Dunedin to retain neurosurgery


The expert neurosurgical panel has recommended that Dunedin retains neurosurgery services.

In a further boost for the south, and the Otago Medical School, it also recommends that Dunedin becomes the academic centre for neurosurgery for the whole country.

The acting director-general of health, Andrew Bridgman, has accepted the panel’s report, he announced at a media conference in Wellington held late this morning.

The panel recommended a minimum of three neurosurgeons should be based in Dunedin, and that the South Island wide service should comprise eight neurosurgeons once fully established.

Of Canterbury’s bid for all of the South Island’s neurosurgeons to be based at Christchurch Hospital, the panel said the DHB “grossly underestimated” the number of emergency cases which could strain the hospital’s facilities.

The University of Otago is a key part of the proposed service, establishing an “academic neurosurgical centre of excellence” integrating research and teaching with clinical services at Dunedin Hospital.

The proposed service would allow the development of sub-specialisation, private sector work, the development of spinal neurosurgery and outreach to other hospitals in the South Island.

The panel suggests an independent governance board be established to oversee the South Island neurosurgery service to be chaired by Melbourne’s Professor Andrew Kaye, an internationally recognised neurosurgery expert.

Mr Bridgman says:

 . . .he was satisfied from the Panel’s report that consolidating neurosurgery on Christchurch was not the best solution either clinically or financially. “The Panel is clear that the impact on patient outcomes combined with the developments in neurosurgery and the ageing population, mean consolidating in Christchurch is not the right decision,” he said.

“Nor is the idea of retaining two neurosurgeons in Dunedin – that is not a sustainable service.”

Mr Bridgman said the Panel’s recommendation to establish academic neurosurgery in Dunedin and to work with orthopaedic surgeons in the region to extend the amount of neurosurgeon involvement in spinal surgery, fundamentally changed the nature of the service.

“We can now establish the whole South Island service as a leading and growing service, one which will be attractive to neurosurgeons to work in and which offers training and career opportunities,” he said. “The service can develop sub-specialities and still retain the reach it needs to be accessible for acute patients.

“This is an outstanding solution for South Island people.”

Canterbury people may be less  enthusiastic about this outcome than those of us on the right side of the Waitaki river but this is great news for the whole South Island.

The southern region will get the services it needs without putting pressure on Christchurch Hospital and it gives more security to the medical school.

The south has lost services in the past, for example paediatric oncology, for clinical reasons. But there were sound clinical grounds for retaining neurosurgical services at Dunedin Hospital which the panel has recognised.

The report is here.

Bad reporting but good idea


Student bond idea `has merit’

By DAN SILKSTONE – The Press | Tuesday, 27 May 2008


National Party leader John Key supports forcing medical graduates to remain in New Zealand for a set period as part of student loan arrangements.


Good grief – how did this reporting  get past The Press sub?


The headline sums up the story but nowhere in the article is there anything to back up the first paragraph’s statement that Key supports forcing medical graduates to remain here. And the Herald  makes it quite clear the scheme, if implemented, would be voluntary.


National leader John Key says his party is considering wiping medical students’ loans if they agree to work as GPs in rural areas for three or four years.

“I am very concerned about the number of young graduates that are completing their qualification here in New Zealand and leaving,” Mr Key said this morning.

“We need them in New Zealand, we’ve got a GP shortage that is well acknowledged and we’re not afraid to look at creative ways of maybe encouraging them to stay.”

Mr Key said any scheme would be voluntary.

“There are plenty of doctors who have a student loan – they might owe $90-$100,000. The concept of them working in part of regional or rural New Zealand for three or four years to have their loan written off might be very attractive,” he said.

That’s the kind of model we are considering.”


And the idea has merit. There is nothing wrong with graduates going overseas for further training or work experience, but we have a problem when they feel forced to go away for better pay and then don’t come back.


There is a shortage of GPs, especially in rural areas – every doctor at one medical practice in Oamaru is from overseas. Otago Medical School has started a rural training scheme which bases fifth year students in provincial towns in an attempt to redress the chronic shortage of rural doctors. There are a variety of reasons doctors prefer working in cities, but writing off a portion of a recent graduate’s loan for every year worked may help encourage some to the country.


Hat tip: kiwiblog


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