A Curtin University COVID expert believes the decision to scale down elective surgery from next month is premature and unhelpful.
The State Government has banned the booking of non-urgent multi-day category 2 and 3 elective surgeries from March 14 at all public hospitals, and from March 21 at some larger private hospitals.
It had previously set next Monday, February 28 as the cut-off date for new bookings, to coincide with the expected Omicron peak, but Health Minister Amber-Jade Sanderson announced last week that the date had been pushed back because the increase had been slower than expected.
“This is an agile and planned approach to elective surgery and will ensure some patients who have been waiting for surgery can be treated,” she said.
The halt on surgery bookings is expected to be for six to eight weeks, and there is no change to category 1 bookings.
Ms Sanderson said the surgery schedule would be reviewed ahead of the start of the temporary pause to some surgeries, based on Omicron case numbers and advice from the Chief Health Officer.
Surgery halt masking real problem
But Professor Jaya Dantas from Curtin University’s School of Population Health told Medical Forum the hold on elective surgery was masking the fragility of the health and mental health systems, the aged care system and Indigenous health.
“These are systemic issues and were problematic before COVID, for example in our hospital system there has been a chronic underinvestment for some time, so after COVID we need to have a proper review of why this has happened and ask the hard questions.
“And personally, I don’t think you should start shifting back elective surgery, because for things like cataract surgery, you’re talking about elderly people and they need those operations done.
“The same could be said for people who have been on waiting lists for hip and knee operations.
“If the (COVID) numbers in hospital are going to be around 400, then they should assign one or two hospitals – maybe Royal Perth Hospital and one like Armadale — to take the cases.
I’m not a doctor but I don’t think they should be avoiding elective surgery, and they should have been more strategic rather than just saying they’re stopping it.”
With new COVID restrictions starting this week, including the 2sqm density rule across retail and hospitality venues, Prof Dantas said the next few weeks would be critical in seeing how the number of cases evolved in WA.
It would have significant implications for hospitals, aged care, schools and universities, and Indigenous communities.
Blanket ban unhelpful
According to Dr Nicole Leeks, WA Chair of the Australian Orthopaedic Association, there needs to be a more sophisticated solution than just a blanket ban approach.
“We expect WA surgeons to prioritise their patients’ needs for surgery, accounting for risk factors and co-morbidities, while having regard for the safety and availability of health care workers and hospital facilities,” Dr Leeks told Medical Forum.
“We recognise that safety of patients and the health workforce is paramount, particularly during the pandemic, however, we do not want to be in the same situation as what we have seen in Victoria where bans on elective surgeries have been inconsistent with other restrictions that have lifted.
Recently, the Victorian government announced a gradual lift on their elective surgery ban, which was implemented early in January. According to data, there are more than 80,800 patients on the waiting list compared to about 65,000 in December 2020 – an increase of more than 15,000.
Dr Leeks said surgeons needed to choose wisely, in conjunction with their patients and anaesthetists, to prioritise operations of great benefit and lower risk at this time. Surgery should be consultant-performed as much as possible, and efforts should be made to use the theatre resource wisely.