Cash row stalls rural-area bus surgery project

By JO-MARIE BROWN

A trial of a $25 million mobile surgery for rural areas has been abandoned after a $20,000 dispute between operators and Rotorua Hospital.

Nine patients at the hospital were scheduled to have operations in the travelling surgery - a specially equipped bus - late next month.

It was to be a pilot for the mobile theatre, intended to go into service nationwide and cater for 1000 patients in its first year.

The dispute arose when Lakeland Health asked the bus owner, Mobile Medical Technology NZ and Surgical Services, to pay $20,000 the hospital would lose in Ministry of Health funding by "lending" patients to the bus.

"We were basically handing over nine patients to the bus," said hospital spokeswoman Wena Harawira. "If we lose nine surgical procedures we lose the funding associated with them."

Christchurch-based MSS, which will receive $25 million from the ministry over five years to build and run the bus and an extra $750,000 to cover its first year, refused to pay the $20,000.

The vehicle had been fitted out in Rotorua and Ms Harawira said the district health board had been prepared to provide and pay for staff to carry out the low-risk surgery.

Patients were to have been prepped in the hospital, moved to the bus for surgery and then taken back into the wards to recover.

MSS director Dr Stuart Gowland said the dispute would not hold the project back and there was no ill feeling over the aborted trial.

He said Rotorua was a good hospital and he hoped the bus' services would be used there in future.

Several other hospitals had already expressed interest in hosting trials, he said. "[Rotorua] was just testing out the system in the bus straight out of the factory. All we are going to be doing is the cases that you would be doing in an operating theatre anyway.

"They will just be doing them in the truck so there's no net cost in that," Dr Gowland said.

Seven other North Island hospitals, including Dargaville, Kawakawa and Wairoa, and six South Island hospitals such as Balclutha, Gore and Oamaru will eventually use the mobile bus.

The vehicle was expected to visit one day every five weeks to perform day surgery while remote surgery using a video link would be performed in mid-sized cities such as Rotorua, allowing surgeons in the bus to communicate with experts worldwide.

The project had been three years in the planning and was the brainchild of a group of GPs and nurses who wanted to improve the delivery of health services to rural communities.

Funding was approved in December 2000 by Health Minister Annette King, who said at the time that the surgical bus would ensure rural patients were not disadvantaged.

"At the moment ... they have to travel quite long distances and often have to stay overnight or even two nights instead of being able to go home the same day."

Dr Gowland said the Government would consider extending the five-year funding deal if the mobile unit worked well.

Opposition health spokesman Roger Sowry said the ministry should provide additional funding so hospitals would not lose out by letting their patients use the service.

"It's just pathetic. The Minister of Health launched this bus with a great amount of publicity.

"I, personally, think it is an excellent initiative and the fact that hospitals are so cash-strapped that they would rather let people stay on the waiting list than let them go to the bus shows a deep flaw in Annette King's health model ... "

Dionne Barton, a spokeswoman for Annette King's office, said the issue did not fall under Mrs King's responsibility.

"It's a local contracting issue ... "