Let's finish the job

Thousands of protesters turn out in Dunedin, in 2010, fighting to keep neurosurgery in the city....
Thousands of protesters turn out in Dunedin, in 2010, fighting to keep neurosurgery in the city. The huge turnout, estimated at between 8000 and 10,000 people, up in arms about a proposal to base all six South Island neurosurgeons in Christchurch. Photo by Craig Baxter.
One of the most uplifting local events of 2010 was the public campaign to keep neurosurgery in Dunedin and the South. Led by this newspaper and joined by The Southland Times, local and regional authorities, Facebook groups and interested parties in the health sector and the University of Otago, it was an issue that united the city and the province as few had done in recent times. In large part this was because of the undeniable logic of the campaign, "It's a no-brainer: Neurosurgery - keep it here". Natural justice, fairness, economics and, most pertinently of all, patient safety and the likelihood of saving lives, made it a compelling and common cause.

That remains the case, which is why the Otago Daily Times is supporting the public fundraising campaign, launched last night, to raise $3 million to help establish and secure the Neurological Foundation Chair in Neurosurgery at the University of Otago. Under the banner "It's a no-brainer: Neurosurgery - let's finish the job" the paper will publish articles in support of the campaign, the people and organisations behind it, as well as keep track on its progress.

The existence of a neurosurgical unit in Dunedin - first established as long ago as 1943 - came into question with the South Island district health boards agreeing there should be a regional neurosurgery service with six neurosurgeons. In June 2009 a planning report recommended a one-site model with all six neurosurgeons based in Christchurch. The then Otago and Southland boards contested this, seeking a further report and, in April 2010, an independent report confirmed there was no consensus on a one-site model. A review panel was established on July 19 by Director-general of Health Stephen McKernan to consider the issues.

On July 24, the ODT launched its campaign, helping to co-ordinate and publicise the strong public views that had begun to emerge in favour of keeping the service in Dunedin, and articulating the reasons for this. Thousands attend- ed town hall meetings and street rallies and upwards of 50,000 people in Southland and Otago signed petitions and sent them to Mr McKernan and Health Minister Tony Ryall.

The report of the review panel, headed by paediatric surgeon Anne Kolbe, of November 5, publicly released on November 10, recommended a South Island Neurosurgery Service with "nodes" in Christchurch and Dunedin. The service was to include initially seven, then eight, neurosurgeons with a minimum of three in Dunedin. It was also to develop an academic neurosurgical component in Dunedin, "supported by the University of Otago and comprising, as a minimum, an appointment at professorial level, an appointment at senior lecturer level and appropriate infrastructural support". The minimum of three neurosurgeons in Dunedin was seen as necessary to maintain a sustainable neurosurgery unit.

Only two of these positions, however, would be funded by the Government, so the Neurological Foundation, working with the University of Otago and the Southern District Health Board came up with a plan to fund the third position by endowing a professorship (or chair) in neurosurgery.

The benefits of such a chair are critical to the enduring vitality and profile of a centre of academic and clinical neurosurgical excellence in Dunedin. A chair would help attract leading academic neurosurgeons to the city and, with it, potentially, ground-breaking research. It would help retain and develop neurosurgery as a specialty at the university and the hospital. Most importantly it would mean that top-flight neurosurgeons were attached to the unit - thus ensuring the viability of life-saving emergency neurosurgical services in the South.

This summer rescue helicopters and ambulance services have been frequent visitors to Dunedin Hospital, ferrying victims of the numerous traumatic incidents that have blighted the holiday period.

The rationale for maintaining a southern neurosurgery site at Dunedin is, as the "No-brainer" campaign articulated, compelling. But lending it permanence and helping to endow it with world-leading credentials requires an additional push. It is to be hoped the people of Dunedin and the greater Southern region will be as generous now as they were vocal in their support of the original campaign. It is time to finish the job.


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