Life on hold due to ‘healthcare crisis’
Invercargill woman Tania Ward’s life is on hold because of what she calls a healthcare system in crisis. She’s unable to work or pick up her grandchildren while she waits for spinal surgery. Blair Jackson and Louisa Steyl report.
Invercargill woman Tania Ward’s life is on hold because of what she calls a healthcare system in crisis.
She’s been unable to work since June 2021 and is dealing with headaches, shooting pains in her neck and neurological problems while she waits for spinal surgery.
Ward should be on the road to recovery already, but her surgery at Dunedin Hospital last month was cancelled just 90 minutes before it was scheduled, because there were no beds available for her.
She’s one of more than 2800 Southland and Otago patients who are waiting for planned surgeries as Southern hospitals juggle staffing shortages, Covid-19 and physical space availability with a growing number of high need, or complex, patients.
But the situation is not unique to the south.
Ward is one of more than 6600 Kiwis waiting for elective hip, knee and spine surgery.
The New Zealand Nurses Organisation delivered more than 2700 messages from its members to the Minister of Health on Wednesday, warning that the health system was ‘‘on the brink of collapse.’’
A growing crisis in primary care also means patients are overwhelming emergency departments, leading to further surgery cancellations.
In this environment, hospital or bed availability depends on whether there are enough staff on deck to look after patients.
The more complicated a patient or surgery, the more staff are needed to look after them.
And as more emergency or acute patients need help, fewer beds are available for patients whose lives are not in danger.
Ward’s anterior C3/4 discectomy and fusion will be a complex surgery that requires the expertise of both an orthopaedic and ear nose and throat surgeon; followed by a stay in an intensive care or high dependency bed.
But Southland and Dunedin Hospitals are operating at capacity with average occupancy rates of 95 to 99% in the past two weeks.
Health New Zealand Southern interim director Hamish Brown said sustained pressure on the healthcare system, high numbers of emergency department presentations, Covid-19, staff fatigue and illness had increased the challenges for an already busy hospital and health system.
‘‘There is huge pressure on our workforce to be able to respond to this demand and our operational teams are working very hard to ensure there are adequate resources, ‘‘ he said.
Brown understood that deferring surgery was upsetting for patients and said staff were committed to rebooking them as soon as possible.
A Te Whatu Ora – Health New Zealand is implementing procedural changes to try and take pressure off hospitals, a spokesperson said.
This includes better resource coordination across districts, expanding telehealth services, giving ambulance services access to GPs and nurses so not all patients have to be taken to the ED, and giving GPs the ability to refer to radiology services so patients don’t need to go to the ED if they need an X-ray.
Ward, 58, understands that the cancellation was for her own safety, and she’s quick to point out there were people in worse positions than herself.
‘‘In some ways I’m the luckiest woman in the world because there are so many people waiting for surgery who don’t have the support I do.’’
She gets an ACC cleaner for an hour a week.
Her 25-year-old son had given up his volunteer job and stopped playing basketball to help her and avoid bringing Covid-19 home.
Ward is isolating at home to make sure she’ll be Covid free if a surgery slot opens up. It’s not being able to do simple things like cooking for her hardworking husband or picking up her grandchildren that frustrates her.
Demand for hospital services has been steadily increasing for years.
National Party health spokesperson Dr Shane Reti requested data on the number of people waiting for a first specialist appointment – a consultation to determine whether they’ll make it onto the surgery wait list.
Health Minister Andrew Little revealed that as of April 2022, 2173 Southland and Otago patients had been waiting longer than four months to see a specialist.
This number had grown from just 417 in January 2017.
And many patients are finding their own way.
A request under the Official Information Act showed 1422 Southern patients were taken off the outpatient wait list in the past year – compared to just 26 in the 2018/2019 financial year – with 443 of them treated privately, while the rest were considered no longer in need of treatment.
A further 757 patients were removed from the elective surgery wait list in the past year – compared to 620 in the 2018/2019 year – with 292 treated privately.
In May, Minister Little announced a taskforce who are expected to deliver a report in September on how the public health system can clear a backlog of 27,000 surgeries.
A Health New Zealand spokesperson said under the previous District Health Board system, hospitals had been operating on extended hours, running weekend lists, outsourcing and using telehealth to try and maintain services during the Omicron outbreak. ‘‘Omicron, new Covid-19 subvariants, flu and other respiratory illnesses are clearly putting additional significant pressure on our health system,’’ the spokesperson said.
Healthcare requiring greater clinical urgency – like cancer treatments, labour and birthing – is prioritised above non-urgent treatment and the public should be assured that those who needed urgent hospital-level care would receive it, he said.
‘‘Omicron, new Covid-19 subvariants, flu and other respiratory illnesses are clearly putting additional significant pressure on our health system.’’ Health New Zealand spokesperson