Sleep the only relief from pain
Waikato Hospital orthopaedic department turns away thousands
There are days when Roy Lewis’s antiinflammatory drugs can’t numb the sciatica that shoots down his left leg. On those days, sleep is his only escape from the relentless pain.
In February, Lewis was seen by a Waikato Hospital doctor who assured him surgery could provide him with relief.
Having waited six months for his first consultation, news his suffering could be remedied brought Lewis to tears.
However, three weeks after his hospital visit, the 74-year-old received a DHB letter saying he had been declined treatment.
‘‘The letter said words to the effect that other people had more serious conditions and there was only a limited amount of money,’’ Lewis said.
Records obtained under the Official Information Act show 671 people referred to Waikato Hospital’s orthopaedic department have been declined treatment this financial year.
In the past three-and-a-half years, 27,333 people were referred to the hospital’s orthopaedic department and 6932 of those were declined treatment.
A lack of sufficient information was cited as the main reason for rejecting a person’s referral.
Orthopaedic surgery treats injuries to the musculoskeletal system, especially hip, knee, ankle, shoulder and spine problems.
Waikato Hospital acting chief operating officer Dr Grant Howard said the health board used the clinical priority assessment criteria (CPAC) to determine who should receive publicly funded elective surgery.
The prioritisation tool puts a numerical value against factors such as pain, the potential to benefit from an operation and the consequences of delaying surgery.
When a person’s score is added up, he or she is either above or below the cut-off point to be accepted for surgery.
The intention of the CPAC scoring system is to create a level playing field for everyone referred for treatment, Howard said.
‘‘Generally speaking, we are doing about as much elective surgery as everyone else is doing in the major centres and that provides some kind of assurance that we are not an outlier on a national scale,’’ he said.
‘‘Whether that’s actually enough to meet the demand is a more difficult question, I think.’’
Howard said for most of the services offered by the DHB, there is an unmet need.
Hospital resources and staff levels also factor in how many elective surgeries Waikato Hospital carries out.
‘‘There is no ideal world where everything is unlimited and the short answer is, yes, we do have a limitation on how much we can do in any particular area, whether it’s cardiac surgery or orthopaedic surgery.
‘‘By and large, we’re keeping up with demand, albeit, here and there, there are patients who aren’t getting exactly what they want or need.’’
Howard said the DHB is recruiting more surgeons to meet demand growth.
Since 2014/15, the number of patients accepted for treatment by Waikato Hospital’s orthopaedic department has increased from 5355 to 5916 in 2016/17.
During the same period, those who were declined treatment decreased, from 2422 to 1765.
Howard said a surgical reinvention programme introduced four months ago allowed the hospital to increase considerably the amount of elective surgery it carries out.
Thirty per cent of declined referrals are accepted within the following three months.
Lewis has received another appointment at Waikato Hospital for a second assessment by an orthopaedic surgeon. An earlier MRI scan showed a vertebra pushing into his spinal cord.
But he’s lost hope he’ll get the care he needs.
‘‘I’ve already given the hospital pages and pages with all my information. I feel as if they are just trying to find some reason why they don’t have to operate on me. In the back of my mind I think my age has certainly counted against me.’’
The average age of patients declined treatment by the orthopaedic department is 53.
‘‘In the back of my mind I think my age has certainly counted against me.’’
Roy Lewis