Surgeon raises alarm over ‘appalling’ lack of trauma service
“Wellington is meant to be the trauma centre for the whole of the lower North Island from Palmerston North to Hawke’s Bay ... servicing a population of more than 450,000 people. You have no-one interested in trauma, no-one employed to do trauma.”
Dr Chris Wakeman
Chairperson of the College of Surgeons’ (RACS) New Zealand
A leading surgeon is raising the alarm over an “appalling” lack of trauma services in Wellington, which he says risks prolonged stays in hospital and longer recovery times for patients.
“You’ve got surgeons who can do fix the leg, fix the liver, fix the brain, but there’s no one who’s actually coordinating, which is just appalling,” Dr Chris Wakeman, chairperson of the College of Surgeons’ (RACS) New Zealand trauma committee said.
“Wellington is meant to be the trauma centre for the whole of the lower North Island from Palmerston North to Hawke’s Bay ... servicing a population of more than 450,000 people. You have no-one interested in trauma, no-one employed to do trauma.”
A trauma surgeon coordinates a patient’s overall care, gets them to the best facility, ensures things are not missed so “the whole package is done correctly,” Wakeman said.
“Trauma is a young person’s disease ... it’s hugely expensive, the ongoing ACC and rehab if you don’t do things right.”
Wakeman wrote to Health Minister Dr Shane Reti urging him to review the “vast inequities“between New Zealand’s five major trauma centres and adequately resource hospitals.
Both Reti and Health New Zealand say they’re comfortable that a newly established national trauma committee has a handle on the key issues and will improve what they admit is a postcode lottery.
But Wakeman said this committee has no budget and no authority to implement change.
“They’re just talk fests. They have no teeth, they can’t make hospitals appoint people.”
Wakeman believes the dedicated trauma service in Christchurch was instrumental in managing 40-odd gunshot wound patients in less than two hours after the 2019 mosque attacks and lost two – one post-surgery and one in ED.
“Without our established trauma service, we would have done a lot worse. You'd hate to think what happened in Wellington if the same thing happened with a total lack of interest in trauma.”
But Wellington’s staff were trained, experienced and capable of providing trauma services within their disciplines, the region’s hospital and specialist services spokesperson Jamie Duncan said.
He said Wellington’s trauma care was done through the assessment and triage process which meant trauma patients received care best suited to their needs – such as orthopaedic, neuro-surgery and neurology, cardio-thoracic, burns and plastics or intensive care.
Wellington’s outcomes were “largely consistent with those of other regions,” Duncan said.
For patients directly transferred to a suitable hospital, the central region had a shorter median turnaround time (1.5 hours) compared with the South Island (two hours) according to the Trauma Registry and Trauma Network’s latest annual report.
But a higher percentage of South Island patients (84%) were transferred directly to a suitable hospital than central region patients (78%).
The trauma network is co-led by Wellington intensive care physician and anaesthetist Dr James Moore who was “conscious of challenges in trauma care and ... dedicated to meaningful improvements,” Health NZ’s interim chief clinical director Dr Richard Sullivan said.
A programme was being developed to guide the committee’s focus over the next 24 months, Sullivan said.
Duncan said Wellington was constantly looking at ways to improve its trauma service.
Reti said the new specialist trauma committee, one of multiple national clinical networks, would find ways to address regional and equity-based variations in care, and find “innovative, efficient, and evidence-based solutions that will inform investments and workforce planning”.