MPs split hairs on surgery figures

People admitted to hospital but sent home because their operations were cancelled were still included in surgical discharge figures, the Government was forced to concede yesterday.

National MP Tony Ryall, who raised the issue in Parliament, said patients who had "passed through" the system without an operation were included in the figures, which the Government regularly cited as proof that more surgery was being done.

Health Minister Pete Hodgson accepted the two categories of patients were included in the figures, but said this had also been the case when National was in Government.

The issue was more complex than at first sight and the discharge figures were not the best measure of how well the system was working, he said.

Mr Ryall had asked for the surgical discharge figures for 2001 and 2005.

Mr Carter said they were about the same for both years - 205,000 people.

He added that if Mr Ryall had instead asked for case-weighted figures - which adjust the figures to account for the difficulty of operation performed - they would show a 7.5 per cent increase in discharges.

Mr Ryall said if the same number were getting surgery and it was more serious "does this not reveal how much sicker people in this country have to be to get an operation?"

Mr Hodgson said this was not the case as a lot of simpler surgery was now being done in out-patient services or primary healthcare settings.

As people were not admitted to hospital, they weren't included in the figures. Mr Ryall pointed to Health Ministry advice, which said "discharges from surgical specialties simply indicate that a patient passed through a surgical service and was discharged from that service. They do not have to receive an operation to be included in that database."

Mr Hodgson replied this had always been the case and might include procedures like endoscopies - technically not an operation.

Mr Ryall then asked if someone could be admitted, have the operation cancelled and be sent home "and the Government counts this person has having surgery"?

"If that is the case, it has always been the case," the minister said.

National MP Jo Goodhew asked if three admissions and cancellations could be recorded as three surgical discharges and got the same reply.

Mr Hodgson said the best assessment of services was whether patients clinically assessed as above the threshold for treatment were getting it.

"That figure has dropped by over a third in the last year and a half."

He announced this month the Government was concerned that the growth in outpatient operations - of which there were thousands - were not being recorded in official statistics.

A non-admitted patient collection database would be running by July 1.

His spokesman said the number of patients admitted whose operations were cancelled was "small".

They included those with problems such as abdominal pain, who needed surgical assessment but might not need an operation, he said.