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Surgeon tires of denying patients

Janine Rankin

Hundreds of people crippled with arthritic pain are unable to get hip and knee replacement surgeries in the MidCentral Health district.

Palmerston North orthopaedic surgeon Geoff Anderson said debilitating pain reduced people’s activity and fitness, making them increasingly unwell, and surgeons were distressed about their inability to fix them.

Overall, more than 951 patients have been waiting more than four months for operations they have been promised at MidCentral Health.

Operations executive for acute and elective specialist services Lyn Horgan said there were 253 people waiting for orthopaedic surgery, with 154 waiting longer than four months. Only 14 of them had a booked date for their operations.

Four people had been waiting for two years.

Anderson said the last time he checked two weeks ago there were 500 patients waiting for what were called ‘‘elective’’ orthopaedic operations.

Most of them could expect to be waiting more than 12 months, he said.

The term ‘‘elective’’ meant a patient would not lose their life or a limb or be paralysed by delays.

Anderson wanted to reassure people with acute injuries or bone cancers they would get the urgent treatment they needed.

‘‘But it leaves us almost no capacity for anyone else.’’

Anderson said the pain of living with osteoarthritis reduced some of the most stoic patients to tears.

Instead of retiring to enjoy the garden, or golf, or tramping, they could be struggling to get to the letterbox, and became increasingly unfit, which elevated the risks associated with surgery.

There were other patients with shoulder conditions, painful bunions or carpal tunnel whose lives could be transformed with surgery who could hardly even get on a waiting list, he said.

Anderson said he spent a discouraging amount of his time reading GP referral letters, and having to turn them away.

Arthritis New Zealand president Philip Kearney said it was a problem that people around New Zealand were not getting surgeries they needed, and the demand was likely to get greater without some alternative thinking.

He said the importance of healthy eating, exercise, early intervention and support could help some people avoid the need for surgery.

‘‘There is not an easy solution to a long-term problem, and we need to find alternatives.’’

For some people going privately for surgery was an option, Anderson said.

‘‘When I came to New Zealand 20 years ago, I could see a patient in public, and they would suggest going private, and I could tell them they would get a nicer room and food, but there was no other difference.

‘‘Now, if you are wealthy enough, you will get treated in terms of orthopaedics. If you can’t pay, you are in for a very long wait.’’

The other problem with going private was that Crest Hospital in Palmerston North also had capacity issues, and had been closed completely during Covid-19 lockdowns, creating its own backlog.

It took in some MidCentral Health orthopaedic patients, but only about one in three of them was healthy enough to be treated at a hospital without an intensive care unit and doctors on site around the clock.

Crest is building a fifth theatre which is planned to be ready in the middle of 2022 to help take pressure off Palmerston North Hospital’s surgical facilities.

But before then, the situation was likely to get worse.

Palmerston North Hospital would have a longer than usual slowdown this summer to enable work to be carried out to upgrade two of its theatres.

And next week, the orthopaedic ward, Ward 24, would be closed for three weeks to have oxygen supplies improved, so it could be used as the Covid-19 ward when there was a surge in cases.

The underlying problem was that the hospital was too small, Anderson said.

There is not an easy solution to a long-term problem, and we need to find alternatives.

Philip Kearney

Arthritis New Zealand president

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en-nz

2021-11-27T08:00:00.0000000Z

2021-11-27T08:00:00.0000000Z

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