Hawke’s Bay now well set to deal with elective surgeries

Hawke’s Bay, a region once starved of operating theatres, now has more public access to surgery and the ability to attract more medical staff and clinicians than ever before. 

What I know from the many local surgeons I have met and talked with, is they love to do. So when looking for a place to base themselves, if they can see a position that is going to provide the work they trained to do – they will come.

It might be hard to believe, but with so much investment into health capital infrastructure in the past three years here in the Tukituki electorate, in both the public hospital and private sector, Hastings and Hawke’s Bay is now well set up for the future.

If I was able to leap forward a few years from now, the vision I see is that we will be positioned as one of the leading health regions in New Zealand, and especially for attracting highly skilled clinical staff where they can work and enjoy one of the best places to live and raise a family.

In the past few months we have seen the private local hospital Royston, which had six theatres, invest $11 million and open two new day theatres. Then right next door to our regional hospital the brand new Kaweka Hospital has been built with four theatres providing 1,500 public operations to start with this year. Plus we have an eighth theatre at Hawke’s Bay’s regional hospital nearing completion. 

It’s impressive. But to put it into perspective it’s taken an entire decade, and funding from the Labour Government to finally get our 8th theatre as part of a major surgical expansion project underway as we get on with rebuilding our hospital.

Together, all this new operating space, gives Hawke’s Bay an unprecedented advantage, with more capacity than ever before to perform thousands more public operations, and as we transform to the new single Health New Zealand structure, we could soon become one the best regions to live in for getting access to surgery.

While this doesn’t diminish the enormous suffering that people have been experiencing with unacceptable delays and cancellations, there is real hope on the horizon. 

I believe we are going to see significant improvements happen relatively quickly. And certainly faster than we have seen for many, many years.

As the local MP for Tukituki, and a former elected HBDHB board member, I have gained a real insight into the health system. Serious under-funding and politically driven ways to report surgeries and waiting lists created what can only be described as a very broken and unfair service.

The damage was really done when, as conservative governments do, National cut taxes and froze infrastructure investment. It is also worth reminding people that National put not a penny more into our regional hospital for new capital building. Instead, as one senior doctor told me, they were told to cut spending on operational budgets if you wanted to build anything, and so year on year, this basically cut to the bone any flesh the hospital had to run the hospital. 

By 2014, you had to be “in more pain to access the publicly-funded operating table”. 

Patients in need of surgery were ranked by their pain and assigned a number – they only made it on to the waiting list if their number was high enough to meet five different criteria thresholds.

The National Government only counted the number of people who had an operation each year, not the number of people turned away. Behind the scenes there was a ‘real waiting list’ and the one that was reported.

New Zealand Medical Association (NZMA) chairman Dr Mark Peterson, who was also chief medical officer in Hawke’s Bay, was reported as saying patients were assessed by clinicians and told that in an ideal world they would have this procedure in the next few months, but as hospitals didn’t have capacity, they no longer met the criteria.

The Health Funds Association of New Zealand, in conjunction with the New Zealand Private Surgical Hospital Associations, conducted a survey of unmet need that found 170,000 Kiwis are turned down from the waiting list every year. It reported 280,000 Kiwis met the clinical threshold for elective surgery, but only 110,000 were placed on the list.

When waiting list times were reduced from six to four months, National basically lifted the threshold to access it. On top of this was a post-code lottery where you could only have your operation where you lived. For example, while there would be spaces available in Palmerston North for a new knee, if you lived in Hawke’s Bay you couldn’t get that spot.

A study showed that under National, one in three people requiring elective surgery were being turned away from waiting lists to meet Government targets. Research recently published in The New Zealand Medical Journal found 36% of patients who needed hip and knee replacement surgery at Whangarei Base Hospital and Hawke’s Bay Regional Hospital from June 2012 to June 2013 were turned away as there weren’t enough resources.

Leap forward to 2022, and we are finally seeing capital investment and movement. 

Exacerbated by Covid, the number of people waiting longer than four months for their first appointments with hospital specialists had doubled because of the pandemic, and the number of people waiting longer than four months for treatment had more than trebled.

But today we now have one public health system and there is the opportunity to work together to get the treatment people need – no matter what part of the country they live in. HNZ has been instructed by the Minister of Health Andrew Little to make full use of all resources including private capacity and clear the backlog.

And it’s this attitude that we need and we are now seeing underway in Hawke’s Bay. Performing public operations in private hospitals is not new. But for our region we have never been in as strong a position as we are now to access this significant operating capacity.

Over the coming year I do expect to see many more people who have been turned away and waiting, in some cases many years, finally start getting their elective operations. 

In my view there are no excuses, the Government has told hospitals to pull every lever. Yes, some operations will be prioritised over others, there are emergencies and accidents that bump people off, even at the last minute – but on the whole I think people accept this, as long as they are given a fair and reasonable explanation.

As we start moving through the waiting list, I do think this will take a change in mindset from a culture within the hospital environment that has not been accustomed to having this new capacity.

But if you know someone who has been waiting a long time, please support them to get in touch with my office. It’s my job as your local MP to work and advocate for them and you.