Wednesday 13 July, 2022
Emma Vitz
Private Individual
Email
: [FYI request #19607 email]
Dear Emma
Official Information Act Request for – Outsourced Elective Procedures
I write in response to your Official Information Act request received by us Wednesday 15 June, 2022, you
requested the fol owing information:
1. The total number of procedures outsourced by year (including the year to date) for the past five years.
2. For each year, provide a breakdown of the type of procedure.
3. For each year, provide the total spend on outsourced elective surgeries.
4. For each year, provide the amount that these surgeries would have cost the DHBs if they had not been
outsourced.
Te Whatu Ora – Counties Manukau District Response:
For context the Counties Manukau District (Te Whatu Ora – Counties Manukau District) employs over 8,500
staff and provides health and support services to people living in the Counties Manukau region (approx.
601,490 people). We see over 118,000 people in our Emergency Department each year, over 490,000
outpatient appointments each year, and over 2,000 visitors come through Middlemore Hospital daily.
Our services are delivered via hospital, outpatient, ambulatory and community-based models of care. We
provide national, regional and supra-regional specialist services i.e. for orthopaedics, plastics, burns and
spinal services. There are also several specialist services provided including tertiary surgical services, medical
services, mental health and addiction services.
1. The total number of procedures outsourced by year (including the year to date) for the past five
years.
10,538 procedures from 1 July 2017 until 31 May 2022. This count includes outsourced procedures,
producers delivered under wet leasing* arrangements, and procedures performed by the Mobile
Surgical Bus.
*Wet leasing is where a private provider provides the theatre, theatre staff, and ward beds/staff. Te
Whatu Ora – Counties Manukau provides the surgical staff involved. Anaesthetic staff are usual y
provided by the private provider, but this can be variable.
2. For each year, provide a breakdown of the type of procedure.
Outsourced elective surgery patient numbers Clinical category
Subspecialty
2017/18 2018/19 2019/20
2020/21
2021/22
(YTD
MAY)
Outsourcing
Opthalmology
0
0
0
19
4
Plastics
15
2
34
152
73
General Surgery
229
268
405
313
239
Orthopaedics
302
252
264
324
248
ENT
177
355
307
233
75
Urology
45
29
11
2
42
‘Wet leasing
Opthalmology
539
914
1207
1680
1221
Plastics
0
0
0
27
8
General Surgery
0
0
0
14
12
Orthopaedics
0
0
0
29
20
ENT
0
0
0
37
14
Urology
0
0
0
101
82
Surgical bus
Opthalmology
0
0
0
0
0
Plastics
0
16
16
0
0
General Surgery
0
29
25
0
0
Orthopaedics
0
0
0
0
0
ENT
39
22
10
0
0
Urology
19
44
17
0
0
TOTAL
1365
1931
2296
2912
2034
3. For each year, provide the total spend on outsourced elective surgeries.
Outsourced elective surgery spend
Clinical
Subspecialty
2017/18
2018/19
2019/20
2020/21
2021/22
category
(YTD MAY)
Total $
Total $
Total $
Total $
Total $
Outsourcing Opthalmology
$941,416
$1,647,903
$1,158,542
$573,368
$482,159
Plastics
$63,763
$4,790
$315,804
$886,637
$443,399
General Surgery
$962,632
$1,080,628
$1,829,554
$1,505,046
$1,136,991
Orthopaedics
$3,299,309
$2,815,461
$3,088,068
$4,162,189
$3,209,948
ENT
$476,953
$986,894
$979,702
$991,294
$319,241
Urology
$218,768
$147,175
$58,912
$10,711
$337,943
Wet leasing Opthalmology
$0
$0
$944,536
$2,503,280
$1,553,558
Plastics
$0
$0
$0
$86,483
$35,433
General Surgery
$0
$0
$0
$122,689
$74,614
Orthopaedics
$0
$0
$0
$194,183
$108,046
ENT
$0
$0
$0
$100,248
$33,353
Urology
$0
$0
$0
$424,610
$405,244
Surgical bus Opthalmology
$0
$0
$0
$0
$0
Plastics
$0
$40,758
$28,133
$0
$0
General Surgery
$0
$32,606
$80,374
$0
$0
Orthopaedics
$0
$0
$0
$0
$0
ENT
$24,876
$36,576
$38,805
$0
$0
Urology
$17,512
$44,812
$36,924
$0
$0
TOTAL
$6,005,230
$6,837,602 $8,559,353 $11,560,738 $8,139,929
4. For each year, provide the amount that these surgeries would have cost the DHBs if they had not been
outsourced.
We are unable to provide data for this question as the information is not available.
I trust this information answers your request. You are entitled to seek a review of the response by the
Ombudsman under section 28(3) of the Official Information Act. Information about how to make a complaint
is available
at www.ombudsman.parliament.nz or Freephone 0800 802 602.
Please note that this response or an edited version of this may be published on the Te Whatu Ora – Counties
Manukau District website. If you consider there are good reasons why this response should not be made
publicly available, we will be happy to consider this.
Yours sincerely,
Dr Peter Watson
Interim National Director - Medical
Interim District Director - Counties Manukau
Te Whatu Ora – Health New Zealand