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C&C DHB offers Australian surgery option to selected cardiac patients
Capital & Coast DHB is finalising arrangements to send patients to a private hospital in Australia for cardiac surgery over the next three months.
The decision to enter into this contract is the latest step in a series of actions the DHB has taken over the past 18-24 months to reduce the number of people waiting for cardiac surgery . Initially the DHB is looking to send up to 10 patients, although the DHB may increase this number up to a maximum of 50 over time if required.
Wellington’s cardiac surgery centre, which serves a population of 900,000 people across seven DHBs in the central region of New Zealand , has experienced growing demand in recent years.
The number of patients referred to C&C DHB for elective cardiac surgery increased by nearly 40% between 2004 and 2006 [from 454 in 2004, to 622 in 2006]. Factors such as anaesthetist shortages and industrial action decreased the volume of elective cardiac surgery which could be performed in Wellington. And at the same time there was an increase in demand for acute cardiac surgery - from 40% of cardiac surgery to 46%.
“We began contracting out cardiac surgery cases to other centres two years ago, and in the past year we have ensured that we are fully utilising every feasible public and private avenue in New Zealand,” Dr Barry Mahon, Clinical Leader of Cardiothoracic Surgery at C&C DHB, said today.
“That has brought considerable success – the number of patients waiting over 6 months peaked at 120 last July, and we have now managed that down to just 25. I believe we have turned a corner.
“While we are capable of meeting current demand, there is a backlog of high priority patients, and in that context the decision to outsource to an Australian hospital with the capacity to perform that surgery within the next three months makes sense.
“As a cardiac surgeon, I believe this is an appropriate one-off measure, which should enable us to get on top of this backlog.
"We will be contacting patients who may be suitable to travel to Australia and discussing this as an option with them. It will be entirely their choice as to whether they wish to pursue this option.
“If they are interested in pursuing this option – and if we and the Australian surgeons agree they are a medically suitable candidate – we will make the necessary arrangements for the patient and a support person to travel to Australia for their surgery, and to return to New Zealand after an appropriate recovery-time post surgery.
“If they decline, or for any other reason do not go ahead with the Australian option, the patient will retain their place on our waiting list and we will book them for surgery here,” Barry Mahon said.
The Chief Medical Officer of C&C DHB, Dr Geoff Robinson, says the DHB’s preference is to source surgery from a public or private provider in New Zealand, but that at present there is minimal additional capacity in public or private, beyond the arrangements the DHB already has in place.
“It’s the middle of the cold and flu season so beds are in limited availability nationwide – and the reality is we need to proceed with surgery for these high priority patients now, not in six months time, to ensure any risk is minimised” Dr Robinson says.
“We will be using a single provider - which will help to streamline the coordination between the DHB, the provider and the families – and we are also aiming to station a DHB person in Australia to help co-ordinate things on the ground for those families.
“Over the past year we have been sending these types of patients to providers around New Zealand for surgery – including Otago, Auckland, Waikato and Christchurch – so in one sense the biggest change in going to Australia is it’s a longer flight.
“Of course heart surgery is never without risk, and we are being upfront about dealing with that, including the risk of mortality. But that is the reality whether your surgery occurs here, elsewhere in New Zealand or in Australia – and it is something we always make clear to patients before they consent to any procedure.
“Naturally we will only be sending those patients who are declared medically fit for the journey,” Geoff Robinson said.
The first cardiac patients are expected to travel to Australia for surgery next week.
“We are fully respecting their privacy, and would ask that others treat them with the same courtesy,” Dr Robinson said.
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