Surgery plan will allow six-month waiting target to be met

By RUTH BERRY, political reporter

Aucklanders are finally about to gain their fair share of hip and knee operations, with the number due to double in the year from July and come close to trebling by 2008.

With Cantabrians, Aucklanders are the biggest winners in yesterday's big-ticket Budget announcement on health, which involves a $70 million-a-year orthopaedic rescue package.

The new funding, beginning at $30 million for the 2004-05 year, will double the number of hip and knee operations within four years, from 4665 a year to more than 9300 nationally.

But Auckland, Waitemata and Counties Manukau District Health Boards will have to perform an extra 800 operations over the next financial year - almost doubling the 837 they are estimated to complete by next month.

By 2008 they will be required to carry out 1425 more operations a year than they are at present doing.

To date the region's boards have performed fewer operations a head of population than most others around the country.

The increase in operations will reflect the need for the boards to catch up as well as the rise in the number that will be performed across the country as a result of the funding injection.

The number of elderly people in each region also affects operation numbers.

Health Minister Annette King conceded yesterday that some people were waiting more than a year to get the operations, well outside the Government's six-month benchmark.

The new funding would eventually see the six-month target met.

"A number of letters I receive are from people who want joint replacements done in a timely fashion and this does ensure that will happen."

The Government has ringfenced the extra spending, which will rise to $70 million by 2007-08.

It covers initiatives to build capacity in hospitals, including provision for extra staff and orthopaedic nursing scholarships.

Bigger hospitals might take longer to build capacity and might have to turn to other boards or to private hospitals to fulfil the new requirements. Some boards, including those in Auckland, are already doing this to try to meet existing benchmarks.

Prime Minister Helen Clark, who joined Ms King at yesterday's launch, said although the vast majority would be performed in public hospitals, the Government's first priority was to get the operations done.

She was confident concerns raised by some boards about their ability to deliver extra operations had been worked through.

The Auckland District Health Board has particular problems.

It is facing a 60 per cent increase in the number of patients waiting longer than six months for a first specialist assessment since Auckland City Hospital opened in October.

About 15 per cent of those offered treatment have waited longer than six months, with worsening orthopaedic delays.

The extra spending will pull New Zealand's intervention rate above Australia's. The present rate of 1.2 interventions in 1000 people is well below Australia's 1.9 and Britain's 2.3 but will double under the plan.

The New Zealand Orthopaedic Association welcomed the announcement.

The Health Funds Association of New Zealand, the industry association for health insurers, said the money was good news but it was a temporary respite which would not alleviate the fundamental problems plaguing the health system.