Electives may cut emergencies

Big increases in the amount of elective surgery may be paying dividends in containing the number of urgent operations that need to be done.

The volume of elective surgery started rising sharply before last year's elections and took off subsequently, as district health boards responded to the outgoing Labour government's increased focus on and funding of electives, and took heed of the incoming National Administration's even stricter instructions.

The Ministry of Health's elective services manager, Kieran McCann, said yesterday that growth in the volume of acute surgery - above the levels expected from population growth and ageing - was now minimal. This may be connected to the increasing rate of elective surgery, giving more people operations such as heart surgery before they collapse and are admitted to hospital as an acute case.

"We can't make a definitive link but have noticed a corollary," Mr McCann said. "The level of provision of electives may help with managing acute demand."

This may prove a reversal of the usual problem that money set aside for electives gets gobbled up by dealing with the more pressing demands of acute and emergency cases.

In the last financial year, 130,000 patients had district health board-financed elective surgery, a huge increase of more than 12,000 on the previous year.

In his health targets, Health Minister Tony Ryall has committed to an average annual increase of 4000 in the number of DHB-funded elective patient discharges.

Mr McCann said that because of the 12,000 increase last year, the expectation for this year had been scaled back to an extra 2000.

The average annual increase since 2000, until two years ago when it started rising, was around 1400. This was insufficient to keep up with population growth, let alone the increased demand resulting from an ageing population - which together required annual growth of 1500 to 2000 discharges.

He said last year's increase had accelerated after Mr Ryall made his elective surgery demands explicit to DHBs. "It has been a much more direct approach." This added to the sector's confidence to do more electives, which was based on guarantees of the continuity of the increased funding.