ICU specialists warn of gaps despite funding

Hospitals around New Zealand are routinely postponing up to 14 per cent of elective surgeries that need post-operative intensive care, even with no widespread transmission of Covid-19, an intensive care specialist says.

Craig Carr, an intensivist at Dunedin Hospital and the New Zealand regional chairman for the Australia and New Zealand Intensive Care Society (ANZICS), said the ICU community did ‘‘not believe that New Zealand currently has sufficient ICU beds to meet our population’s needs’’.

His comments came despite Minister of Health Andrew Little’s announcement of $645 million in additional funding ($100m for capital works and $545m for operational costs such as staffing) approved by Cabinet to boost ICU capacity in the next six months.

Three district health board proposals to boost the number of ICU beds at four hospitals were given the green light on Thursday – Waitemata, Canterbury and Tauranga.

Nationally, there are 284 resourced ICU and high dependency unit (HDU) beds in public hospitals, a number that can be increased to about 550 beds if there was a ‘‘major outbreak of Covid-19’’, according to the Ministry of Health.

Andrew Stapleton, ICU specialist at Hutt Hospital and chair of the College of Intensive Care Medicine, said the ministry’s estimate of beds included 40 paediatric beds and cots, and did not include staffing.

The society estimated there were 174 staffed ICU beds for adults.

He said New Zealand had four ICU beds per 100,000 people, the fewest in the OECD. Australia had nine beds per 100,000.

The extra funding would take the rate to 5.2 per 100,000, Stapleton said.

But the additional money was ‘‘really big’’, and the only time-specific additional funding for ICU beds in 70 years. Most critical was funding of staffing, Stapleton said.

National’s health spokesman, Dr Shane Reti, said he worried about smaller DHBs with fewer ICU beds, large unvaccinated Ma¯ ori populations and summer holiday flows.

‘‘We have barely avoided overrun hospitals despite poor planning and at a cost of 100,000 people having important procedures cancelled,’’ he said.

‘‘The only reason ICU numbers are fewer than expected is because ICU Covid19 case numbers are being hidden on general wards managed with non-invasive ventilation methods where normally they would be in an ICU.’’

Carr said data collected by ANZICS in

2019 showed New Zealand ICUs postponed up to 14 per cent of surgeries requiring ICU such as ‘‘heart surgery, brain surgery, and even occasionally cancer surgery’’ due to a lack of resources.

He was not convinced the country’s ICU capacity could cope when Covid-19 became endemic.

This week he spoke to ICU specialists in Europe. They reported increased ICU and hospital bed demand ‘‘as immunity wanes’’.

‘‘By my estimate, to meet similar demand to that seen overseas, we would require an approximate doubling of resourced ICU bed numbers from our current levels in New Zealand.’’