Cairns Hospital surgical wait times robbing patients of sight, doctor claims

Ophthalmologist Dr Michael Karpa, who only began working at the hospital in Decber, has this week spoken publicly after becoming increasingly alarmed at the number of Far North Queensland patients presenting with poor vision and dense cataracts due to significant surgical delays.In response, the Cairns and Hinterland Hospital and Health Service (CHHHS), which operates the hospital, has completely rejected the claims, insisting patients do not wait several years and, in fact, receive surgery within the recommended time frames.In highlighting some of the most severe cases, Karpa told Insight he had spoken with Cairns Hospital patients who waited six years for cataract surgery, with deteriorating eyesight eroding their independence and freedom, including the ability to drive.He claimed other Cairns-based eyecare providers told him the average wait time was approximately four years, leading him to estimate that many patients, if not hundreds, could be affected.{{quote-A:R-W:400-I:2-Q:“In the Pacific Islands, these patients often present late so their cataracts are frequently quite dense, and that’s what I’m seeing when I’m working in theater at Cairns Hospital.” -who:Dr Michael Karper, ophthalmologist}}Blaming severe resourcing issues at the hospital, Karpa said the condition of his cataract patients in Cairns was akin to people he had treated in Vanuatu and Fiji as part of work for the Fred Hollows Foundation and Pacific Eye Institute in 2016.“In the Pacific Islands, these patients often present late so their cataracts are frequently quite dense, and that’s what I’m seeing when I’m working in theater at Cairns Hospital. I’ve worked around Australia as well, including Northern Territory, and I’ve never seen this level of vision loss and density of cataracts,” he said.“When the cataract gets to the level of density, it increases the chance of complications during the surgery and it also increases the amount of energy we use to rove the cataract, which has potential consequences for damaging other intraocular structures and can lead to probls many years down the track.”Karpa blames poor resource allocation for the probl. The hospital has two visiting medical officer ophthalmologists, with one of those being Associate Professor Dr Stephen O’Hagan. Karpa is ployed as a locum physician under the O’Hagan’s contract. Their share of the work involves a clinic and theater list every two weeks, equating to one each per month.“The department is under resourced, they do not have enough consultant ophthalmologists there to cope with the throughput of patients,” he said, adding that limited resources also led to minimal oversight of junior doctors.Prior to speaking publicly, Karpa said he and O’Hagan had raised concerns internally with hospital managent, and were told the hospital had funding for unoccupied surgical positions, but not within the ophthalmology department. Karpa said he left the meetings feeling ophthalmology was not a high priority to the hospital, and believed some funding should be redirected to address the claimed resourcing issues.Hospital denies claimsCairns Hospital women’s and perioperative intensive care director Ms Susan Henderson said there were no patients waiting several years for surgery, and claimed, “currently ophthalmology surgery patients are seen within the recommended timeframes for surgery”.She said patients who are referred to see a specialist ophthalmologist outpatient appointment were categorised according their clinical urgency. Category 1 (most urgent) should be seen within 30 days, Category 2 (si-urgent) should be seen within 90 days and Category 3 should be seen within 365 days.“The average waiting time for a Category 3 non-urgent patients is 292 days which is within the recommended time of 365 days for an ophthalmic surgical appointment at CHHHS,” she said.“The Cairns Hospital performed 5,608 ophthalmology consultations in 2018 and this year we are predicting that we will exceed this number.”Henderson said the health service was working through several options to meet service dands for outpatients and elective surgery.“An assessment of ophthalmology services across CHHHS areas planning to align services, identification of infrastructure needs, consideration of clinical services capability and available resources is required before any decision can be made to increase services,” she said.The hospital’s total number of patients ready for care on the ophthalmology outpatient waiting list as of 4 April 2019 is 1,462.