Dunedin Neurosurgery: a win for people power

Dunedin not only keeps, but expands its neurosurgery service.

This decision will ensure that the South will continue to have a safe and viable neurosurgery service for decades to come.

I’m really hopeful that this process sets the benchmark in both process and outcome:

Process: This process was (eventually) a model of rational consideration and community involvement. The panel commended the public comment as being “well informed and thoughtful” that “public health providers ignore the community view at their peril”, and that “it is important to have real community involvement in our planning processes”. (recap: 10,000 people marching in Dunedin).

Outcome: The decision is an absolute rejection of centralisation in favour of patient centred integrated regional service. I think it sets a precedent for the provision of health services for our far-flung community and special geography: “a regional, distributed service” is very different to the centralised model we were faced with. This truly South Island solution is, as the Director-General of Health describes, a change in paradigm.

Ministry of Health: press release
Full report (1MB)

News coverage:

Channel9: Neurosurgery to stay in Dunedin
Praise for public support

Following today’s decision, the tributes were flowing to the public support, with some saying without it, Dunedin could well have ended up without neurosurgery.

Neurosurgery services to stay in Dunedin

ODT: Southerners celebrate neurosurgery decision

National Business Review: Dunedin to keep neurosurgery, but in different form

Southland Times: Decision a victory to the people

Southland Times: Neurosurgery plan ‘will save lives’  (incl Anne Kolbe video)

You spoke. They listened.

In a tough battle the united voice of people in Southland and Otago was heard and we’ve not only managed to retain neurological services in Dunedin, we will have an even better service in the future.

Press (borrowing from Southland Times) Southland wins neurosurgery battle

Southland Times editor Fred Tulett, who spearheaded a campaign to keep neurosurgery services in Dunedin, said the decision was “a fantastic result for the South” and showed what ‘people power’ could achieve.

Dunedin Mayor Dave Cull was thrilled with the inquiry’s decision, which he said created a model for other South Island health services going forward.

“It’s testament to people power, and good rational analysis. This decision is not based on the fact that a whole lot of people raised their voices. They have got the right people in, analysed it in the right way, and come up with the right decision.”
Southland Times editor Fred Tulett, who spearheaded a campaign to keep neurosurgery services in Dunedin, said the decision was “a fantastic result for the South” and showed what ‘people power’ could achieve.

“We’ve forced Health Minister Tony Ryall the Ministry of Health to back down on plans to shut down the neurosurgery unit in Dunedin by sheer weight of numbers.

Scoop: South Island neurosurgery service success

“The Expert Panel has listened to the community and clinicians and has come up with a plan that will not only keep neurosurgery services in Dunedin, but revitalise the specialty by boosting academic neurosurgery at Otago University,” says Dunedin-based NZNO industrial adviser Glenda Alexander.

“This is a clear demonstration of people power. When time is critical and lives are at stake, it is great to know that the communities of the South Island will not settle for a below standard service,” Glenda Alexander says.

TVNZ: Neurosurgery services to stay in Dunedin (Pete Sinclair talks with Loreli Mason who has read the report)

Dr Anne Kolbe said there was too much risk to patient safety if Dunedin was taken out of the mix.

Kolbe admitted the more than 2000 public submissions helped swing the decision.  “They raised the issues that caused us to look critically from a clinical perspective at the services involved.”

NZ Herald: South Island neurosurgery reforms announced

“Service changes which knowingly resulted in increased deaths or less favourable patient outcomes would be difficult for the panel to recommend,” it said.

Dunedin Mayor Dave Cull said it was a good decision because it addressed the needs of both Dunedin and Christchurch and more importantly the wider region “without there being any losers”.

“I think we are getting as much as we could need. This is a South Island solution to a South Island problem.”

Samuel Mann, one of the organisers of the Keep Neurosurgery In Dunedin campaign, said crowds cheered when he announced the service would stay outside Dunedin museum today.

It sort of vindicates all the hard work that we did.

“We were quietly confident that the panel would see that the arguments we were putting up weren’t parochial – ‘lets just keep it in Dunedin for the sake of it’.”

The decision would set a precedent for regional services in the long-term, he added.

“The default model now is ‘we can make this work’ rather than ‘hmm let’s centralise all this in Wellington, Christchurch or Auckland’.

“It really has put a very strong line under the need to keep services close to people.”

Pete Hodgson (on NZ Doctor Online).

“The rallying for the retention of Neurosurgery at Dunedin Hospital has gone from strength to strength. Otago and Southland today celebrate a victory, banding together over the past few months to show that the community is a strong united force. This announcement bodes well for the newly merged DHB,” Dunedin North MP Pete Hodgson said.

Scoop: Canterbury DHB reaction

Canterbury District Health Board chief executive, David Meates says, “we are pleased to see a focus on South Island neurosurgery and the commitment to longer term planning and investment which includes Canterbury.

Stuff: Dunedin keeps neurosurgery services

Dunedin has won its battle to retain neurosurgery services after a long-running inquiry.

Timaru Herald: Neuro decision a boost for south

The battle to keep Dunedin-based neurosurgical services may have saved other health services from being lost to the South Island, Waitaki mayor Alex Familton says.
Waitaki MP Jacqui Dean said the people of Otago could now “get on with their lives”.

“It’s been a long five months since the possibility of all six neurosurgeons being based at Christchurch was first mooted but we now have a positive outcome.

Radio NZ: Dunedin, Christchurch to share neurosurgery services

Mr Thomson says he was always confident in the panel. He says it was clear to him that if a competent group of people examined the issues, they would realise the service could not be removed from Dunedin.

ODT Editor Murray Kirkness: compliment to the people of the South Island, we should feel proud.

3 News: Otago, Southland residents stoked neuro staying video

The threat of centralising neurosurgery in Christchurch prompted outrage from Otago and Southland residents.

Now they believe the fight was worth it.

It is eight years since Casey Coombes needed emergency brain surgery at Dunedin Hospital after a serious car accident.

She doesn’t think she would have survived a two hour flight to Christchurch, and is relieved that other patients will also get local treatment.

“Stoked and quite amazed, because thought they were going to take neuro away from Dunedin,” Ms Coombes says.

Chris Ford (via Voxy) Neurosurgery Decision A Great Day For Southerners!

Today the people of Otago and Southland are celebrating the big neurosurgery decision.

People power is what has secured this victory. Nearly 10,000 people marching in Central Dunedin, a 55,000 signature petition and well attended public meetings have all demonstrated the depth of feeling on this issue in my part of the world.

ODT: No news became good news

Prof Samuel Mann, co-founder of the Keep Neurosurgery in Dunedin Facebook campaign, relayed acting Director-general of Health Andrew Bridgman’s decision.

To cheers, claps and visible relief, he announced Dunedin Hospital would be home to a minimum of three neurosurgeons.

Facebook page co-founder and Southern District Health Board member Richard Thomson told the happy crowd he “always believed” that when the expert panel considered the matter and heard the arguments, the decision could only go one way.

ODT: Decision deemed a victory for common sense

Surgeons “overstepped” the mark in advocating a Christchurch-only service, Dunedin Hospital intensive care clinical leader Mike Hunter said yesterday, commenting on the announcement Dunedin will keep neurosurgery.

The decision was a “victory for common sense” that would save people’s lives.

“I am greatly relieved that we will not have to face the unsavoury prospect of seeing acute patients die while we struggle to transport them in a timely manner to Christchurch.”

ODT EditorialDecision demonstrates innovative solutions can be found

It has been gratifying to see the generosity of spirit, the intellectual purpose and the genuine altruism with which the people of Dunedin, Otago and Southland embraced the cause of retaining neurosurgery services in the South.

ODT: ‘Implementation starts today’ – co-operation expected

Acting Director-general of Health Andrew Bridgman says he is not expecting people to be “tossing toys out of the cot” over the radical changes announced yesterday to neurosurgery services in the South.

He does not want to see any time wasted, although it is expected it will take up to two years for the two-site service to be fully working as one service.

“Implementation starts today. That’s the key message.”

ODT: New governance head not fazed by hot seat

ODT: Result made all the effort worthwhile

Pam Adams abandoned her privacy to tell southerners about the emergency neurosurgery that saved son George Clarke’s life – and yesterday, she said the effort was worth it.

Ms Adams went public to get people to talk more about neurosurgery and to understand why the issue of timely care was so important in the debate about sending the service to Christchurch.

When she spoke to panel member David Russell, she told him George would not be the healthy university student he was today if he had had to travel more than another hour for surgery in Christchurch.

“We know that every minute counts – people in rural Southland or places like West Otago are a long way [from Dunedin Hospital] and in a critical position time-wise as it is – so moving neurosurgery to Christchurch had some very real risks.”

ODT: Smiles all round
(slideshow).

Jeremy Elwood (3newz blog). A no brainer.

Even more impressive is the fact that the powers that be actually listened. It’s been too easy in recent times to dismiss the power of protest, as successive governments both here and overseas have paid little more than lip service to petitions and referenda before going ahead and doing what they wanted to anyway…

The idea that having to transport patients an extra 362km to Christchurch without risking further damage or death was, quite frankly, idiotic.

So it is with a sense of uncommon yet very welcome surprise that I would like to congratulate everyone involved with this decision on the sheer level of common sense they have shown.

Protecting jobs and treatment levels, tying the new hospital appointments in with the world renowned Otago School of Medicine, thus strengthening both institutions, and acceding to the well argued wishes of a local populace. In the end, it was a bit of a no-brainer.

TV3: Otago neurosurgery service ‘common sense’

Dunedin is keeping its neurosurgery service; a reversal of a controversial plan to shift it to Christchurch.

Casey Coombes needed emergency brain surgery at Dunedin Hospital after a serious car accident.

She doesn’t think she would have survived a two-hour flight to Christchurch, and is relieved other patients will now also get local treatment.

Radio New Zealand: Neurosurgery decision an ‘innovative’ solution

The decision on neurosurgery in the South Island is innovative and will provide useful lessons as other complex services are reorganised in coming months, a senior doctor believes.

Radio New Zealand: Richard Thomson on Nine to Noon (audio)

Radio New Zealand: Neurosurgery decision a winner for Dunedin (audio), Casey Coombes, Samuel Mann

Radio New Zealand: Otago to keep its neurosurgery services (audio)

There were scenes of jubilation in Dunedin today as the news came through that Otago will not only keep its two neuro-surgeons, it will get at least one more.

Radio New Zealand: More on today’s neurosurgery announcement (audio)

Glenda Alexander, she’s from the Nurses Organisation and helped run the rallies against moving neurological services away from Dunedin.

Timaru Herald Editorial: Consumer Power

The decision, announced yesterday, to retain neurosurgery services in Dunedin, will rightly be seen as primarily the result of a review conducted by an expert panel, appointed to resolve an impasse between southern district health boards over the question of a one-site model for a South Island neurosurgery service.

But it is arguable that the decision had at least as much, if not more, to do with the concerted campaign mounted by thousands of people throughout Otago and Southland to ensure the retention of services in Dunedin.
…
But it’s notable that consumer advocate David Russell was the third panel member. In other words the panel was constituted to take not only the expert medical views, but also the views of affected consumers, into account.

And those views could scarcely have been clearer.
…
While the overwhelming public response on the issue was certainly not the only factor at play in the decision, it certainly must have been a major factor. Had the general public of Otago and Southland simply shrugged their shoulders and carried on with their daily lives when the possibility of a one-site service was on the cards, one can only assume that would have been instructive for the panel, notwithstanding their responsibility to make the most informed decision possible.
…
A concerted public campaign is plainly a powerful thing and the people of Otago and Southland deserve great credit for making their voices heard so powerfully on this issue.

Radio New Zealand: The Panel with Brian Edwards and Michelle Boag (Part 1) (audio) (Neurosurgery at 7:30)

Radio Live: Dunedin’s neurosurgery battle

Maggie Barry talks to SDHB member Richard Thomson, brain injury survivor Casey Coombes & General Surgeon, Otago Medical School and neurosurgery campaigner Dr Mike Hunter.