Orthopaedic unit ‘unacceptable’

Press, 2 April 1980, Page 6

Orthopaedic unit ‘unacceptable’

'Health reporter

Ths Christchurch Hospital’s : orthopaedic wards have again come under fire. Medical critics say the wards are “unacceptable.” ind the future of orthopaedic surgery there is described

as “grim.”, . Two orthopaedic surgeons have resigning because of their dissatisfaction with the progress made by the North Canterbury Hospital Board in providing better- facilities for orthopaedic ..patients and hospital staff.

In the last two days, the, future of the orthopaedic wards? jias been the subject of two- special meetings. OnO: meeting was held on Monday evening between the medical -superintendent-in-chief of the board (Dr R. A. Fairgray) and representatives of the. orthopaedic depart- / A -second meting last evening discussed the problems :of the orthopaedic wards and potential problems for orthopaedic.patients and staff. It was attended by all the orthopaedic surgeons, the board’s chief executive (Mr R.'l. Parker), and the board’s chairman (Mr T. C. Grigg). No decision was reached on any move to re-' duce problems facing the wards:' '

The centre of the problem is the old Chalmers block which was built 73 years ago. This block houses wards 1 and 3 (orthopaedic male and female wards respectively); No money has been spent on maintenance of the block for more than two years. A proposal to spend .$400,000 to improve the block was axed, and plans to demolish it before the end of the year are going ahead.

Until recently, the Chalmers block was to be demolished in March. This was postponed because wards 7 and 8 had not been renovated to take the orthopaedic patients who would havebeen displaced. Wards 1 and 3 accommodate 80 patients. The wards which will act as.-“holding wards,” wards 7 and 8,: will provide 60 beds : until the new orthopaedic wards are commissioned in abput lOi years.; \ .

A report prepared by Mr A. Panting, an orthopaedic tutor at the hospital, and Dr RACoates, a registrar in the same department, is severly critical of the arrangements -being proposedifor the future of the orthopaedic patients and staff.

The report, which has been submitted to the hospital board, said that even with 80 beds available in-wards 1 and 3, up to 15 patients have to be “scattered” about the hospital because of overcrowding. . The report said the problem will be made worse when only 60 beds will be available in wards 7 and.. 8, neither of which are ready to take orthopaedic patients. Use of wards 7 and 8 must take into consideration the occupancy rates of wards 1 and 3 which are consistently well above 70 per cent. Unless extra beds are provided in wards 7 and 8 to bring the total near to 80, then waiting list surgery will - have to be discontinued. Present restraints' on health expenditure almost rule, out the possibility of building a temporary ward. The report said the public is getting a "raw deal” in the orthopaedic facilities being provided and planned.

Based on past plannjng delays, the report was not confident that the new orthopaedic wards in the $lOO million Stage 111 of Christchurch Hospital’s redevelopment plan would be ready before 1990. The inclusion this year of a new academic, programme in orthopaedics further complicated the problem as a reduction in bed numbers would severely intrude on medical teaching requirements.

The orthopaedic surgical waiting list showed 1013 cases. Of this number, 117 had to wait more than two years, 265 cases faced a wait of more than one year but less than two years, and 238 had to wait up to one: year.

If beds were not available at the hospital then many patients would be forced to pay for operations in private hospitals..

' There was also a shortage of time allocated for orthopaedic operations in the operating theatres, which were also due for replacement, the report said. For example, in November last, year, the theatres were used for orthopaedic surgery for almost 100 hours. Of this, 19 hours were for waitinglist surgery. Acute orthopaedic surgery (such as road accident cases) accounted for 37 hours, all bf which was performed after 5.30 p.m. More than 24 hours of surgery was performed between 10.30 p.m. and 8 a.m.

Orthopaedic surgeons were often forced to work at such late hours because' of a shortage of about 22 hours on the normal surgery list in the daytime. Many medical staff came back on duty after such late sessions after a minimum amount of sleep, the report said. An investigation on the use of operating theatres at the hospital is being conducted by the chairman of surgical services (Mr J. W. Ardagh) and the professor, of surgery (Professor W. A. G. Macbeth). The orthopaedic staff of five registrars, six house surgeons, a tutor specialist, and six consultants hoped that some other ward would close and be given over to orthopaedics to supplement the provisions planned for wards 7 and 8.

The staff held little hope of extra finance for a temporary building. However, Mr Grigg said late last evening that the board would negotiate with the Government for "at least a feasibility studv” on a temporary ward for 20 beds to be built near Ward 7. The Chalmers block would not be demolished until this temporary ward was available, Mr Grigg said.