By Rowan Quinn of RNZ

Surgeons say the postcode lottery is still alive and well - with no national criteria yet for who gets surgery and how quickly.

Te Whatu Ora replaced the 20 separately run district health boards last year, with the aim of ending big differences in access to health care in different parts of the country.

But Association of General Surgeons president Vanessa Blair said when it came to planned surgery, the criteria to get an operation were still different all over the country.

“The progress has been too slow and it’s not been really transparent,” she said.

Te Whatu Ora needed to share more data to give a better picture of what was going on, she said.

There was strong anecdotal evidence that the criteria for getting on waitlists, or the time spent waiting on them, varied from district to district.

Health Minister Ayesha Verrall. Photo / Jed Bradley, File

“In some parts of the country there is a fatigue where GPs will not even put a patient with a hernia, for example, forward for a consideration of repair because they’ll say to their patient ‘look, you’re just not going to get on the waiting list,’” she said.

In other areas, they might get treated more quickly.

“In an ideal world, if you had the same patient who presented with the same hernia, wherever they were in the country, they would be measured by a tool and have equal access to get that hernia repaired,” she said.

The lack of criteria also applied for other relatively common surgeries like for breast reconstruction after cancer, incontinence or obesity, she said.

Association of General Surgeons president Vanessa Blair. Photo / Supplied, File

Health Minister Ayesha Verrall told Nine to Noon on Monday that setting up Te Whatu Ora was just the start of the health reforms which would take years to complete.

Getting even access to treatment had started on a small level - including removing some of the financial barriers to patients moving between hospitals to get the surgery they need, she said.

But it needed to be “scaled up” and more needed to be done.

 “The crux of it is those conversations between surgeons, and surgical managers, and the wait list managers around ‘who is this patient, is it safe for them to move, who’s got a list in another hospital and can we do that?’” she said.

Work also needed to be done to use theatres more efficiently, she said.

Blair said more information was needed on the number of “functional” theatres available around the country.

“It’s not just enough to have a theatre, you have to be able to staff that theatre so it’s operational,” she said.

Some hospitals, such as the three Auckland districts and Northland, were drawing up their own agreements to try to make sure patients had the same access no matter which part of the region they lived in, she said.