Deteriorating access to hip and knee surgery

11 November

Figures highlight deteriorating access to hip and knee surgery

“Some hard questions need to be asked about access to hip and knee surgery around the country and why the threshold for getting treatment seems to be getting higher and higher,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

He was commenting on figures released today by Labour’s health spokesperson Annette King, which show that 13 out of 20 district health boards (DHBs) have increased their average Clinical Priority Assessment Criteria (CPAC) for hip and knee surgery since 2012 or since they started recording them. More information about these figures can be found at (http://www.scoop.co.nz/stories/PA1511/S00196/patients-waiting-in-more-pain-for-operations.htm).

“The figures raise a number of questions about access to orthopaedic surgery but it looks as if access to this treatment is becoming harder for patients,” says Mr Powell.

MidCentral DHB orthopaedic surgeon Dr Geoff Anderson says the figures support his impression that it has become increasingly difficult to access orthopaedic surgical treatment.

“While we are maintaining the number of joint replacements we perform, the demand for surgery is growing in parallel with the aging population,” he says.

“I will say to a patient in a clinic that I think you will benefit from a joint replacement operation. I’ll submit the waiting list paperwork and often the patient gets turned down due to lack of sufficient resources to enable them to be treated within the Ministry of Health four month maximum waiting time.

“There needs to be greater public awareness of this. The New Zealand Orthopaedic Association has worked with the Ministry of Health to develop an internet-based scoring system for orthopaedic patients to try and achieve greater equity of access and transparency of decision-making. This has been piloted and is expected to be in general use in the near future.

“The threshold for access for joint replacement surgery varies enormously, depending on where you live in New Zealand. The thresholds are changed without discussion or debate. We need to be talking about this as there are obviously difficult decisions to be made regarding the allocation of resources across different areas of health care.”

ENDS

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