Heart ops slower for NZ young

By MARTIN JOHNSTON health reporter

Heart operations for some New Zealand children at Starship hospital are being delayed by surgery on youngsters from the Pacific Islands.

Up to one in 10 heart operations at the hospital are on foreign babies and children.

The staff of the country's only paediatric heart unit treat more than 1000 patients a year and perform surgery on 400.

Up to 20 of the surgery cases are from Tahiti, which pays the Auckland District Health Board about $5 million a year for cardiac surgery or other heart treatment for children and adults.

Some of the income has been spent on expansion of its heart facilities.

The other foreign paediatric surgery cases, around 20 a year, come from the rest of the Pacific. Some operations are financed from New Zealand's foreign aid budget, and the rest from fundraising, insurance and other sources.

Supporters of five-week-old Margaret Mandan from Vanuatu, who is recovering well from open-heart surgery last Friday, are relying on public donations to pay the estimated $40,000 cost.

Doctors expect to decide by Friday whether to operate on her twin sister Karen, whose inherited heart defect is more complex. She is stable now, but without surgery is expected to die within months.

The hospital's head of paediatric cardiac surgery, Dr Kirsten Finucane, said Margaret's operation probably meant a New Zealand child had dropped down the waiting list.

"Some are waiting longer than they should. We try to keep it down to six months, but at times it gets worse than that."

Their health was not compromised, but it was disruptive for families who had prepared themselves for the surgery.

New Zealand-born doctor Derek Allen, who brought the twins to Starship with their mother Julie, is appealing for donations to Operation Vanuatu Charitable Trust at Westpac branches to pay for the girls' surgery. The bill could exceed $110,000.

The Government gives foreign development aid of $6 million a year to Vanuatu, including $150,000 for health.

Vanuatu's Government selects patients to be treated in New Zealand hospitals under the scheme.

This year's health budget is spent and the next allocation is not until July.

Dr Allen said he had approached the Vanuatu Government about the Mandans' surgery but was told there was no money left in the scheme.

Dr Finucane said the unit needed the Pacific's population of one million to make its catchment the ideal size. New Zealand's four million was too small to safely sustain a children's heart unit.

Paediatric Society president Dr Nick Baker said the unit treated acutely ill children quickly, but non-urgent patients and their families could face frustrating and demoralising postponements.

"With elective surgery, the supply is never going to meet demand, but compared to other services, the Starship heart unit is managing demand very well."

He backed Dr Finucane on the right size for a children's heart unit.

"We have recognised that for many services critical mass is an important factor."