Heather Roy's Diary

A Healthy Alternative To Public Health.

While there is a great many people who complain about the public health system's inability to deliver, there are few people who do anything about it.

One exception to the rule is Christchurch Public Hospital Associate Professor of General Surgery Philip Bagshaw - who, while having an impressive record of contributions to medicine within the State Sector, has gained fame for his philanthropy.

Born and medically trained in the UK, Professor Bagshaw has been in New Zealand for more than 25 years, having arrived and begun performing fibre optic surgery in the early 1980s. Fibre optic surgery is now a routine procedure but, at that time, was the new frontier as surgeons used the new technology of 'fibre-optics' to conduct operations using flexible telescopes.

This meant surgeons could gain access to the diseased organ - such as a gall-bladder - without having to cut through a lot of healthy tissue. As a result, patients recovered more quickly and turnover in surgical wards was dramatically increased - various Health Ministers claimed the increased output vindicated their health reforms but the real story was that physicists discovered fibre optics, engineers used the concept to make useful surgical tools and surgeons painstakingly perfected the techniques. Surgeons also had to fight running battles with management along the way, with Professor Bagshaw fighting more than most.

Recently, however, Professor Bagshaw was nationally recognised when 'North & South' magazine named him 2007's New Zealander of the year for his philanthropy -particularly his contribution to providing free healthcare for those on whom public health had given up.

It is difficult for doctors to see people disabled by readily treatable conditions. As public hospitals have had to bunker down, a higher proportion of patients are acutely ill and require priority treatment. People with moderately severe conditions struggle to be seen, and some once common procedures - ie inguinal hernia repairs and varicose veins - are now almost never seen in public hospitals. This is a double difficulty: patients go untreated and trainee doctors never see operations that are the 'bread and butter' of their profession.

To try to fill the glaring gaps in the public system Professor Bagshaw created his own charity hospital and, realising the danger, has decided against lobbying Government for funding and would turn it down if offered - Government money always comes with strings attached. While describing himself as a socialist, Professor Bagshaw's system uses no compulsion - a surgeon and an anaesthetist simply declare their availability, and GPs can book their patients online. This system has the added advantage that the patient has a definite date instead of being told they're on the waiting list.

Such voluntary donations of time and money could only be described as 'philanthropy' or 'charity' in the Christian sense - Professor Bagshaw could use his formidable skills to develop a lucrative private practice, but has chosen instead to meet gaps in the system. Meanwhile, the public system likes compulsion and a public monopoly - and isn't much worried by waste as long as nobody is making a profit.

I had the pleasure of visiting the Canterbury Charity Hospital in Christchurch this week. The hospital performs surgery that is now very difficult to get in the public health system - including hernia repairs and varicose vein stripping - and, thanks to a recent donation of new equipment, is about to start performing cataract operations. Patients are referred by their GPs, must not have health insurance and must be unable to afford the surgery themselves.

The Charity Hospital is still building up to capacity. At present, an average week sees approximately two half-days of surgery - two surgical lists. Eventually, the Trust that runs the hospital would like to perform 700 operations a year and provide around 700 consultations a year - the equivalent of the First Specialist Assessment in the public system.

Currently, there are two types of patients who have quality access to healthcare in New Zealand: the very sick who can't wait for treatment - heart attacks, car accidents, etc - and those who can afford to pay for their own treatment or who have health insurance. Everyone else gets to queue for care in the 'no man's land' of the health system. While some get lucky after a long wait, others are dumped from hospital waiting lists and sent back to their GPs.

What is ignored by health officials is the fact that prompt treatment saves money and improves quality of life further down the line. No economic calculation is ever considered - for example: a hernia often means a person cannot work and they end up on a Sickness Benefit because they've been denied a $7,090 Hernia operation they can't afford.

Professor Bagshaw and a small group of fellow altruists felt this was intolerable and joined forces to establish the Canterbury Charity Hospital Trust. Money was raised to buy an old Christchurch villa, which had to be renovated and a surgical theatre built; equipment has been donated by professional and community groups; some large donations have been received, as well as many much smaller but given in the same spirit; people have donated time and services to get the buildings into shape.

The Trust has just one paid employee; everyone else - the surgeons, anaesthetists and nurses, the cleaners and cooks - donate their time and services. The local community is right behind this enterprise - it recognises the need, has risen to the challenge of playing its part, and is all the stronger as a result.

People have said to me that it's terrible that there is now a charity hospital - the implication being that the Government should provide for all the health needs of the population. This will never be the case, and nor should it be. A thriving civil society is made up of most people taking responsibility for themselves and then, with the physical and financial wealth that provides, assisting in taking care of the vulnerable. That's what Professor Bagshaw has demonstrated. I don't consider him a socialist - I think he's a good Kiwi bloke.

Lest We Forget

On March 31 1903, Timaru farmer and inventor Richard Pearse became the first man to engage in powered flight - some nine months prior to Orville and Wilbur Wright.

Pearse flew around 350 yards before crashing into a hedge but, as he later admitted, the flight was at a low speed and altitude and poorly controlled. The Wright brothers are credited with the first controlled flight, robbing Pearse of the international fame he deserved.