Call to measure unmet health need

19:20, Nov 22 2013
Linda Dorris
EXCRUCIATING PAIN: Linda Dorris needs knee surgery but the Canterbury District Health Board has removed her from the waiting list.

Unmet need has become "the elephant in the room" and Canterbury's health sector is calling for the Government to start measuring it.

An article in this month's edition of the New Zealand Medical Journal labels the nation's "substantial, undocumented unmet healthcare needs" as alarmingly high.

The article, co-authored by 10 health experts, calls for a "systematic, objective documentation of unmet healthcare needs throughout New Zealand".

Unmet need has been in the spotlight recently, with The Press last week reporting that the Government was distorting elective surgery waiting lists to conceal thousands of patients who would benefit from an operation, but do not qualify for the public system.

Government figures show more elective surgeries are being done than ever before and Health Minister Tony Ryall said this would be addressing unmet need, yet surgeons claim the increase is not coming close to matching the demand.

Dr Phil Bagshaw, one of the authors of the NZMJ article, said it was time to resolve this debate.


"There is no question that the public system is doing more surgeries, but the question is how big is the unmet need?" he said.

"There are a lot of arguments going on about this and I think it's time to resolve them . . . It's time that it was measured properly."

New Zealand needs an independent, scientifically robust system to do so, he said.

Christchurch Hospital intensive care specialist Dr Geoff Shaw agreed and said unmet need was now "the elephant in the room".

"The Government is avoiding having the public debate on unmet need and because we don't know how bad the problem is, we are not going to be able to address it."

"The Ministry of Health is saying that we are doing fantastic things and that we are doing more surgeries, but at the same time we have surgeons saying we have unmet need. What we have to do is let the people of New Zealand know the truth," he said.

Shaw said unmet need was a "euphemism for suffering".

"We need a suffering index to show the public just how much people are suffering," he said.

The journal article, titled The Canterbury Charity Hospital: An Update and Effects of the Earthquakes, also reviewed the role the CCH played in the region's health sector since the quakes.

The CCH was established in 2004 to address unmet healthcare needs and provide free treatment to patients turned down from the public system.

So far this year, it has completed 1258 procedures. Last year, it completed 1023.

The CCH only has limited services available to those who can be treated as day patients and the number of surgeries it performs represented only a fraction of unmet healthcare in the region, the article said.


Linda Dorris is a "tough old nut" with a dodgy knee.

The 70-year-old has been hobbling around her North Canterbury lifestyle block in "excruciating pain" ever since she was headbutted in the knee by a ram.

When Dorris opened a letter from the Canterbury District Health Board (CDHB) that said she was not in enough pain to qualify for publicly-funded surgery, she uncharacteristically started to cry.

‘I couldn't believe it and I actually sat outside on the chair and I cried, but don't worry, I didn't let anyone see me," she said.

Last August, the ram broke her ankle and damaged the soft tissue in her knee.

She underwent physiotherapy and when the pain became unbearable, her GP sent her to the public system.

Dorris went through a physio assessment in March and waited until August to see an orthopaedic surgeon, who gave her an injection to temporarily relieve the pressure in her knee and told her she needed an operation.

She received a preparation for surgery letter from the CDHB on August 26.

A month later she opened another letter from the CDHB that read: "We regret that we are not able to offer you this procedure".

She was referred back to her GP and has since returned to her orthopaedic surgeon, who told her she is now classified as "urgent".

The pain wakes Dorris every night.

The Press