COMMUNICATIONS

Media Release - 06/09/06

Apology and Extra funding for Elective Services

Canterbury District Health Board has publicly apologised to patients and staff as a result of the way some patients have been referred back to GPs without an operation, specialist appointment, or other procedure. To reduce the effect of this action, the DHB has allocated $1.7 million of additional funding for elective services this year.

DHB Chief Executive, Gordon Davies, says the surgeons have publicly expressed their genuinely felt concerns about some aspects of the Ministry of Health's elective services policy. Mr Davies says, he acknowledged that many staff had held these concerns for some time. He has offered staff the opportunity to work together with the Ministry and the DHB to help address the concerns raised.

Mr Davies says, the DHB regrets any instances where surgeons were not involved in selecting patients to be returned to the care of their GP without an operation. He says it was expected that each surgeon would be fully aware of their patients, who were proposed for removal from the hospital booking system. Managers have been required to work more closely with clinical staff on this and other issues.

"If this did not occur, I regret that omission, as clinicians must be fully involved in this process. It is accepted that the time permitted for the process posed difficulties for all DHB staff. I am aware many surgeons did receive such lists: but they may not have been permitted sufficient time to review them."

Mr Davies says, ensuring internal processes were appropriately followed is an issue for the DHB to resolve. The DHB started working on this project late in December - he acknowledges that it could have been doing the work from early 2005.

"More importantly all DHB staff are concerned about the impact of this process on patients and on their behalf I apologise to those individual patients adversely affected, where this would not have been the case if appropriate procedures had been followed," Mr Davies says.

He says the DHB has agreed to $1.7M of additional one-off funding to deal with the most urgent surgical and medical procedural cases affected by the policy. This additional funding is from an end of year underspend and is available this year only. It equates to an extra 188 to 200 more people being treated, depending on the cost and volume mix of the procedures that are granted for approval. Some procedures are more expensive than others.

If necessary, the funding will be directed to operations carried out in private hospitals. He says the funding is to treat, as promptly as possible, those most seriously affected, or for specialties where interventions are significantly below the national average (this to recognise the relative urgency of some cases).

'My belief is that by working together the surgeons, the DHB, PHOs and the Ministry can overcome the difficulties that they feel are present in the current policy,' Mr Davies says.

He says the surgeons that have signed this letter understand the reasons the DHB is implementing the policy. These include:

"It must also be noted that the electives policy in the end does not dictate who is prioritised. Clinical overrides and our combined duty of care will be the determinant of those that are and are not treated," Mr Davies says. "We must ensure that we reduce to the minimum possible the outcomes feared on the top of the second page of the surgeon’s letter. If I feared those were the likely consequences, I would not accept its adoption. Nor would the branches of the College of Surgeons or the many other DHBs that are using the Ministry policy."

"It is important to remember that when we believe a patient’s life is at risk, that patient gets the treatment they need as a matter of urgency. That will always be our top priority."

Meanwhile the Ministry is doing intensive work and engaging the whole sector in improving both the systems and the prioritisation tools. "Many invited are Canterbury staff and I hope they can contribute to improving the system," Mr Davies says.

"Several projects have been offered to Canterbury for pilot work: again I hope we can use this to influence improvements to the system."

Discussions with the spokesperson for the surgeons have clarified the root cause of the five issues raised relates to current inadequate overall resources (facilities, staff, systems as well as money.) "If more elective service volumes were funded and performed and they were organised so that acute activity did not interfere with the delivery of service, most of the problems the surgeons have listed significantly reduce. The DHB will work with its staff to achieve this objective," Mr Davies says.

ENDS

Attached to this media release is:

Letter presented to Mr Davies by a substantial group of surgeons employed by the Canterbury DHB.

Media Contact – Michele Hider, CDHB Communications Manager, Ph 364 4103
or 0275 314 796