Heart-unit decision hangs in balance as planners weigh up Chch’s case

Press, 16 August 1978, Page 1

Heart-unit decision hangs in balance as planners weigh up Chch’s case

Health reporter

Should the proposed open heart unit for Christchurch go ahead? 1 his question is now receiving serious examination by the Treasury and medical planners.

Plans for the unit are veil advanced, but strong doubts have arisen about the wisdom of setting it up. It will cost SIM to build and another SIM to run in its first year. At a time when all medical expenditure is under the closest scrutiny, the future of the unit seems uncertain, despite the almost unequivocal support for it from the North Canterbury Hospital Board. Last week, the board asked its architects to reexamine planning for the unit with a view to having the two operating theatres proposed for the top of Princess Margaret Hospital completed by the end of 1980. An urgently needed new theatre block at Christchurch Hospital cannot proceed until relief theatres are provided elsewhere.

The two operating theatres for Princess Margaret Hospital could, therefore, still proceed even if the heart unitp roposal were cancelled. The Dunedin open heart unit cost about $780,000 to run last year, yet, because of a drop in the number of cases, it is only doing one or two operations each week. It has the potential for a maximum of eight operations each week. Because it is running at less than two-thirds of its capacity, the tw r o surgeons are not able to maintain the level of operations essentia] for an effective unit. The 213 cardiac bypass operations done last year by the Wellington cardio-thoracic unit, which had a case load of about four or five operations

each week for open heart surgery, cost §852,000. Last year, 90 heart patients from the North Canterbury Hospital Board area were referred to the Wellington unit for treatment. So far this year only nine patients have been operated on in Wellington. Critics of the proposal to set up an open heart unit in Christchurch believe it would be cheaper, and more effective, to fly patients and some supporting relatives to other centres than to proceed with the Christchurch' unit. The Medical Superin-tendent-in-chief for the 'Torth Canterbury Hospital Board (Dr L. McH. Berry) said last week that the numbers of patients being referred to Wellington for open heart surgery had fallen off considerably,

while those being referred to Auckland had increased To make an open heart unit viable in Christchurch, an annual case load of more than 200 is considered necessary. Figures for the last three years and a half fall well below this level. Up to August 14 this year, 108 patients from the North Canterbury Hospital Board area have been referred to other centres for open heart surgery. These comprise 76 patients to Auckland (Green Lane Hospital), 17 to the Wellington unit, and 15 to Dunedin. Not all patients referred for surgery are actually operated on. In 1975, N.C.H.B. patients receiving open heart operations in other centres numbered 121 (27 to Auckland, 34 to Wellington. and 60 to Dunedin), tn 1976, there were 177 such patients (18 to Auckland, 50 to Wellington, and 109 to Dunedin), and last year there were 172 (70 in Wellington. 63 in Dunedin, and 39 in Auckland). While the question of another open heart unit might become a “political footha’J” during the next few months, the examination by medical planners of the cost and effectiveness of the existing open heart units could spell the end of the Canterbury proposal.