Richard Sullivan: Health NZ Chief Clinical Officer on surgeries not being performed past 4pm

Are early finishes to blame for the surgical backlog? 

Surgeon Chris Wakeman claims that public health professionals won’t perform surgeries past the 4pm cutoff, causing backlog issues.  

Health NZ’s Chief Clinical Officer Dr Richard Sullivan told Mike Hosking that early finishes do occur. 

The rosters generally run until about 4:30/5pm, and he says that there are very few operations that can be done in less than half an hour.  

He says they’ve been running weekend theatres to try get more people through, but you need quite a big work force to do that consistently. 

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Episode Transcript

Speaker 1 (00:00):
Trying to get to the bottom of the idea and
Health that some of the blockage in the public system
is because they run to a clock. In other words,
if things look like they're going past four o'clock in
the afternoon, a procedures put off for another day. This
is all part of the private sector doing an increasing
number of elective operations. Labor party angsting over it. This week.
Doctor Richard Sullivan is the chief clinical Officer at Health
New Zealand and he's with us Richard morning, Good morning mart.

(00:22):
So just background for you. We're a surgeon on does
public private like most of them. And he said, look,
the problem is four o'clock in the public system and
we don't do it in the private system in simple terms.
Is that true?

Speaker 2 (00:34):
In simple terms? That does occur year. So what we've
managed to do MIC over the last year or two
is get a view across the whole country now about
what we kill court really finishes. And that's what he
was referring to. So when a roster might run through
to say four to eighty or five, are they finishing
you know, within an hour at that time, because that's

(00:55):
lost opportunity A. And so yeah, we measure that. Look,
you know, we know in his particular hospital way, look
at this last night they had about thirteen percent of
their cases that finish with the now of the rosters
finished time. So that's a focus we're trying to improve.
We have had some food and we've had about a

(01:16):
four percent improvement in reducing those their finishes, but clearly
they're still an opportunity to make sure we get more
patient through the door.

Speaker 1 (01:23):
Am Okay. We had the Health minister and also said
this is union based and that's the problem. It's the
union deal rightly, Wrongly, it's the way the unions have
stitched this up. Is that true?

Speaker 2 (01:33):
Yes, So look, we have to align our schedules with
our employment agreements, and so most of our theaters start
around eight in the morning. We bring them to two shifts,
so they start around eight, they go through the midday.
In the afternoon there starts about twelve thirty and goes
through the four point thirty And that's very much in
line with our employment agreements. And so you can kind
of that thirteen percent is when theater finishes to his

(01:56):
point at around about you know, four or thereabouts, rather
than the fourth third. There are not many operations to
be fair, that are the less than half an hour,
So you know that is trying to squeeze it. And
let's say, you know, we know we can do better
for sure, but thirteen percent early finishes in that particular
hospital and some of the other hospitals are as high
as twenty percent.

Speaker 1 (02:17):
So that you're doing operations to date at.

Speaker 2 (02:20):
Night, that's I mean, we did do operations at night.
We do quite a lot.

Speaker 1 (02:25):
So outside of emergency I'm talking about regular scheduled elective operations.
Why are you running theaters twenty four seven?

Speaker 2 (02:32):
Yeah, so we don't run theater's twenty four seven. Part
of that is about our employment agreements. Also part of
that is about looking after our workforce, but we do.
We do run. So even though we have these early finishes,
we do focus on trying to run beyond that time,
you know, paying people extra after our kind of salaries
or fees to do those extra shifts. And we've had

(02:52):
a real focus and to the point of the elective
boost and trying to get more people through. So we've
been running Saturday theaters, Sunday theater, but we don't do
that consistently. So we do that, you know, at times,
but we know we need to gure people.

Speaker 1 (03:06):
To do it if you really wanted to or are
you constrained by the unions and the collective.

Speaker 2 (03:12):
With workforce. He so it's more than just the unions,
So you need quite a big workforce to run full
sad day lists all the time. Now that's not say
that's not someone shouldn't look at, but what you know,
we need to look at the most efficient way of
getting people through our theaters. You know, these metrics are
being super helpful. So we measure you know, what we
call the utilization, So how well we use our youth theaters.

(03:34):
Our benchmarks eighty five percent, we're tracking at eighty one
point three, so we could do better there. We look
at our start and finished times, which is this conversation.
We look at our cancelation rates, which is really important.
You know a number of people who don't get in
that sitting at around two percent in christ set, so
that's a pretty good effort. So we're doing beta, but
no doubt room for improvement.

Speaker 1 (03:55):
Great insight, Richard, and appreciate it very much. Doctor Richard Sullivan,
who is the chief Clinical Officer at Health New Zealand.
I'm depressed because what I was hoping, well, I wasn't hoping.
I wanted to get to the bottom of it, but
I mean, you got your question answered nice and clearly.
What I was hoping he would say is no, none
of that's true. We're working really efficiently, we're doing as
best we possibly can. But he didn't. He basically confirmed

(04:17):
everything that was said on this program, and that is
of its past four o'clock. Don't worry about it, We're going.

Speaker 2 (04:21):
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Speaker 1 (04:26):
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