The Wait For Surgery, How Long is Too Long?

The Wait For Surgery
Waiting for surgery in New Zealand is becoming more common. Last year despite 350,000 operations being carried out there were still 280,000 people that couldn’t get the surgery they needed. Worryingly 170,000 of them didn’t even make it onto the health service waiting list.
350,000 elective (non-emergency) operations were carried out in New Zealand last year, but only about half of them were done on the health service. The other half were carried out privately, generally through health insurance. The main difference between these two treatment alternatives was the waiting time and how long the patient had to sit around in pain and discomfort. The Health Funds Association of New Zealand (HFANZ) and The New Zealand Private Surgical Hospitals Associations Inc (NZPSHA) commissioned a study to look at these numbers and what they found could be thought of by many to be worrying. At any one time there are around 110,000 people on the waiting list and a further 170,000 who have been put forward for treatment by their Dr and specialist but aren’t deemed unwell enough by the DHB to go onto the waiting list. That’s over 6% of the New Zealand population that are need of an operation at any one time so it’s no wonder there is a waiting list. It is the amount of time on the waiting list that is important though. The average time for those waiting for surgery has increased 80 days to 304 days, or if you prefer 10 months. That means for every person accepted in a week there is someone waiting 20 months. Once on the surgery list the average time for those getting treatment has increased 30 days to 144 days. It is only fair to point out that the 144 day average includes private treatment and as the private waitlist averages 44 days the public average is going to be much greater than the reported144 days.

How Does This Impact Patients?

Let’s take “Sarah” a 28 year old woman working a good job with prospects, she is about to have an ‘average’ New Zealand experience for elective surgery. It’s Christmas 2014 and she begins to get pelvic pain and goes to her GP straight away. The GP decides to refer her to a specialist, and in May she finally meets her. The specialist believes it may be endometriosis and refers her for a laparoscopy. Unfortunately, although her GP and Specialist both believe she needs the operation the District Health Board doesn’t rate her as a high priority. It takes a further 10 months before she is considered unwell enough to be put on the waiting list. In the 14 months of waiting the pain and discomfort has increased and her performance at work has slipped, she has used all her sick days so is turning up for work but not able to focus and management have noticed a drop in her productivity and her career prospects are drying up. Her social and personal life is also beginning to suffer. In March 2016 she is happy to hear she is on the surgery list and will be going ‘under the knife’ in five months. August can’t roll round soon enough and on the day fortunately the surgeon is not unwell and there are no emergencies so the surgery goes ahead. In September after recovering a 30 year old Sarah returns to work … almost 2 years after she first complained. She is now pain free and grateful that she can resume her career and get her personal life back on track but she is aware that the endometriosis may return and she will have to do this all again.

Would Health Insurance Make A Difference?

If Sarah had health insurance, things would have been very different. When the GP had made the referral Sarah would have seen the specialist within a few weeks. After the initial consultation a laparoscopy would have been scheduled, very likely within 6 weeks. Treatment would have taken place in a private hospital with Sarah getting a room to herself to aid her recovery. The whole process taking 2 months or less rather than almost 2 years on the health service. The detrimental effect on Sarah’s personal and work life wouldn’t have been nearly as bad. This is just one example but it would be the same for her husband hernia operation, her father’s new knee, her mother’s hip, her uncle’s heart bypass or her sister’s wisdom tooth extraction the time from diagnosis to treatment would be much shorter in the private system. Many private health insurers will actually take a patient to Australia to get an operation if the waiting list is over 6 months.

The Hidden Costs Of Waiting.

As I alluded to earlier it’s not just getting the operation done quickly that matters. Waiting for an operation can have a huge impact on the patient’s family life and employment. When we look at the 270,000 waiting for an operation 1 in 3, or 90,000 people, have had to make significant changes to their life. This could be anything from giving up hobbies and recreation to having to stop work. As you can imagine this has a huge impact on quality of life and more than half say this worsened while waiting and 25% say that their mobility has been impacted. Absence from work is also a problem, especially as this will impact directly on the patient’s ability to earn. 15% admit that they have had to take time off work because of their issues. 30% needed to receive unpaid care from family members and almost 20% needed state benefits to help them. Waiting lists are a problem and their impacts on the patient and society can be far reaching. Health insurance needn’t be expensive either and there are policies that will fit most budgets. Why not drop me a line and we can talk about what policy might be right for you. Source: “Assessing the demand for Elective Surgery amongst New Zealanders” was conducted by TNS New Zealand in January this year. It involved 1800 people and has a margin of error of 3 percent. The research was funded jointly by Health Funds Association of New Zealand (HFANZ) and New Zealand Private Surgical Hospitals’ Association (NZPSHA).

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