Tony Ryall MP
National Party Health Spokesman

3 September 2008

Heart surgery depends on where you live

More and more Kiwis' access to heart surgery depends on where they live rather than how sick they are, according to information released by the National Party today.

"The cardiac surgery crisis is getting worse as New Zealand falls further and further behind other countries. And here in New Zealand, where you live determines whether you get life-saving surgery or not."

Health Ministry information obtained under the Official Information Act shows a huge variation in access to heart surgery.

"If you live in Wellington you have less than half the chance of heart surgery than if you live in Dunedin.

"If you live in Tauranga you have only a third of the chance of heart surgery compared to someone living in Timaru.

"The Government was warned about this huge unfairness in a December 2003 Health Ministry report, but did nothing.

"The Health Minister yesterday promised ‘a comprehensive plan to upgrade New Zealand's cardiac services’.

“This is yet another panicked reaction in advance of what is expected to be a damning report on cardiac patients dying while on waiting lists at Wellington Hospital. This crisis is not only about Wellington.

"The data released today shows which areas the Ministry of Health thinks it got a fair share of all the heart surgery performed in the country in the past year. The fresh information doesn't show whether there was enough surgery for the DHB or country as a whole. But it comes on top of the major draft cardiac services report disclosed on Monday that says New Zealand is providing much less heart surgery than comparable countries."

Reporters note:
The Ministry of Health has provided "standardised discharge ratios" (SDR) for various heart procedures. This is based on looking at the amount of heart surgery performed in the country in a particular year and then calculating how much should have been done for patients in each DHB area if everyone was being treated the same. This is based on age, gender, ethnicity and deprivation.

So, a SDR of 1 means that the Ministry of Health thinks a region got its fair share of the heart surgery performed that year. An SDR of 0.5, for example, means the MOH thinks that people in that area only got half the surgery they should have got based on the population profile of the district. An SDR of 1.5 means the MOH thinks that people in that region got more than their fair share of the surgery.

For example, Wellington's CABG SDR for 2007 was 0.64, which is less than half of Otago's 1.40.
This information is based on a fair share of what surgery was done, not on how much should have been done if New Zealand was providing world levels of surgery.

Attached: Extract SDR OIA – 1 page

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Marker procedure standardised discharge ratios by calendar year
Standardised by age group, ethnic group, sex and deprivation quintile
Casemix filter exclusions applied; non DHB domiciled, sex=U and no dep events have been excluded
Note that 2000 is standardised using the 2001 population
Extracted 5 June 2008

Marker Procedure / DHB of domicile // 2007
M05 / Coronary Artery Bypass Grafts / 11 / Northland / 1.17
M05 / Coronary Artery Bypass Grafts / 21 / Waitemata / 1.13
M05 / Coronary Artery Bypass Grafts / 22 / Auckland / 0.92
M05 / Coronary Artery Bypass Grafts / 23 / Counties Manukau / 0.98
M05 / Coronary Artery Bypass Grafts / 31 / Waikato / 0.88
M05 / Coronary Artery Bypass Grafts / 42 / Lakes / 0.91
M05 / Coronary Artery Bypass Grafts / 47 / Bay of Plenty / 0.46
M05 / Coronary Artery Bypass Grafts / 51 / Tairawhiti / 0.59
M05 / Coronary Artery Bypass Grafts / 61 / Hawkes Bay / 0.73
M05 / Coronary Artery Bypass Grafts / 71 / Taranaki / 0.94
M05 / Coronary Artery Bypass Grafts / 81 / MidCentral / 0.96
M05 / Coronary Artery Bypass Grafts / 82 / Whanganui / 1.25
M05 / Coronary Artery Bypass Grafts / 91 / Capital & Coast / 0.64
M05 / Coronary Artery Bypass Grafts / 92 / Hutt Valley / 0.87
M05 / Coronary Artery Bypass Grafts / 93 / Wairarapa / 0.62
M05 / Coronary Artery Bypass Grafts / 101 / Nelson Marlborough / 1.60
M05 / Coronary Artery Bypass Grafts / 111 / West Coast / 0.96
M05 / Coronary Artery Bypass Grafts / 121 / Canterbury / 1.14
M05 / Coronary Artery Bypass Grafts / 123 / South Canterbury / 1.32
M05 / Coronary Artery Bypass Grafts / 131 / Otago / 1.40
M05 / Coronary Artery Bypass Grafts / 141 / Southland / 1.63

ENDS

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