Janina Ochkas is lovingly cared for by her 91-year-old husband Wally. Photo / Paul Taylor
Ninety-year-old Janina Ochkas' hip is "crumbling".
So when she was finally sitting on a bed in Hawke's Bay Hospital, prepped and ready to go into surgery, her family thought they could finally breathe easy.
But at the last minute on Wednesday, her surgery was deferred as other cases took priority.
Her family say they are at their wits' end, months of planning lost, back to square one.
Hawke's Bay District Health Board has apologised for the inconvenience, but say it is not uncommon for acute surgeries to take priority. And the union representing senior doctors says it's a case that represents a problem with NZ's health system that is not unique to Hawke's Bay.
Janina suffers from dementia, but still lives in her own home at Mahora, Hastings with her 91-year-old husband Wally.
The surgery is what she needs so she can have a better life. Instead, she's now facing a fourth trip through the health system to get a new hip.
"Most of the day she either sits in her chair and knits, or lies down, because she can barely walk. She shuffles, she is in so much pain," her daughter-in-law Jaki Livingston said.
"Six months ago she had her last x-ray and the whole weight-bearing pocket in her leg is crumbling."
Janina had two previous surgeries booked and then cancelled via a letter in advance. But the cancellation once she was already in hospital was galling, Livingston said.
"Every time she needs to go to hospital we have to plan everything beforehand, and this time because she was going in for surgery I was going to be there for her at the hospital, and when I couldn't stay we'd asked my sister-in-law to stay, her other son was going to be with Wally.
"It took months for us to plan this. Now we are all left feeling we can't trust the system.
"Our whole lives are committed to Janina and Wally, we can't go away for two nights at a time.
"Having her mobile would make a huge difference to us."
Livingston is so desperate for Janina to get surgery, she's considering going to Royston to get it done privately, but is financially constrained.
"It would cost us about $25,000 if we get it done at Royston and we don't have that kind of money lying around," she said.
"Our GPs can't understand why it has taken so long, this is now urgent."
She said Janina was in "extreme pain", but she doesn't show it.
"She's a Polish refugee, she was one of the children taken in by Pahiatua, she's so staunch, but her pain is visible in her face."
On October 31, 1944, 733 Polish refugee children and 105 adult caregivers sailed into Wellington Harbour on the USS General Randall.
On November 1, they settled in the Polish Children's Camp in Pahiatua. They had been invited by Rt Hon Peter Fraser, Prime Minister of New Zealand, for the remainder of World War II.
"Because she has dementia and because of her background she is resigned to the fact that her surgery got delayed," Livingston said.
"I am the one who gets angry because I can see what she's going through."
In response, Chris Ash, chief operating officer of Hawke's Bay DHB, said postponement of surgery does happen from time to time on the day of surgery with acute life or limb (which includes cancer cases) taking priority in theatres.
"At all times patient safety and care is our top priority and patients deferred have been clinically reviewed as safe to do so," Ash said.
"The DHB apologises for any inconvenience to both the patient and their family overall patient safety must take priority. The patient will be rescheduled for surgery as soon as we can."
The hospital has had issues with capacity in recent times.
On May 11, a record number of people arrived at its emergency department - 188 over 24 hours. The volume of admissions meant some planned operations also had to be cancelled that day.
In a report to the board earlier this year, chief executive Keriana Brooking said it was recruiting more nursing and medical staff for the ED team to "address the impacts".
The Association of Salaried Medical Specialists is the union representing senior doctors.
Executive director Sarah Dalton said the problem was not exclusive to Hawke's Bay.
"It's all around the country, it's a big problem in hospitals like Hawke's Bay, it's a very old building, it's well overdue for an upgrade and replacement," Dalton said.
"If there's an overflow of acute need, which is people who cannot wait, that puts pressure on beds or operating theatres, that pushes back planned care and planned operations like hips."
Doctors found events like this "frustrating" because they wanted to do the best for patients, she said.
"Situations where there are very late-notice cancellations, they're really wasteful in terms of resource - they really feel for those patients who would've been nil-by-mouth for a period of time, may have already had drips put in things - it's really horrible for patients to have a last-minute cancellation."
Dalton said she had a meeting with Hawke's Bay DHB management just last week.
"They are very aware of these issues and they're working hard to address them. The new chief executive has inherited a lot of long-standing problems and obviously, she's got to pick up things as she finds them and do the best that she can but also, the way that hospital rebuilds are being managed centrally is slow, it's messy, it's very reliant on very expensive business cases."
She hoped Health NZ would pick up the slack.
"Some people would probably think it couldn't be worse than it is currently."