Heart surgery delays: Man waited five weeks for triple-bypass in Waikato Hospital

A man needing triple bypass heart surgery waited in Waikato Hospital for more than a month, in a ward of other patients similarly delayed.

Tracy Collins, 68, is now recovering back home in Ōhope, Bay
of Plenty. His wife, Theresa Collins, said the five weeks waiting in hospital were gruelling.

The couple contacted the Herald after a report last month revealed one in two New Zealanders needing heart surgery waited longer than the maximum time frame considered appropriate by their specialists.

“If he was the only one that this happened to due to his complex health position then I would accept it,” Theresa Collins said.

“However, at any given time there were four to five people in the ward, all sitting playing the waiting game… from Taupō, Thames, New Plymouth, Ōpōtiki … the cost to the health system, the cost to people’s wellbeing, is huge.”

New waitlist figures, as of November 19, show 62 per cent of cardiac surgery patients at Waikato Hospital were overdue – an improvement from 70 per cent in September.

Waikato takes patients from across much of the North Island, including Rotorua, Tauranga, Taupō, Taranaki and Gisborne.

Tracy Collins was accepted for triple bypass surgery, and an operation on an abdominal aortic aneurysm, which is an enlargement of the aorta, the body’s main blood vessel.

He was admitted to Waikato Hospital on July 10, and was told the urgent heart surgery would happen first, hopefully in the week beginning July 18.

However, there were repeated delays – including because of emergency surgeries and a lack of ICU recovery beds – and Collins didn’t get surgery until five weeks later, on August 14.

There was Covid in the ward, and Collins and the other patients were unable to leave their room. Talk of transferring him to Auckland and Middlemore hospitals came to nothing.

“My father passed away in the beginning of August, prior to his surgery, and they would not allow [Collins] a day pass for the funeral as the risk was too high,” Theresa Collins said.

“Waiting for a major operation in a hospital ward for five weeks is not positive for your mental or physical wellbeing, and does not hold you in good stead before a major operation.”

Tracy Collins was airlifted from Whakātane to Waikato Hospital on Labour weekend last year, after a heart attack.

He was initially told he needed a triple bypass, but after over a month in hospital doctors held a “high risk” meeting and decided his co-morbidities, including renal failure, meant surgery shouldn’t be offered.

He endured debilitating, daily angina attacks in the following months, and the couple appealed the hospital’s decision.

After reviews (including his renal physician saying his prognosis was much better than the mortality data previously cited) he was accepted for surgery.

Michelle Sutherland, interim group director of operations for Waikato Te Whatu Ora/Health NZ, told the Herald comment couldn’t be made on a patient’s private health information.

“Due to high demand for cardiac services, theatre and critical care capacity, at times there are delays for services … patients on waitlists are monitored and prioritised in line with clinical acuity.”

Suitable patients can be sent to other public or private hospitals if agreed to by them. If surgery is considered high risk then medical treatment “may be trialled as a safer alternative,” Sutherland said.

“The patient will be monitored and if their condition changes and/or the medical treatment option is not effective then surgery will be reconsidered.

“Mortality risk for patients with multiple co-morbidities will generally be discussed by multiple specialists … to reach a consensus. There are tools or ‘calculators’ which can be used to inform this process, but these are not definitive.”

In September the Herald revealed cardiac surgery delays were so severe that in January officials prepared to brief the Health Minister about sending sick patients to Australia, a proposal that was abandoned after opposition from clinicians.

Cardiology services – a related but separate department – are also under strain. Both the Cardiac Society (the professional body for cardiologists) and Heart Foundation have warned patients are often not being treated on time, which can be life-threatening.

Waiting too long

People accepted for heart surgery are put in “urgency bands”.

The most urgent should be treated within 72 hours, “Band 2″ within 10 days, “Band 3″ between 11-30 days, and the least urgent, “Band 4″, within 90 days.

Waikato Hospital’s latest available waitlist information from November 19 shows that 56 of 90 patients were overdue, or 62 per cent.

Auckland, Waikato, Wellington, Christchurch and Dunedin public hospitals do cardiac surgery, operating on people from around the country. There are significant delays at all those hospitals, but Waikato’s have been the worst.

Nicholas Jones is an investigative reporter at the New Zealand Herald. He won the best individual investigation and best social issues reporter categories at the 2023 Voyager Media Awards.