Dramatic fall in heart surgery waiting times

Auckland's heart surgery waiting list has undergone a dramatic turnaround.

It follows intervention by Health Minister Tony Ryall after a review of the Auckland District Health Board heart list in May showed that nine patients who should have been given surgery within two weeks had been waiting for more than three months.

The review, by cardiologist Dr Andrew Hamer, who heads the National Cardiac Clinical Network, found that most very urgent and urgent cases waited longer than was clinically appropriate.

Acutely unwell patients should receive surgery within three days; the very-urgent within 14 days; urgent within 42 days; and the semi-urgent within 90 days.

Dr Hamer says the policy of most countries is to operate within three months on patients who need cardiac surgery, because of the link between time waiting, and increasing risk of death.

He also noted that the Auckland DHB had not been treating cardiac patients in order of clinical priority - something the board has committed to rectifying.

The health board initially resisted giving the review and an associated audit to the Herald but agreed following a request under the Official Information Act.

The documents show the scale of the waiting list problem, which dates from when cardiac services shifted from Green Lane Hospital to the new Auckland Hospital in 2003.

But the health board - which provides heart surgery, such as heart artery bypass operations and valve replacements, for patients from throughout the Auckland-Northland region and some national cardio-thoracic services - appears to have overcome the delays following a one-off state grant.

Mr Ryall said yesterday he was pleased with the board's progress.

"It became clear there was pressure in Auckland, so we asked a senior Ministry of Health official and Dr Hamer to go up there and they worked with the clinicians and management."

Mr Ryall in July announced the Government would give the board $5 million to reduce heart patient waits. He wanted to avoid a repeat of the Wellington situation, where heart patients had died waiting for treatment.

The money was in addition to the $50 million, four-year boost by the previous Labour Government for cardiac surgery nationally last October, following a review which found State-funded heart operations per capita had declined, especially at Auckland Hospital, and that New Zealand was behind comparable countries.

The Auckland board's general manager of cardiac services, Kay Hyman, said the waiting list now stood at 82 patients - down from 220 in July - and no one had waited for more than three months.

The turnaround is largely the result having enough staff, for the first time in years, at the cardio-thoracic and vascular intensive care unit; and a big but temporary increase in the number of operations "outsourced", mainly to the private sector but also, for a few, to Dunedin Hospital.

THE WAITS

An audit for Auckland District Health Board checked how long patients had been waiting for heart surgery:
* 9 classed "very urgent" had been waiting more than 100 days.
* 36 urgent patients waited more than 100 days.
* 3 urgent patients waited more than 400 days, of whom 1 waited more than 500.
* Now no one has waited more than 3 months.