Chch heart unit plan Illogical’

Press, 14 July 1978, Page 1

Chch heart unit plan Illogical’

Plans for a S2M open heart surgery unit in Christchurch should be abandoned, according to a visiting Boston Medical School health planner. New Zealand’s economy and its need for effective health planning made such a unit “illogical and without foresight,” Professor John McKinlay told "The Press.”

Professor McKinlay, who is working as a consultant to the Health Department, said that steps to set up the Christchurch unit were not sound economic planning.

However he emphasised that he had made his comments as a visiting professor of community health at the Wellington Clinical School, “and not as a consultant to the Department of Health.”

The Waikato Hospital Board’s application for a cardiac unit was deferred yesterday, and the Minister of Health (Mr Gill) said the Christchurch proposal — "which is at an advanced stage of planning” — was one of the factors influencing that decision, reported the Press Association from Wellington. Evidence of reductions in waiting lists for cardiac surgery and a change of approach by the medical profession to the treatment

of coronary-artery disease had led to the decision,” he said. “In view of the facts presented to me by the Hospitals’ Advisory Council, I have come to the conclusion that it would be inappropriate to allow development of a cardiac unit at Waikato at this stage,” said Mr Gill.

He was prepared to have the Waikato proposal considered again in the future if it could be shown that national statistics and evolving medical opinion supported the need for a unit there.

Professor McKinlay believes that the Treasury has questioned the need for the Christchurch unit because of the cost and its likely effectiveness. To take steps which would further aggravate the financial problems of the nation’s health system was not economically or medically rational, he said.

Effective health planning demanded value for money, and a further open-heart unit would not give that. The Health Department should pay air fares to take patients from the South Island to Dunedin or Wellington. he said. To claim that cardiac by-pass surgery was an emergency operation was unrealistic. “Only 1 per

cent of all medical care can be regarded as emergency.” Speaking of the costs of performing open-heart surgery in Christchurch, as calculated by a former Wellington heart surgeon, Mr Hedley Brown, Professor McKinlay said these figure were “way, way out.”

Fifth-year medical students at the Wellington Medical School had calculated the cost of a cardiac bv-~■ ~ operation at §5OOO to $6OOO.

“This is about 400 per cent more than Mr Brown calculated,” Professor McKinlay said.

In one area alone—that of “disposables”—Mr Brown had calculated a cost of $2OO. “The real figure is nearer to $1000,” said Professor McKinlay, who was particularly critical of the "mystique” surrounding open-heart surgery units. Pressure from politicians, professional groups, and the public must be weighed up against costs and medical “good sense.” “The medical profession, who have spent long years in training, want to play with the technological ‘toys.’ The cardiac thoracic unit is one of the best of these toys but the taxpayer will have to play ‘Father Christmas’,” he said.