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Heart patients worse off in Northland than Auckland – specialist
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- Northland heart patients and doctors say it is harder to get specialist care there.
- Health NZ says there’s no difference in “threshold” for care between Northland and Auckland.
- Recruitment is underway for a sixth specialist.
- The Heart Foundation says there’s a lack of specialist services in some regions, leading to worse outcomes for patients.
Heart patients in Northland have to be much sicker to even get a specialist appointment than if they lived in Auckland, which is where they get referred for surgery if they need it.
That claim (by the region’s cardiologists) appears to be backed up by Health NZ data, which shows huge variations in wait times between regions.
Hokianga farmer Tokowhati Piripi lives with a ticking time bomb in his chest – an aortic aneurysm (a bulge in the wall of the main artery going to his heart), high blood pressure and an irregular heartbeat.
The 69-year-old was waitlisted for surgery in November as “routine priority”.
“I started to run out of wind going up hills about two-and-a-half years ago. It’s alright, as long as I don’t try to walk up hills or do things,” he said.
His wife, Teina, said they have been told the current wait time for non-urgent operations is about nine months – “up to three times longer than it should be”.
“We’re really worried that he could just cark it. He won’t be able to see his mokopuna.”
The aneurysm could rupture at any time and then he will need emergency surgery in Auckland, probably transported by helicopter – as long as there is one available at the time.
“So that’s the other way you get in front of the surgeon too,” Teina Piripi said bleakly.
She knows her husband faces “a triple whammy of health inequities”: he is Māori, male and he lives in a rural area.
“Our acute services, the care you get here, is not the same.
“He has a higher risk of actually dying than if he keeled over in Auckland.”
According to Health NZ data, seen by RNZ, 116 Northland patients (just under 17 percent) were waiting more than the target three months for a first specialist appointment in March.
In Auckland, 120 patients – or about one in 10 – had waited too long.
About 17 percent of Northland patients are waiting more than three months for a first specialist appointment. Photo: 123RF
In Auckland, 120 patients – or about one in 10 – had waited too long.
Northland’s head of cardiology service, Marcus Lee, said by the time he sees patients, they are sicker than they would be if they lived in Auckland.
The first barrier to get a specialist appointment was getting a referral from a GP, and some Northland people struggle to get a GP.
“Secondly, the barriers to get a specialist review is much higher because we don’t have the resources, the thresholds are much higher.
“And if we see someone who doesn’t meet the threshold, we are depriving someone else of care.
“So it’s just this constant juggling of who you can see within the right time frame.”
Auckland City had more than 20 cardiologists for a population of half a million, while Northland has just five to serve 200,000 people, he said.
Health NZ was recruiting for another cardiologist for Northland, but he estimated they really needed eight or 10 specialists to get the same access as in Auckland.
His team has worked hard to clear the backlog of patients waiting for first appointments – but that meant pushing back some patients with “known severe cardiac disease”.
“So you live with that right – sometimes you think ‘Have I made the right call?’.
“And it’s quite hard because you know GPs are under significant pressure, and they’re working long hours too.”
Northland has no after-hours or weekend cardiology service, so general physicians pick up those patients.
Health NZ says patients and their whānau are supported to travel to Auckland for specialist care. Photo: 123rf.com
Anne Wetere, 62, is also waiting for a heart procedure.
Three years ago, she collapsed at work the day after completing a half marathon.
“I said to them, ‘I think i’m just dehydrated and I’ll be fine’. But then five weeks later, I went into ED and they picked it up.”
She has had to go to Whangārei Hospital’s emergency department 14 times with atrial fibrillation, when her heart suddenly starts racing at over 160 beats a minute.
“I wait and if it doesn’t go back to normal, I have to go in.
“When I have an attack, it takes a whole day [to recover] and I have to take time off work as well, because I still work full-time.”
She had a specialist appointment last August and was put on the waiting list to be assessed by a surgeon, which finally happened in March.
However, she has been told it could be eight to 10 months before she gets the procedure to fix it: cardiac ablation.
Meanwhile, she has had to give up competitive waka ama and other activities.
“I just worry I might go into atrial fibrillation while I’m out on the water or away on trips.”
rnz
The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.
On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.
Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.
In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.
“Now that the election results have confirmed an increase to the number of members we are looking at several options.
“We are confident we will be able to accommodate all members within the Chamber.”
VNP / Phil Smith
Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.
That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.
“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.
Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.
Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.
The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.
Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.
Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.
“It could do so to allow former members to address the House.”
Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.
rnz
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