September 1, 2024 • 5 mins
The Government says it has a clear focus on reducing cancellations for planned surgeries.
Health NZ analysis shows about eight percent of elective surgeries are cancelled within 24 hours by a hospital.
One in five elective surgery cancellations are caused by an acute or emergency case, needing to take precedence.
Health Minister Shane Reti told Mike Hosking there's a number of things to work on.
He says they include, ensuring theatres are being used properly, with the right surgeons, and making sure they're working on time.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
There's Business of Health New figures this morning nearly one
and five elected surgeries have been canceled and that's because
they get bumped due to the acute of emergency patients
and great Indeed, now the Health New Zealand's been investigating
this particular problem at the request of the Minister, and
the Minister is, of course, Sir doctor Shane Ritti, who
is with us. Very good morning to you.
Speaker 2 (00:17):
Good morning, Mike.
Speaker 1 (00:17):
Have you got any answers?
Speaker 2 (00:21):
Look, we've certainly got solutions, but this is a key
issue that twenty percent to are canceled due to acute surgery.
Of course we want that if you're urgent, you do
take a priority, but the consequences if you've been planned
for weeks, months or whatever, you get bumped off. And
so the most immediate solution is a model of care
that separates the accuses and electives. That is that one
hospital little More, for example, does the acutes, and counties
(00:44):
Monakal does the elective. Then you don't get bumped off
with what's coming in through the front door. Yep.
Speaker 1 (00:48):
That's good on a major city like Auckland. What about
every other city that doesn't have quite the same facilities
as Auckland does.
Speaker 2 (00:55):
Yeah, so this is part of the models of care
that we're looking to roll out across the country. How
we can separate either physically or functionally acute from electives
so that the electives are not canceled out. There's a
number of things to do here. We need to look
at that workflow into theater, so your theater utilization. Are
we starting on time? Are people turning up with their
(01:16):
consents all done? And then of course making sure we've
got the right people in theater to do these cases.
Six five hundred more cases done to the end of
June twenty four, So that's pleasing, but a lot of
work to do.
Speaker 1 (01:26):
Good do you have the facilities and the people And
isn't that fundamentally what the problem is.
Speaker 2 (01:33):
Yes, it is a couple of things. One of the
pinch points for the last eighteen months has been something
called anesthetic technicians, which are a really specialized group of
people that actually were holding up or not enough of them.
We're holding up some of our ambitions around planning here,
So building up that workforce and then if you say
more beds like tot to the Homo, the new building
with more beds.
Speaker 1 (01:54):
Okay, by the way, a couple of things before I
forget because I haven't interviewed you since there was a problem.
A couple of weekends ago, there was a massive jobs
fair for nurses and the queue was a mile long.
And there's all these unemployed nurses in this country who
have got visas who came into the country, but they
can't be employed. How come we got so many one?
How many? We got so many people coming into the
country on a visa for a career that we're short of,
(02:15):
and yet they don't get jobs. How does that work?
Speaker 2 (02:18):
Yeah? Great question. And in fact from OBAD we asked
for briefings and receive some of them around our immigration settings,
because if we just don't have places for these iqns,
these international qualified nurses, then we shouldn't be offering them
pathways through what's now in Oski into New Zealand. Furthermore,
the risk we run is that we're then unable to
(02:39):
take on our own domestically trained graduates. You know, part
of the issue We've got here now, so have got
that piece of worker looking at the immigration leaders, looking
at the nursing Council leaders, because I think we need
to be honest with some of these nurses. There is
a place or there is not a place.
Speaker 1 (02:52):
Yeah, exactly good. Then the next question is this emergency
stuff that's bumping electives off? Is it an emergency because
they didn't go the GP in the first place, because
they can't get to a GP things have got bad,
then they're an emergency or are we just getting sicker?
Speaker 2 (03:08):
It's a combination of both or to the first point, though,
I have seen some papers suggesting that it's not always
that everyone turning up at ED are people who could
be seen in primary care because to your second point,
people are presenting much more ill than they previously would.
So it is a combination of the b both. There
are some who do turn up at ED who could
(03:29):
be seen in primary care, and in places where we
have a primary care facility alongside the ED, they go there.
But it's not quite the answer that people would think, Ah,
just turn on more primary care and that'll solve our
ED turn ups. Some of them are turning up so
ill just the nature of being an older population getting
more ill that actually they were unsuitable for primary care
as well.
Speaker 1 (03:47):
Is it just age or are we not looking after ourselves?
We're eating too much crap. We're too fat and we're
ending up ill and that's going to burden us for
years to come.
Speaker 2 (03:56):
Combination of things, because if we look at all around
the world that aging population. As you get older, regardless
of the perfect lifestyle, age will be for you and
so you will be more susceptible to getting ill. Your
immune system naturally runs down. You'll become more susceptible to
getting ill and that is more likely to place you
in hospital. Undoubtedly, the lifestyle choices that we make can
(04:19):
enhance that can further run down your immune system, but
age will do that regardless.
Speaker 1 (04:24):
Okay, Lester Levy, do you have a sense of how
he's going.
Speaker 2 (04:28):
Yeah, making good progress. This is a hard job. Just
remember this is the biggest organization in New Zealand and
as we've lifted back the covers has been financial surprises,
as you'll be aware of. And he's making really good progress.
We've appointed the four regional deputy chief executives, so passing
those decisions making out of Wellington back into the regions
they will been appointed. Most of them have already started,
(04:50):
so making good progress. This is a long slow haul
to lift this up, fix the holes.
Speaker 1 (04:55):
Okay, given the size of the problem you face and
the money involved, how is it I'm watching the news
last night and we're having a debate about toast and
pregnant women, and how has it got so bad that
toast is a debate.
Speaker 2 (05:08):
I agree with you, these are adult women who can
make choices and a furthermore, toast is an easy comfort
food after having a baby. So, as I expressed, too
healthy is in seriously reconsider your position on This makes
no sense to me.
Speaker 1 (05:23):
Good nice to talk to you, Appreciate it, Doctor Shane
Retti Health Interstance. For more from the Mic Asking Breakfast,
listen live to news talks that'd be from six am weekdays,
or follow the podcast on iHeartRadio.
There's Business of Health New figures this morning nearly one
and five elected surgeries have been canceled and that's because
they get bumped due to the acute of emergency patients
and great Indeed, now the Health New Zealand's been investigating
this particular problem at the request of the Minister, and
the Minister is, of course, Sir doctor Shane Ritti, who
is with us. Very good morning to you.
Speaker 2 (00:17):
Good morning, Mike.
Speaker 1 (00:17):
Have you got any answers?
Speaker 2 (00:21):
Look, we've certainly got solutions, but this is a key
issue that twenty percent to are canceled due to acute surgery.
Of course we want that if you're urgent, you do
take a priority, but the consequences if you've been planned
for weeks, months or whatever, you get bumped off. And
so the most immediate solution is a model of care
that separates the accuses and electives. That is that one
hospital little More, for example, does the acutes, and counties
(00:44):
Monakal does the elective. Then you don't get bumped off
with what's coming in through the front door. Yep.
Speaker 1 (00:48):
That's good on a major city like Auckland. What about
every other city that doesn't have quite the same facilities
as Auckland does.
Speaker 2 (00:55):
Yeah, so this is part of the models of care
that we're looking to roll out across the country. How
we can separate either physically or functionally acute from electives
so that the electives are not canceled out. There's a
number of things to do here. We need to look
at that workflow into theater, so your theater utilization. Are
we starting on time? Are people turning up with their
(01:16):
consents all done? And then of course making sure we've
got the right people in theater to do these cases.
Six five hundred more cases done to the end of
June twenty four, So that's pleasing, but a lot of
work to do.
Speaker 1 (01:26):
Good do you have the facilities and the people And
isn't that fundamentally what the problem is.
Speaker 2 (01:33):
Yes, it is a couple of things. One of the
pinch points for the last eighteen months has been something
called anesthetic technicians, which are a really specialized group of
people that actually were holding up or not enough of them.
We're holding up some of our ambitions around planning here,
So building up that workforce and then if you say
more beds like tot to the Homo, the new building
with more beds.
Speaker 1 (01:54):
Okay, by the way, a couple of things before I
forget because I haven't interviewed you since there was a problem.
A couple of weekends ago, there was a massive jobs
fair for nurses and the queue was a mile long.
And there's all these unemployed nurses in this country who
have got visas who came into the country, but they
can't be employed. How come we got so many one?
How many? We got so many people coming into the
country on a visa for a career that we're short of,
(02:15):
and yet they don't get jobs. How does that work?
Speaker 2 (02:18):
Yeah? Great question. And in fact from OBAD we asked
for briefings and receive some of them around our immigration settings,
because if we just don't have places for these iqns,
these international qualified nurses, then we shouldn't be offering them
pathways through what's now in Oski into New Zealand. Furthermore,
the risk we run is that we're then unable to
(02:39):
take on our own domestically trained graduates. You know, part
of the issue We've got here now, so have got
that piece of worker looking at the immigration leaders, looking
at the nursing Council leaders, because I think we need
to be honest with some of these nurses. There is
a place or there is not a place.
Speaker 1 (02:52):
Yeah, exactly good. Then the next question is this emergency
stuff that's bumping electives off? Is it an emergency because
they didn't go the GP in the first place, because
they can't get to a GP things have got bad,
then they're an emergency or are we just getting sicker?
Speaker 2 (03:08):
It's a combination of both or to the first point, though,
I have seen some papers suggesting that it's not always
that everyone turning up at ED are people who could
be seen in primary care because to your second point,
people are presenting much more ill than they previously would.
So it is a combination of the b both. There
are some who do turn up at ED who could
(03:29):
be seen in primary care, and in places where we
have a primary care facility alongside the ED, they go there.
But it's not quite the answer that people would think, Ah,
just turn on more primary care and that'll solve our
ED turn ups. Some of them are turning up so
ill just the nature of being an older population getting
more ill that actually they were unsuitable for primary care
as well.
Speaker 1 (03:47):
Is it just age or are we not looking after ourselves?
We're eating too much crap. We're too fat and we're
ending up ill and that's going to burden us for
years to come.
Speaker 2 (03:56):
Combination of things, because if we look at all around
the world that aging population. As you get older, regardless
of the perfect lifestyle, age will be for you and
so you will be more susceptible to getting ill. Your
immune system naturally runs down. You'll become more susceptible to
getting ill and that is more likely to place you
in hospital. Undoubtedly, the lifestyle choices that we make can
(04:19):
enhance that can further run down your immune system, but
age will do that regardless.
Speaker 1 (04:24):
Okay, Lester Levy, do you have a sense of how
he's going.
Speaker 2 (04:28):
Yeah, making good progress. This is a hard job. Just
remember this is the biggest organization in New Zealand and
as we've lifted back the covers has been financial surprises,
as you'll be aware of. And he's making really good progress.
We've appointed the four regional deputy chief executives, so passing
those decisions making out of Wellington back into the regions
they will been appointed. Most of them have already started,
(04:50):
so making good progress. This is a long slow haul
to lift this up, fix the holes.
Speaker 1 (04:55):
Okay, given the size of the problem you face and
the money involved, how is it I'm watching the news
last night and we're having a debate about toast and
pregnant women, and how has it got so bad that
toast is a debate.
Speaker 2 (05:08):
I agree with you, these are adult women who can
make choices and a furthermore, toast is an easy comfort
food after having a baby. So, as I expressed, too
healthy is in seriously reconsider your position on This makes
no sense to me.
Speaker 1 (05:23):
Good nice to talk to you, Appreciate it, Doctor Shane
Retti Health Interstance. For more from the Mic Asking Breakfast,
listen live to news talks that'd be from six am weekdays,
or follow the podcast on iHeartRadio.
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