Looming crisis in orthopaedic surgery

Association calls on Government for national approach to avert looming crisis in orthopaedic surgery

The New Zealand Orthopaedic Association is calling for a national taskforce on future orthopaedic surgery, to avert a looming crisis.

President Richard Keddell says the orthopaedic workforce and surgical facilities will not be able to cope with the forecast demand for orthopaedic surgery.

“This means New Zealanders needing joint replacements and other orthopaedic surgery will have to live in pain because they can’t get the surgery they need.”

Mr Keddell says the current approach to planning for future demand for orthopaedic surgery is arbitrary and disconnected.

“Unless key agencies start working together, we will not have the surgical teams or theatres needed to meet rising demand. Agencies have collectively not paid enough attention to the problem, and if we don’t start taking a different approach we will be facing a crisis in the future.”

He says the increasing demand for orthopaedic surgery is due to a number of factors, including the ageing population, more joint replacements, and technological advances.

“It’s not just about having enough orthopaedic surgeons – we also need more anaesthetists, nurses and theatres. Teams take time to train; theatres take time to build.”

The Association is calling on the Government to convene a taskforce to take a national view on the future planning of orthopaedic services.

“Key players like the Ministry of Health, ACC, Health Workforce New Zealand, district health boards and speciality services need to work together, and with the Association, to plan for future demand.”

Mr Keddell says there are a number of options that could be considered to help cope with the increasing demand for orthopaedic surgery.

“We need to start exploring things like having longer operating hours, with better use of resources; as well as using more of the capacity available in private hospitals.

“People unable to access joint replacements in a timely way can be denied an active, healthy life where they are able to continue to work, contribute to the economy and participate in their communities. Not to mention some having to spend months and sometimes years in debilitating pain while they wait for surgery.”

Facts and figures

• The number of hip and knee replacements is predicted to double by 2026, based on previous increases and future trends around the world.

• We are currently training between 9 and 12 orthopaedic surgeons per year, but recent workforce planning suggests that the expansion of joint replacement surgery alone is likely to require up to 25 additional orthopaedic surgeons per year in New Zealand by 2026.

• Surgical training requires six or seven years of time investment after graduation from medical school, so must be planned for well in advance.

• Data from the Ministry of Health shows that orthopaedics is the worst among the surgical specialities when it comes to access to elective clinics.

• There are about 8700 primary knee and hip replacements done in public hospitals each year.

• 73% of all hip and 77% of knee replacements were performed on patients aged over 60 years of age.

• The overall decline rate for elective orthopaedic surgery such as hip and joint replacements is 16 percent across all DHBs.

The New Zealand Orthopaedic Association is the professional body representing orthopaedic surgeons in New Zealand with the aim of advancing the quality of orthopaedic practice through training and ongoing education of orthopaedic surgeons to the benefit of their patients.

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