3 Sep 2008

Cardiac review shows fewer surgeries performed in NZ

6:36 pm on 3 September 2008

New Zealand hospitals perform fewer potentially life-saving heart operations than in most other comparable countries, according to a draft nationwide review of cardiac surgical services.

The draft Ministry of Health report, issued on Wednesday, reveals a person's chances of getting heart surgery are greater if you live in Southland or Northland than in the Bay of Plenty or Wairarapa.

The report says the rate of public cardiac bypass operations performed in New Zealand is much lower than in England, Scotland, Ireland, Wales and Canada.

It says the consequences are serious because patients have a greater likelihood of dying if they do not get surgery.

National Party health spokesperson Tony Ryall describes the rates as appalling.

On Wednesday Mr Ryall released figures under the Official Information Act which he says continue to show people's access to heart surgery depends more on where they live, rather than how sick they are.

Patients in Wellington have half the chance of those in Dunedin to get surgery, while people in Tauranga have only a third of the chance that Timaru residents have, Mr Ryall says.

"We should be aiming to provide a much better standard of heart surgery across the country for all New Zealanders."

Mr Ryall says the system is unfair. "I think it will be concerning for a whole lot of New Zealanders that their region does not offer the sort of access to heart surgery that other parts of the country get."

The medical director of the National Heart Foundation, Professor Norman Sharpe says the figures do not come as a surprise, and for years there have been large regional inequalities.

He says staffing is a major contributing factor, largely because heart surgery is so complex and involves input from specialist surgeons, technicians, anaesthatists and nurses.

"These skills are part of an international pool (and) there's an international shortage of these same skills. So we're competing for them with other countries."

The report calls for New Zealand's cardiac surgery rate to increase to 74 operations for every 100,000 people, up from the current 54 operations per 100,000.

Auckland heart operations down

The Ministry of Health draft report shows the number of public cardiac bypass surgeries performed in Auckland has fallen by almost a third in the past five years.

The number of coronary artery bypasses performed fell from 641 at the end of 2003 to a provisional figure of 454 in the year to July.

A meeting of the Auckland District Health Board on Wednesday was told the reduction is due to staffing shortages and other problems when services were transferred from Greenlane Hospital to the new Auckland City Hospital and Starship Children's Hospital.

The report says the shift caused a 27% reduction in staff numbers in the 18 months following the move, and cardiac intensive care nurses remain in short supply internationally.

It says recruitment initiatives have reduced staff turnover, but more needs to be done.