Waiting lists are rigged, say surgeons

Health boards are turning away patients who need surgery to make their elective surgery waiting lists appear shorter, say bone and joint surgeons.

Orthopaedic Association president Geoffrey Horne said there was a huge demand for hip and knee replacements, but many health boards were restricting who could get on a waiting list to meet the Government's guideline of patients waiting no longer than six months.

Professor Horne, an orthopaedic surgeon at Wellington Hospital, said Taranaki District Health Board was allowing only 50 patients on a surgeon's waiting list, meaning that if lists were full, patients needing operations were sent back to their GPs.

Waiting lists in Wellington were not as bad as in other areas, he said. The Otago board had reduced the number of elective orthopaedic operations between now and June 30 by 40 per cent to meet budget constraints.

"Some of these people waiting for a hip or knee operation are in constant pain 24 hours a day and their movement and activity can be severely reduced ... It's unacceptable that they meet the clinical threshold for surgery but are not getting on a waiting list for other reasons."

The longer a patient waited for joint replacement surgery, the worse the outcome. Patients who had surgery quickly after being assessed reported less pain and better mobility.

Professor Horne said a hip replacement cost about $10,000, but it was estimated that patients who had to wait more than seven months incurred at least that much in other costs such as drugs, physiotherapy and time off work.

It was "deceptive and dishonest" of district health boards and Health Minister Annette King to claim they were reducing waiting lists when they were manipulating figures.

Ministry spokesman Colin Feek said the number of orthopaedic operations this year was on target to match last year's tally.

Figures varied among health boards and although most were the same or up on last year, some were down significantly, he said.

Taranaki had recently implemented elective surgery guidelines that were consistent with those of other boards, which meant it was doing less orthopaedic surgery than last year, he said.

A Taranaki board spokeswoman denied there was an artificial cap of 50 patients allowed on a surgeon's waiting list, but said the criteria patients had to meet to get a joint replacement had been raised in the past year.

Professor Horne said leaving orthopaedic patients on waiting lists was a false economy.

"We know from recent research that it costs more to have an orthopaedic patient on the waiting lists for a few months than it does to have an operation."

In Christchurch, more people are waiting for orthopaedic surgery than any other speciality.

Last month, 2333 people needed joint surgery, with 1652 having been waiting for more than six months.

Christchurch orthopaedic surgeon Grahame Inglis said the Canterbury District Health Board bought the equivalent of 380 joint replacements last year, compared with 800 in 2001.

"There is a huge lack of resourcing going on, and whether you like it or not that comes from the top."

- NZPA