Patient rejection rate at 10 a day

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More than 3000 patients seeking elective services were turned away by the Auckland District Health Board last year before they had been physically assessed by a board specialist.

That is more than 10 each working day.

A further 1444 who lived outside the Auckland Health District and were referred by a GP were redirected to their own health boards, according to the statistics, obtained under the Official Information Act.

A "first specialist assessment" is the front door to elective surgical or medical treatment, tests or assessments in the public health system.

Christchurch surgeon Phil Bagshaw, the co-founder of the Canterbury Charity Hospital, said the statistics revealed the significant unmet need for elective surgery nationally.

But the DHB's acting chief executive, Dr Margaret Wilsher, yesterday portrayed the issue as more complex.

Mr Bagshaw said: "Many patients referred to hospitals by their GPs never get an outpatient appointment, and many who are put on waiting lists by specialists have their names removed by administrators.

"Most GPs can list patients that have been turned down by public hospitals and referred back for 'GP-managed care', even though specialists thought they needed surgery."

Dr Wilsher acknowledged that some patients were turned away because they were not sick or disabled enough to meet the "threshold criteria" used in some hospital departments.

Other reasons included that the DHB did not provide the service requested, or a suspected abnormality seen in an x-ray might turn out to be benign.

"In other cases we ... don't need to see the patient because the GP can manage the patient with advice from us; that's a 'virtual referral'."

Health Minister Tony Ryall said: "There is no doubt there is still unmet need but the National Government is delivering record increases in elective surgery."

The charity hospital in Christchurch, one of several run by volunteers around New Zealand, treated more than 350 patients in 2009.

Mr Bagshaw said commonly performed operations included cataract surgery, hernia repair, varicose vein removal and laparoscopic sterilisation procedures for women.

"A lot of the people we see can't work because of their condition.

"We see people who either don't qualify to have their cataracts done as not being bad enough, or they can only get one eye done [because that gives them adequate vision]. "

Counties Manukau DHB spokeswoman Lauren Young said if cataract surgery patients had only one eye treated in their first operation, the second was usually done within three months.

NO ADMITTANCE

Number of elective services referrals refused a first specialist assessment last year:

3394 - total
589 - ophthalmology
324 - dermatology
271 - orthopaedics
250 - paediatric orthopaedics
249 - general paediatrics

Total number of assessments last year:

84,119

Source: Auckland District Health Board