The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) acknowledges that current limitations within the public health system, both workforce and facility shortages, have led to outsourcing of planned (elective) surgery to address surgical waiting times and achieve the Government’s surgical waiting time targets.
While outsourcing cases to private hospitals is a pragmatic short-term solution that may help some women receive the care they need, it is not a sustainable fix. In the long term, a comprehensive plan is needed to build capacity within the public healthcare system. This requires investment in hospital facilities, staffing, and the expansion of services provided by skilled GPs and physiotherapists with appropriate training and resources.
TV supports a model of surgical care delivery that provides equity of access and continuity of care for patients, and fosters surgical training opportunities to grow a future Obstetrics and Gynaecology (O&G) workforce.
Given the current realities of long waiting lists and limitations within the public sector, RANZCOG recommends that outsourcing (and insourcing) be organised with a planned approach and appropriate clinical governance.
This should include:
- Patient safety considered at every step of the journey when public surgery is outsourced. This includes tracking adverse events and appropriate clinical key performance indicators.
- Gynaecologists are involved at all stages of designing, implementing, and monitoring the system, noting that some critical decisions require surgical expertise. This includes appropriate procedures and cases for outsourcing to ensure effective prioritisation and equity of access.
- Contracts include mandatory quality and safety standards and are designed to ensure sustained quality of care.
- Contracts include an obligation to provide surgical training opportunities for trainees.
- Design and implementation pay particular attention to managing and communicating effectively the transitions in the patient journey, from the initial selection process, through surgery and to post-operative care.
- Contractual processes are open, transparent and fair, and workforce issues are considered.
- Gynaecologists maintain an open professional culture and focus on patient needs to deal with the inevitable challenges of outsourcing of surgery, including potential conflicts of interest.
For media enquiries
Catherine Cooper
Executive Director Aotearoa New Zealand
Email: ccooper@ranzcog.org.nz
Phone: +64 21 137 0748
