Though you wouldn’t believe it from the tripe spouted forth in the media, the outcome of the South Island Neurosurgery saga is a triumph of level-headed reason in the face of massive public pressure. It is clear from reading the actual report from the panel entrusted with gathering the facts and making a decision, that the media campaign and protest rally have not made the slightest difference to the final outcome. The report is an excellent, and considered, one that concentrates only on the facts of the situation. It does not contain even a hint of the turf wars that have been rumbling around South Island for 15 years or more, except to mention said wars in passing. It does not dwell on financial imperatives at the expense of clinical ones. It does not engage in populist “rule of rescue” arguments. No matter how much the editor of the Southland Times might like to take credit for the favourable result, it is clear that the outcome had nothing to do with protests or campaigns, only facts.
“Southerners in their tens of thousands turned out, refusing to accept the National Government’s decision… Today’s announcement is a direct result of their protests, petitions and the pressure they placed on the Government,” she said.
“Health Minister Tony Ryall had taken the coward’s way out by refusing to intervene in the issue. Thankfully the people of the Southern regions displayed a lot more backbone than the Minister.”
Conveniently, she overlooks the fact that no decision had been made, by National or anyone else, on Neurosurgery services. Christchurch DHB has been advocating for a single service at least for all the time I have been in this country – some 15 years. Dunedin DHB has been resisting for all that time. Kudos to Tony Ryall for getting them to sit down and sort it out properly using an expert panel. The expert panel was formed in March 2009, well before the latest campaign kicked off in July of this year and long before the rally in September. Had the panel caved into public demands, they would have lost the opportunity to put a cogent argument forward for a third neurosurgeon in Dunedin.
For those who are not familiar with doctors rosters, a third specialist means that each specialist spends only one week in three on call (much more sustainable than one in two) and still only has alternate weeks (instead of continuous call) when one is on leave. It also much reduces the need for locum specialists – and Neurosurgery is a particularly difficult speciality to find locums for.
Thoughtlessly, Dyson accuses Ryall of cowardice. This is a bizarre accusation to make about a politician who has resisted the urge to buckle in to public pressure and simply make a pronouncement about neurosurgery, rather than allow the experts to make the call. Dyson would undoubtably have caved in and dictated to the DHBs in the undemocratic fashion that Labour was so fond of (remember Indiana Cosgrove and the Health Board of Doom?). It is not, nor should it ever be, the Minister of Health’s purview to dictate the clinical composition of a health service. He can say “I want you to concentrate on increasing elective surgery”, but he cannot say “I want you to do more hip replacements instead of coronary bypasses”. He can insist that schools follow a National Standard, but he cannot insist that all schools teach math for four hours a day. To do so would be to usurp professional acumen. It is the primary reason why the Soviet Union failed. It is not a situation that New Zealanders should tolerate.
Newspaper editors have a right to campaign how they like. The Public has a right to protest about whatever they are concerned. But the best way to solve a problem that is entirely clinical in nature is to find experts, with no vested interests, and allow them to make an informed decision. Populism is usually a disaster in medicine. The decision to house Neurosurgical services in Christchurch and Dunedin is not a victory of populism, but a victory for sound, clinical reasoning.