BATEMANS Bay Hospital has the longest average wait for elective surgery in NSW, with the primary cause a more than 10-month delay on cataract removal and other basic eye surgery.
This week the NSW Opposition released NSW Health data placing Batemans Bay Hospital at the top of the “10 worst performers for surgery”, with an average wait of 240 days in March this year.
At that time, 641 people were awaiting day surgery at the hospital and of those 590 were awaiting ophthalmology.
The average wait for all surgery had increased by 36.8 days on the previous year.
The hospital offers the Eurobodalla’s only eye surgery for public patients and, until the appointment of an ophthalmologist in Pambula in May, was the only public service on the Far South Coast.
The least urgent category of eye patients in March had an expected wait of 10.7 months for cataract removal, intra-ocular lens insertion, and other procedures.
In contrast, 25 women were expected to wait just over a month for gynaecological surgery at Batemans Bay, eight patients were expected to wait just over two-and-a-half months for orthopaedic surgery and 18 were expected to wait about two months for urology surgery.
Batemans Bay Hospital offers only day surgery and any patients requiring overnight admission are referred elsewhere.
Patients on the waiting list for all surgery are categorised according to whether their condition is likely to worsen or if a delay would demand more complex surgery.
According to NSW Health guidelines,
category one patients must have surgery within one month, category two must be seen in 90 days and category three within one year.
Eurobodalla Health Services general manager Lisa Kennedy said Batemans Bay Hospital’s overall performance was “skewed” by the ophthalmology figures, but the hospital was meeting its requirements.
“The figures are influenced by the type of service we provide at Batemans Bay hospital, day surgery, and primarily the ophthalmology figures,” she said.
“What it does is skews the data for Batemans Bay. Batemans Bay has been labeled amongst the worst performers in the state, but if you just looked at the numbers of patients coming through and whether they are being seen in the appropriate amount of time, we are actually achieving that.
“It is not really an indication of poor performance when the majority of the patients being referred are actually category three and referred for 365 days’ wait.
“Urology, orthopaedics and gynaecology are usually category one or two, in terms of their waiting time for elective surgery.
“For opthalmology, generally the patients are a category three. When you have 590 patients waiting a potential 365 days and a much smaller number of patients waiting between 30 and 90 days, your average wait is going to be over 90 days, it is going to be towards the longer end of the year, just through sheer numbers.”
She said orthopaedic surgeon Christoph Ahrens operated one day each month at Batemans Bay and “typically sees five or six patients, as opposed to (ophalmologist) Dr Phil Larkin, who does four lists per month and sees 12 patients each day”.
She said most eye surgery at Batemans Bay was cataract removal and intra-ocular lens surgery.
She said the growth in waiting times between March 2011 and 2012 “would be related to additional referrals”.
“We had a key peak in about March and April last year in terms of the number of referrals coming in for that month. I also understand that Dr Larkin had an extra couple of weeks off this year, which would have resulted in potentially a couple of weeks longer for some of the patients.”
Ms Kennedy said she was comfortable with the waiting periods and did not believe the Eurobodalla required another ophthalmologist.
“If the patient’s condition deteriorates they are able to go back and see Dr Larkin and he can change the category. They can be seen much more quickly. They are categorised as level three because it is anticipated that they are not urgently in need of care, it is anticipated they will need it within the next 12 months.”
She said Dr Larkin has been the “only opthalmologist on the coast for Bega and the Eurobodalla for a very long time”.
“We would be seeing people from the Bega Valley as well and also from potentially north and west of the Eurobodalla,” she said.
“We have added the service at Pambula recently and it will be interesting to see how that affects changeover time.”
Ms Kennedy said the hospital was not permitted to appoint an extra ophthalmologist.
“We have activity targets to meet,” she said. “Our budget is set according to the level of our activity. The higher the activity, the more expensive the cost. We have our activity set according to what we can afford.
“I think we are very lucky, we have some very good surgeons and they work extremely hard. With our ageing population we are going to see a significant number of people continuing to need ophthalmology services, and you do therefore see those big numbers.
As more services become available around the state we may see some changes in demand, which will be helpful.”