Is $11m wasted on tonsil surgery?
Other countries are looking at ditching tonsil surgery, while New Zealand spends an average $11.5 million on the medical procedure every year.
Research published this month in the British Journal of General Practice has found seven in every eight children who have their tonsils out were unlikely to benefit from the operation.
This followed an announcement from the National Health Service in the United Kingdom that listed the throat surgery as one of 17 routine procedures deemed ‘‘ineffective or risky’’, according to reports in the BBC and The Guardian.
However, Associate Professor Patrick Dawes, an ear, nose and throat specialist at the University of Otago’s Department of Surgical Sciences, said a similar shift was unlikely here.
‘‘I don’t think you can necessarily make the comparison in terms of the populations and clinical approach.’’
In New Zealand, both adults and children had relatively high bars to cross before surgery is an option, he said.
‘‘One is that they meet the HealthPathways guidelines. The patient has to meet those guidelines and then have to score sufficient points on the national prioritisation scheme to cross the threshold for surgery,’’ Dawes said.
HealthPathways are a map or guideline for professionals to follow in managing medical conditions.
Over the past decade, international policy and academic debate has raged over the short and long-term effectiveness of tonsillectomy surgery.
However figures released by the Ministry of Health under the Official Information Act show a consistent number of such surgeries in New Zealand.
In 2012/2013 there were 4165 hospital discharges listing tonsillectomy and/or adenoidectomy as the primary reason for the hospital stay.
Five years later, in 2016/2017, this number was 3923. On average $11.5m was spent on the procedures each year.
According to data published by the Health Quality and Safety Commission in New Zealand, four in every 1000 Kiwi children will have a tonsillectomy.
While the surgery relieved symptoms related to tonsilitis, a growing body of literature pointed to issues later in life.
In the June, 2018, issue of Journal of the American Medical Association, Otolaryngology – Head and Neck Surgery, researchers published a study that concluded that having tonsils out as a child made a person three times more likely to suffer from common colds and respiratory infections.
People without their tonsils were also found to have a greater susceptibility to parasitic infections, skin ailments and eye complaints, according to the researchers.
The study was based on health records from 1.2 million Danish children between 1979 and 1999, of which 60,400 had a tonsillectomy, adenoidectomy or both.
The Ministry of Health was contacted for a comment on the future of tonsillectomies in New Zealand.
A spokesperson said it was up to professional clinical colleges and associations to oversee the training and professional development of surgeons.
It did not reply to questions on whether there would be any change to public funding of tonsillectomies in light of recent research or international tends.
‘‘The patient has to meet those guidelines and then have to score sufficient points on the national prioritisation scheme to cross the threshold for surgery.’’
Ear, nose and throat specialist Patrick Dawes