New Zealand is aiming to deliver 3,500 more cataract surgeries as part of a new nationally consistent threshold that removes “the postcode lottery” that has denied some New Zealanders access to this life-changing procedure, the government has announced.
In the recent budget Minister of Health Dr Ayesha Verrall said $118 million was allocated to reduce wait lists and standardise access to healthcare, including cataract surgery.
“Ophthalmologists and patients across the country have been calling for consistency around life-improving cataract surgery and the revised threshold I’m announcing today responds to that,” she said.
“For decades the former DHBs used a point system that had wildly differing thresholds for access to cataract surgery – largely varying from 46 to 61 points. A score of 46 represents mildly reduced vision. A score of 61 represents poor vision and meant that the person could no longer legally drive.”
In Auckland and Waitematā, for example, patients become eligible for cataract surgery with a score of 46. But in Canterbury and Southern, people needed a score of 61.
That variation represented the worst of what’s become widely known as ‘post code’ health, Verrall said.
“In a first under the new health system there will be a nationally consistent score of a maximum of 46 in order to access surgery, opening up eligibility for approximately 3,500 more surgeries,” she said.
“A score of 46 means patients with mildly reduced vision as a result of cataracts will have much earlier access to surgery, improving their quality of life considerably.”
Te Whatu Ora’s Hospital and Specialist team will work with referrers to identify who will be eligible for surgery under the new score and ensure they have timely access to the procedure.
“Today’s announcement is a first in what we can expect to see across elective surgeries from now on; a joined-up health system working towards timely consistent access to healthcare regardless of where you live,” Verrall said.
“We will now be able to use and build on this revised cataract surgery threshold as a model to improve other waitlists into the future.”
Although the news was widely welcomed, ophthalmologists have raised concerns about whether public hospitals would be able to cope with increased demand.
To cater for the new demand, the government is implementing initiatives such as outsourcing to other providers and ophthalmologists, as well as improving productivity through innovative models of care, and improving theatre efficiency.
“Hospitals will probably need to allocate some resources just to cataracts, which in a stretched service might reduce access to other types of eye surgery,” Dr Jesse Gale told Radio NZ on behalf of RANZCO.
He said the plan to outsource some operations to private ophthalmologists could be effective as long as the price was right. But he wasn’t sure how the government was going to improve productivity when all public hospitals were working hard to be as efficient as possible.
More reading
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