“Elective surgery” is not elective, it is essential

The halt to ‘elective’ surgery in January, across all NSW hospitals, for the third time in two years, was the state government’s biggest failure in its handling of the pandemic. As this inevitable wave of COVID-19 sweeps through our community, surgeons and anesthesiologists have stood idle, twiddling their thumbs unable to work, while thousands of patients suffer. Our limited return to work, starting Monday, is good news but it is long overdue, and it will now take years to clear a desperate backlog and help all those in need.

The four weeks and more already endured in the latest shutdown will leave tens of thousands of patients in pain and psychological distress awaiting life-changing surgery. It has inflated waiting lists, it will cause harm to patients, and it should have been avoided.

Despite what Prime Minister Dominic Perrottet has said, elective surgery is not “elective” surgery. In fact, much of the elective surgery that has been halted is urgent and those who are now waiting for this surgery are waiting in pain and discomfort as no plans have been made to deal with this predictable increase in COVID cases. -19.

Part of the problem is how we talk about surgery. In the operating room, and in the eyes of bureaucrats, surgery is either an emergency or surgery. Emergency surgery refers to what is needed with minimal delay to save a life or limb. Elective surgery is everything else. There is no intermediate solution. However, in the outside world, it’s not so black and white.


Take, for example, the elderly patient who needs joint replacement surgery for painful and debilitating arthritis. They are unable to mobilize, are bedridden and in constant pain. The physical and mental condition of this patient will deteriorate while waiting for his new joint. The longer they wait, the more their health deteriorates. Their “elective” surgery is life-changing, life-restoring and can even save lives. It’s essential. But as part of the current shutdown, this patient has had his surgery postponed for several months, possibly more than a year, because his condition is not “urgent”.

Many other conditions cause similar distress in patients and negatively affect their health. Women with endometriosis are currently waiting in significant pain for surgery. Some are unable to get pregnant until they are treated. Patients with hiatal hernia suffer from the discomfort of reflux at night and risk pneumonia from this regurgitation. Breast cancer patients are desperately waiting for reconstructive breast surgery after disfiguring cancer surgery. These are not assumptions. These are real people who have been entrusted to me in the context of my work as an anesthesiologist. They are the ones paying the price for the government’s inability to plan.

We’ve had over two years of restrictions, border closures and lockdowns to flatten the curve and give the New South Wales government time to prepare our healthcare system for COVID-19. What do we have to show for this?

Apart from a vaccinated workforce, not much would appear. At the first sign of increased COVID hospitalizations in early January, the government decided to shut down surgery again. It did that

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