KEY POINTS:
Auckland residents are less likely to receive elective surgery through the public health system than most other New Zealanders, a study has found.
Reports released yesterday by the Ministry of Health comparing productivity in 13 areas of surgical specialty at all 21 district health boards has found huge discrepancies in surgery rates - a trend National health spokesman Tony Ryall dubbed "healthcare by postcode".
While access was patchy throughout the country, people living within the Auckland DHB area appeared the worst off.
They were found to receive 41 per cent less orthopaedic surgery than the national average - the lowest in the country - while patients in South Canterbury needing a similar operation were more than likely to get it, with their health board performing nearly twice the national average.
Auckland also recorded the lowest output in dental and gynaecology surgeries, and was one of the lowest in paediatric, vascular and general surgery.
The figures have been adjusted to factor in each board's population demographics and relate to a subset of elective procedures. They do not include urgent surgery such as acute appendicitis or for cancer.
Auckland DHB acknowledged the findings, which a spokesman said was in part attributable to historically low Government funding of health services in the region - an issue which has been addressed over the past five years. The board did its own audit of the issue over a year ago, and has set aside more money to fix the problem, particularly in areas such as orthopaedics.
"We are very positive going into [the next financial year] that our intervention rates are going to start creeping up closer to national intervention rate levels," he said.
The reports did not take into account surgery done in private hospitals, which he said would greatly affect the number of operations done in public hospitals, given the established private surgery market in Auckland.
The reports also found that the number of surgeries in some specialties dropped from 2003/04, despite a massive cash injection by the Government.
In Auckland, gynaecological surgeries actually fell by 13 per cent, while in Counties-Manukau, there was a 21 per cent drop in 2005/06 from 2003/04. Counties spokeswoman Lauren Young said this was because more women were being seen before they needed surgery.
The ministry reports were done to help ensure all New Zealanders get similar levels of access to elective services.
Dr Ray Naden, clinical adviser to the elective services programme, said this work was a major step towards trying to address the imbalances.
He said a board which was providing around 80 per cent of the national average may be providing good preventive services, so the requirement for surgery may actually be less than for people in other parts of the country.
But Mr Ryall said the reports showed that in many parts of the country, DHBs were simply failing to provide the level of services that patients would expect.
"These numbers are showing that people in some areas are having trouble getting a level of service that other New Zealanders are getting. If we are to have a health service that treats people equally rather than by their postcode, then it means that we have to look for an improvement in what those DHBs are doing."
