram
It has been stated that loss of neurosurgical services at Dunedin Hospital will result in an inevitable increase in cases of serious disability due to length of time before treatment.
This will impact upon ACC funding for long-term support of people injured by accident.
Surely, ACC must have deep concerns regarding this situation?
Elwyn Kaye
Kew
The retention of the neurosurgery department is essential for the future of students, patients and doctors not only at Dunedin Hospital but throughout New Zealand. Hospital services must not be fragmented around New Zealand.
Macraes Flat
[Abridged]
I have followed the articles and letters in the Otago Daily Times with increasing concern for the future of neurosurgery at Dunedin Hospital.
As a chaplaincy assistant in the neurosurgery-neurological ward for more than 10 years, it is clear to me that for patients, their families and friends, ongoing moral support, spiritual care and love are essential for healing body, mind and soul.
Many people are stressed when a loved one requires neurosurgery and often need to make huge changes to their lifestyles in order to travel long distances from home, rearrange schedules at home and work, drive long distances, find local accommodation, care for their own health needs and cope with anxiety and grief.
It is difficult to conceive how it is proposed to increase treatment time concerns and the attendant disruptions to lives by the need for transportation to Christchurch.
City Rise
[Abridged]
Aware as I am of the population-based funding methologies which drove some earlier attempts at reform, particularly in the 1990s, I am surprised that something which smacks of this has reappeared.
Any future failure to continue services in Otago places a significant population group at risk.
I trust that the Government's arguments for such publicly funded endeavours will be made available for public scrutiny.
Opoho
[Abridged]
