Dark Brightness

The South Island is long and narrow. There is one moderate size city (Christchurch) and a smaller University City (Dunedin). The next sized town is around 50 000.  It takes four hours to drive from Dunedin to Christchurch. It can take four hours to drive to Dunedin.

The entire island has about 1 million people — 300 000 in the South (Dunedin) and the remainder in the Northern areas. The very North often travel by ferry to Wellington.

There is a move from central government to move all neurosurgery to Christchurch — a city now approaching 500 000.

Board chief medical officer Richard Bunton said yesterday he hoped the decision would be favourable to Dunedin. If the decision went against Otago, he expected the public would have “a strong view” on the matter and make those feelings known.

Having neurosurgery allows the board to have what is known as a level six intensive care unit.

This is needed to train staff in advanced levels of intensive care, advanced anaesthesia and for some surgical specialists such as cardiothoracic surgery.

The national strategy for trauma management also requires Dunedin to have a level six unit.

via Future of neurosurgery services in Otago may be known next week | Otago Daily Times Online News.

The important message here is in the bottom paragraph. To deal with Trauma, there needs to be a bunch of these units around the country. There is an argument for Otago/Southland — which has a clinical medical school and a smaller population — to take on the hard, difficult cases as a final referral centre for NZ. If there was a market, Dunedin would have moved there years ago.

We are centrally planned. To allow for the trauma issues, we cannot be completely efficient — we cannot import cases, the way services in Australia or the US do. But if we lose level 6 trauma, this will affect patients, because of the tyranny of distance.