Nelson surgical team ‘in tatters’

Nelson Hospital’s understaffed surgical team is ‘‘in tatters’’, putting both staff and patients at risk, a senior doctor says.

In a letter to chief executive Dr Peter Bramley, obtained by the Nelson Mail, general surgery head of department Dr Ros Pochin detailed her concerns about the ‘‘dire state’’ of staffing.

The letter detailed how the addition of another surgeon had been promised last August, with another in 2018 but neither had eventuated.

The board said the issue was part of the challenges faced by the public health system. It had advertised two part-time positions for general surgeons last Friday.

In the letter, Pochin said when she joined the surgical team in 2007, its capacity increased from four surgeons to five. Since then, retiring surgeons had been replaced, but there had been no increase in additional capacity.

‘‘It is now 2018 and we have been at five surgeons for 11 years,’’ it read.

Pochin wrote that when a vascular surgeon retired in 2015, the general surgeon call roster went from one in six days to one in five. The recent resignation of another surgeon, who had become ‘‘burnt out and stressed’’, meant there would soon only be four in the team.

‘‘We are effectively on a one in three roster of 24 hour call with no fatigue cover,’’ Pochin wrote. ‘‘This puts both ourselves and our patients at risk.’’

A department-wide crisis meeting about the ‘‘lack of manpower and resource’’ in general surgery was held last August.

Another was held in December and the most recent meeting was in March. Pochin wrote that the minutes of the August meeting noted a new surgeon was promised in 2017 and another in 2018. But there had been no new appointments.

‘‘I think the DHB needs to acknowledge that the general surgical department is now in tatters due to the lack of investment and future planning by successive DHB teams,’’ the letter read.

Pochin wrote that the ‘‘failure to plan for expansion and be reactive to our well documented concerns’’ had greatly affected the department, with herself and other surgeons taking stress leave.

While Nelson Marlborough Health was operating within its budget to allow for the rebuild of Nelson Hospital, it should not be at the expense of hospital departments becoming unsafe to work in.

The letter was also sent to senior medical officers in the region.

A joint statement released by Bramley and Pochin yesterday afternoon said the letter reflected ‘‘some very real challenges of delivering services across our district, and not just for general surgery’’.

‘‘This is a challenge the entire public health system faces – how to manages services within resource constraint.’’

The two additional permanent part-time positions for general surgeons advertised last Friday would be based in Blenheim and Nelson, working at both hospitals as required.

The statement acknowledged there had been an increase in demand for surgery which reflected Nelson’s ageing population but also said there had been no increase in the number of general surgeons since 2007.

‘‘Our decision to appoint two new general surgeons across the district is a significant investment that we are not resourced for.’’