Surgical waiting list rises as patients languish in pain say they feel like ‘living dead’

Thousands of people who need hip or knee replacements and other elective surgeries languish in pain on waiting lists for more than 12 months, with one surgeon saying they feel like the “living dead.”

Hospitals across the country have trimmed the “lists” of elective operating rooms they had planned ahead of the Omicron outbreak this year, adding to the rapidly growing waiting list.

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Of those to be rescheduled, many are being canceled or postponed at the last minute due to staff illness or a shortage of hospital beds as the country grapples with Covid-19 and the first flu season since 2019†

But surgeons say “chronic, institutional job openings” are the main reason for the problem.

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By early May, the waiting list had grown to 27,000 for scheduled, non-acute treatment, up from 8,000 in February 2020, before the pandemic broke out.

Health Minister Andrew Little has announced that task force to address the issue on May 4, with a report expected in September.

But surgeons say the problem now requires action, and some have put forward ideas to help.

New Zealand Orthopedic Association president and Christchurch surgeon John McKie said about 6,600 people were waiting for elective hip, knee and spine surgery.

The group has proposed a plan to add 4,000 government-funded operations to their private theater lists over a two-year period.

McKie said 200 surgeons working “for public and private services…will commit to having one additional person per month on their private list for 10 months of the year.”

The plan would require $80 million to $100 million in government funding over two years.

“That’s not the whole answer, but it’s something that can start right away, and it means that within the existing infrastructure and private hospitals, we can all do an extra case per month without putting an undue burden on it.”

McKie said people with joints severely damaged by arthritis would live with severe pain and often be unable to walk or work.

“Nobody dies from hip arthritis, but sometimes they say they feel like the living dead because of their pain and disability,” McKie said.

“We don’t work for fun.”

He said that “morphine-based drugs” for pain relief often had significant side effects, including duodenal ulcers, constipation, “or they get blurry in the head.”

“So essentially they suffer silently, or not silently, out in the community, and they become more and more weakened.”

The surgeon said there had always been waiting lists, but the situation over the past three months was the worst he’d seen in his nearly 30 years on the job.

In a recent eight-week period, he performed just one instead of the usual quota of 16 hip or knee surgeries.

Where he and his colleagues would have taken electives, they instead operated on trauma patients who “came in through the front door.”

Christchurch Hospital completed only “emergency and non-delayed surgery” and staff “assessed and reprioritised patients who have undergone deferred surgery,” Becky Hickmott, Waitaha/Canterbury senior officer responsible for winter planning.

Burwood Hospital had cut its theater capacity by 40%, she said.

A Te Whatu Ora – Waitaha/Canterbury spokesperson could not say how many operations have been postponed, because “some that would normally be scheduled have not been scheduled, so we can’t just count canceled operations in the system”.

New Zealand Association of General Surgeons president and Waikato surgeon Rowan French said most hospitals have cut planned surgeries by at least a quarter.

He said serious staff shortages, rather than illness, were the cause of the cuts to elective surgery theater lists, which were made up to six months in advance.

“Where I work, we have 40 to 45 job openings for theater nurses and what I hear… is that they often get 50 to 60 applications for a role [last year]but now they are lucky enough to get some and those people will not be qualified for the job.”

French said the situation needs urgent attention now.

“What we were trying to make clear is that it is a very urgent issue, it cannot wait another six months because at the rate we are losing staff, we will have another 10-15% less… it is a bleeding of the staff.

“So we want them to put things in their place. Sort the nurse [pay equity deal]the nurses residency, figure that out and do it under Covid-like urgency.”

A spokesman for Te Whatu Ora – Health New Zealand said that as of June 26, approximately 6,358 scheduled health care surgeries had been canceled or postponed since January 23, 2022, compared to the previous five-month period in which 7,052 elective surgeries were canceled or postponed.

“It is important to note that the number of patients postponed or canceled has not changed significantly in recent months.”

stuff asked Te Whatu Ora – Health New Zealand to explain this claim, as the data did not rule out surgeries that were not planned due to budget cuts. The health authority did not respond in time for publication.

McKie said the situation was the worst he had seen in his 28-year career.

“Anyone who works in public hospitals would know that we have done negligible elective surgeries [this year]†

“From time to time we have peaks and troughs with trauma service that affect the ability to deliver elective care, but at this point this is unprecedented.”