Hospitals told to consider delaying surgery for older and overweight people

Health care investigations, treatment and surgery have always had to be prioritised and limited do to demand outstripping resources, but this will raise a few eyebrows: Hospitals urged to consider putting off some surgery

Hospitals are being told to consider putting off surgery for seriously overweight people and those over 70 unless it is urgent.

A memo from the Ministry of Health to district health boards has outlined how they should manage getting normal services up and running again with the risk of Covid-19 still looming.

It said deferring treatment should be considered for people over 70, those with a body mass index over 40, or those with other conditions including heart, lung or kidney disease.

That is because if they contracted Covid-19 they had a higher risk of death.

But if they urgently need treatment, they should get it, the memo said.

I don’t know why people who are at higher risk from Covid are being put on a lower priority. At this stage the risks of anyone getting Covid look very low.

There has to be prioritising as they crank up normal health care again, there always is, but putting people down the list due to the (low) possibility of catching a specific virus looks dicey to me.

Why not include influenza as well? Anyone with a greater chance than normal of having any sort of lung or heart problems?

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27 Comments

  1. Alan Wilkinson

     /  4th May 2020

    Demand never got within a bulls roar of reaching supply. A tremendous amount of disruption and damage was caused for nothing. And now people are too scared of hospital transmission to go there for treatment.

    Reply
    • Alan Wilkinson

       /  4th May 2020

      The mismanagement of this event has been catastrophic and the consequences will now play out.

      Reply
    • And if demand had exceeded supply you’d be bellowing like a testosterone-laden bull calf that the mismanagement of this event has been catastrophic and the consequences will now play out.

      Meanwhile the real world moves on.

      Reply
      • Alan Wilkinson

         /  4th May 2020

        The witchdoctor’s clam: if I hadn’t killed you you would have died anyway.

        If the models were good enough to predict disaster they were good enough to say it wasn’t going to happen. Or they weren’t good enough for either.

        Reply
      • Pink David

         /  4th May 2020

        Ishmael, why are Sweden’s hospitals not overrun?

        “And if demand had exceeded supply you’d be bellowing like a testosterone-laden bull calf that the mismanagement of this event has been catastrophic and the consequences will now play out.”

        This has been mismanaged and the catastrophic impacts of it will play out over the next 12 months. US unemployment is now 35 million. How high do you think it will go in NZ? 10% or 20%? How much money will the government burn this year on propping up a profoundly damaged economy, $50bn? Perhaps $100bn?

        Reply
        • My neighbour’s response was that she’d risk the virus in hospital; what did she have to lose ? Her heart condition’s likely to kill her anyway !

          Reply
        • Blazer

           /  4th May 2020

          I pick over 20% …worldwide recession was imminent with or without C19.
          It has accelerated it and provided an excuse for financial mismanagement and flawed economic wisdom’.

          Reply
  2. David

     /  4th May 2020

    Its a triage thing and quite sensible and done in normal times as well, we have to ration healthcare otherwise we run out of money.
    If you are 70 and obese you probably have other issues best we focus on younger healthier folk who pick up cancer etc. given the massive backlog we will now have.

    Reply
    • lurcher1948

       /  4th May 2020

      Hell David, David Seymour is your go to person to put old farts like me down with his death bill,as no sane old person would ever dream of voting for Seymour and ACT as the fool wants to lower our pensions,My dream is National putting up a candidate in Epsom to take the leech on or Epson might see the light

      Reply
      • Gezza

         /  4th May 2020

        My still-working old B&W laser printer is an Epson, neighbour. (An Epson EPL 5200, to be exact. But I have to use my XP system to run it.)

        Reply
        • David Seymour’s bill makes it very clear that the end of life is the patient’s choice, They have to be in their right mind, there are untold checks and if there is any suspicion of coercion, it won’t happen. It’s not a question of putting people down as has been said many, many times without the message getting through,

          Reply
      • Pink David

         /  4th May 2020

        “fool wants to lower our pensions,”

        Your pension is going to be cut regardless of which party is in power.

        Reply
        • Duker

           /  4th May 2020

          Cullen Fund .

          Reply
          • Pink David

             /  4th May 2020

            They going to cash it in are they? NZ spend more on wage subsides alone than the value of the Cullen Fund. That’s before all the tax receipts collapse this and next year.

            Reply
            • Blazer

               /  4th May 2020

              produce your evidence…looks like you are making shit up…again.

            • Pink David

               /  4th May 2020

              I can add up Blazer. It’s not difficult maths. Take a look at the bonds being issued by the NZ Govt.

            • Blazer

               /  4th May 2020

              not more than the Cullen Fund at least as of today!
              What figures do you have?

        • ACT doesn’t want to cut pensions. They have suggested gradually raising the age, as the cost is so vast.

          Reply
        • Gezza

           /  4th May 2020

          Your pension is going to be cut regardless of which party is in power.

          Source & link for that one please Pinky. 😐

          Reply
  3. Gezza

     /  4th May 2020

    I don’t know why people who are at higher risk from Covid are being put on a lower priority. At this stage the risks of anyone getting Covid look very low.

    A cynic might perhaps think Covid-19 is being utilised as a handy excuse for allowing some high end health system users to expire before they cost the governmenr & DHB’s money.

    Reply
  4. david in aus

     /  4th May 2020

    Baby boomers, get used to it: you will be shafted in healthcare but more severely financially.

    Nevertheless, the prioritization of surgery should be based on clinical grounds and not the carte blanche rules they have suggested. Some of those older and obese patients have a higher risk of dying from delaying surgery than from Covid19. Whether it is categorised as urgent surgery or not.

    If Spain and Italy are any guides, after months of level 4 lockdown, they still have thousands of new cases. In NZ, I expect a small trickle of cases for months but NZ could be lucky. Human behaviour is not and will not be perfect, as those rule-breakers have shown. That is, unless you have a police state like China.

    So under the new proposed surgery rules, there could be no surgery for some until a vaccine is available.

    Reply
    • Duker

       /  4th May 2020

      Thats what I thought , obesity is always a higher risk of negative outcomes and no doctor wants too many of those. Even to get bariatric surgery some need …to lose weight.
      The elder care wards for those 80+in hospitals in normal times mostly have the ‘spiritedly elderly’ , even the ‘big framed’ tend not to make it that long.

      Reply
  5. david in aus

     /  4th May 2020

    I expect that currently, elective surgery is at below capacity because of COVID 19 precautions.

    All these proposed measures that reduce capacity, will have permanent effects. Like all services, we can’t make up lost surgeries. Analogous to ‘suppressing the curve’ to preventing overwhelming the health service, underwhelming services like surgery will have permanent health effects.

    Australia, where I am, have restarted elective surgery with careful screening of patients for COVID 19.

    Reply
  6. Conspiratoor

     /  4th May 2020

    Older folk who have worked hard all their lives to divorce themselves from dependence on nanny state and pubic health saw this inevitability. We need not worry. So nothing to see here. Move along please

    Reply
  7. Conspiratoor

     /  4th May 2020

    To anyone who knows the hospital system the beds are dominated by three classes of clientele…

    The elderly, the chronically ill, and the frequent flyer. The latter are folks who cycle through every couple of months and basically just enjoy a comfy bed for the night and being looked after. The hospital equivalent of the guy in the back seat at funerals who comes along to steal the sandwiches

    Reply

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