New era cut comes early for hospital

By MARTIN JOHNSTON health reporter

National Women's Hospital specialists have lost their battle to keep four operating theatres.

The say the reduction will reduce safety margins and lengthen surgery waiting times.

But the Auckland District Health Board dismisses their concerns about the cut to mostly three theatres from four, which is part of a plan to save $40 million a year with the shift to the super-hospital in Grafton.

That hospital, beside the Starship children's hospital, opens progressively from October.

It will combine the inpatient services of Auckland, National Women's and Green Lane Hospitals. Most outpatient appointments and day surgery will be at the new Greenlane Clinical Centre under the $450 million scheme.

The board will then have 37 theatres - compared with 29 now - but its immediate plan is to commission only 33.

National Women's clinical leader Dr David Knight said last year he was confident his hospital would retain four theatres at the new hospital.

Not only was he proved wrong, but the board plans to impose the reduction at the Epsom hospital within weeks - well before most of its services shift to Grafton next April.

A senior National Women's doctor said the board's assurance that the fourth theatre would remain set up and could be used for emergency cases if needed did not answer the difficulties in finding anaesthetic and nursing staff at short notice.

"I don't think that's safe," said the doctor.

Waiting times for elective gynaecological surgery - now within the Government's six-month benchmark - would increase.

But Dr Knight says the cut - which also involves shifting some day surgery to Green Lane - will improve safety.

"We will have two theatres available for emergency caesarean sections until we move to the new hospital.

"At the moment, we only have one for much of the day. At the new hospital we will have one."



Last year, he said National Women's having only three theatres at its new home on level nine at Grafton would be riskier than having four, because of the loss of precious minutes if a general theatre on level 8 had to be set up for a emergency caesarean.

But yesterday he said his safety concerns had been assuaged by the systems established.

The board's director of anaesthesia and operating rooms, Vanessa Beavis, said nurses for the fourth theatre in emergency cases at Epsom could be drawn from the likes of nurse-managers and nurse-educators. She denied that the cut would lead to elective surgery patients waiting longer.

The aim in mostly having three theatres was to reduce the amount of time they spent idle.

By "creative scheduling", including staggered staff lunch-breaks, it would be possible to do the same amount of work.

Several hundred thousand dollars a year would be saved through the loss of about 10 jobs, but this would happen gradually as staff left, rather than through redundancies, she said.

The reduction would be "audited" as a dry run for the shift to Grafton, but was not an experiment.