Patients turned away

Nearly a third of orthopaedic patients referred for a first specialist assessment are being turned away from Dunedin Hospital, and the situation is becoming "untenable", orthopaedic surgeon Prof Jean-Claude Theis says.

The Dunedin School of Medicine professor of orthopaedic surgery  said the relationship with Southern DHB management had become "very bad". Orthopaedic surgeons were not consulted about a recent decision to outsource 129 surgeries. Prof Theis had not known about the outsourcing until an Otago Daily Times story a little over a week ago.

"I read it in the paper — all the information I’m getting is from the ODT.

"Management doesn’t talk to us, really. We are short-staffed, so we can’t do the elective work. That’s why the DHB is outsourcing it rather than employing more surgeons, and they feel that is the solution, but I don’t think that’s a sustainable solution.

"We’ve been battling this for years; most of my colleagues are disillusioned. 

"With management, we’re not getting anywhere. There’s no engagement. There’s no clinical governance any more, across the hospital."

Prof Theis said 32% of patients referred to the department for first specialist assessments were being turned away.

Some patients who do get an FSA are sent back to the GP even when the surgeon says they need an operation.

"And I can tell you, they’re all pretty bad.

"I get regular letters from GPs complaining about the situation, but management has ignored our request for more staff for now over two years.

"The situation is becoming untenable and patients are suffering unnecessary pain and disability unless they have the means to access an appointment in the private sector."

The department had 6.1 full-time equivalent surgeons, and would need another two surgeons just to provide the same level of service as last year, he said.

"Two surgeons who were supposed to come and work in Dunedin, one in 2016 and one in 2017, have made alternative plans, including one of them taking a job in Christchurch."

Dunedin Hospital’s reputation as a good place to work had slipped because of the publicity about its problems, he said. In an emailed statement, DHB planning and funding director Sandra Boardman made no comment on the disclosure that 32% of patients are missing out on first specialist assessments.

The statement said a representative from the orthopaedic department was involved in early discussions about the outsourcing.‘‘That representative sent a summary email and included all members of the orthopaedic team early in September.

"We regret that our communications process was not fully effective in this matter."

The board had recruited a full-time orthopaedic surgeon, who would start in a few weeks, and an orthopaedic fellow would join the department next July.

"The DHB is committed to delivering as much surgery in-house as possible but even if fully staffed it would have been a challenge to achieve the additional operations," Mrs Boardman’s statement said.

The outsourcing tender closes on November 25.

The tender website shows a company based in Mumbai, India, expressed interest in providing the 129 operations, but the SDHB told them only New Zealand-based providers are eligible.

eileen.goodwin@odt.co.nz