Doctors lash out at Starship dithering

By MARTIN JOHNSTON

Child-health specialists have condemned the dithering over a $33 million heart unit at the Starship hospital.

Plans to shift the heart unit from Green Lane Hospital and expand Starship's often-overcrowded intensive care unit are in doubt as health managers flag trade-offs between high-tech treatments and basic community healthcare in poorer suburbs.

The Government has told the Auckland District Health Board to reconsider this and other projects because of its $72 million budget blow-out.

The board has yet to decide on the heart and intensive care project, which would see children's and adults' heart treatment separated, but chairman Wayne Brown favours more integration of services, not less.

Paediatric Society president Dr Nick Baker, said yesterday that the option of treating children with heart complaints at the adults' super-hospital in Grafton, then sending them to the Starship would turn the clock back 20 years. It would be below the developed world's minimum standard.

"This move absolutely contravenes the United Nations Convention on the Rights of the Child and every piece of evidence on good practice. Children must be cared for in children's environments and with children's specialists."

"We need to be funding national services nationally. There needs to be a part of the Ministry of Health that takes that on so a single district health board isn't expected to clear their deficit by strangling a national service."

The ministry said it had been in contact with the Auckland board over its children's heart service.

"We want to be sure Auckland DHB's new board makes the best decision for both Auckland DHB and the whole country as it is a national service they provide," said ministry spokesman Andrew Holmes.

"We expect Auckland DHB to consult all relevant stakeholders, including other DHBs."

The ministry had to be told of, and approve, any significant proposed changes to national services, he said, and the Auckland board had not proposed any alterations to its children's heart services.

The plan thrown back by the Government would involve expanding the Starship intensive care unit from its present nine beds to 16, with room to add four more in future.

The unit's clinical director, Dr Liz Segedin, said the higher number of patients that would come with the heart unit would make it safer. "The more we do something, the better we get at it."

Dr Baker also questioned the sense of cutting back specialist services - a prospect raised at Starship and other central Auckland hospitals after board management called for plans on how to prevent them from exceeding their budgets.

Chief executive Graeme Edmond insisted the instruction was just planning for next year's budget and no decisions had been made. But it has been interpreted by Starship clinical leader Dr Scott Macfarlane as requiring doctors to show how they could avoid doing the amount of work indicated by demand.

Dr Baker said cutting specialist services might lead to higher healthcare costs because patients might need more drugs and be less independent.

nzherald.co.nz/hospitals