A patient's death at Wairarapa Hospital may have been caused by a "stupid" requirement to transfer her back and forth over Rimutaka Hill after hospital managers restricted operations at Wairarapa.
A Wairarapa Hospital medical specialist told The Dominion Post that the patient was sent over the hill for surgery because of what other staff have called the "needless" restrictions on operations at the Masterton hospital's high-dependency unit.
"She got sent away for what was supposed to be a better treatment and ended up having a different surgery without appreciation of her medical history," said the specialist, who did not want to be named because of employment concerns.
The specialist believed this might have led to a fatal complication - and that the physical stress of being transferred back to Wairarapa within five days of her operation might also have contributed.
The specialist claimed to be speaking out in "desperation" at the way Wairarapa Hospital was being "mismanaged".
Graham Dyer, chief executive of Wairarapa and Hutt Valley DHBs, confirmed the woman's death and said it had been referred to the DHBs' patient safety committee.
He insisted patient safety was not being compromised by recent management changes at the DHBs, and labelled the specialist's concerns as "opinion and accusation and lack of evidence".
The death comes after Wairarapa and Hutt hospitals' chief medical officer, Iwona Stolarek, based at the Hutt site, sent a memo to staff at Wairarapa Hospital in August, advising them that patients who scored high on anaesthetic risk tests should be transferred to Hutt or Wellington hospitals for surgery.
Until then, Wairarapa surgeons and anaesthetists had made that call based on their professional judgment, patient knowledge and standard safety checks.
The woman who died needed surgery, but had a pre-existing condition that made her a high anaesthetic risk, so Wairarapa Hospital had to transfer her.
Medical staff called the memo "needless", "bureaucratic" and "heavy-handed", and said it could hurt the hospital's financial viability and harm patients.
The specialist said the "stupid" memo came as a surprise to Wairarapa staff.
"A memo written in the Hutt, without talking to us . . . about what patients can or can't be operated on in Wairarapa, which we have been operating on safely for years . . . We are not idiots, we know what we're doing."
Hutt Valley and Wairarapa DHBs' senior management teams were merged under Mr Dyer this year as part of their "3DHB" service-sharing, cost-cutting process with Capital & Coast DHB.
Mr Dyer said the restrictions on Wairarapa surgeries were part of a 3DHB critical-care review, and were set by Dr Stolarek after extensive consultation with specialists at all three hospitals.
However, the specialist said critical-care staff at the other hospitals told him they trusted their Wairarapa colleagues' professional decisions, and did not want to interfere.
There was widespread anxiety at Wairarapa Hospital about a seeming "merger" with the Hutt. "That merger has left Masterton far more ignored and disabled than it was before - and [managers] in the Hutt just don't listen."
Documents seen by The Dominion Post indicate concerns expressed by the specialist are shared by at least 16 other medical staff at Wairarapa Hospital.
Mr Dyer said he talked regularly to Wairarapa medical staff and Dr Stolarek visited them weekly. "There is no poor cousin-wealthy cousin relationship there. There is only patient safety concern."
Management changes were still "settling down", he said.
One outcome of the patient safety committee review, expected to be finished within a fortnight, could be the reporting of the death to the Health Quality & Safety Commission.
- © Fairfax NZ News
Do you intentionally buy organic food?Related story: Wellingtonians driving organic food mainstream