FEISTY AUSTRALIAN PROFESSOR TELLS IT LIKE IT IS

A leading hospital's director of surgery has resigned in disgust, saying it is ethically, "if not criminally", wrong to force cancer patients to wait up to six months for an operation. Professor David Morris, who stepped down as divisional director at St George Hospital last month, but continues to operate, said: "I am aware of two patients that have died waiting and others whose cancer has progressed, and I do not think that is appropriate."

As senior doctors prepare to overhaul the state's surgical services in an attempt to fix lengthy waiting times, a fight has broken out at the hospital over delays in potentially life-saving surgery for cancer patients. Trauma surgery at the hospital is also under enormous pressure, while waiting lists continue to deteriorate, according to Professor Morris. He said 732 people had waited more than a year for an operation and 185 of those classed as most urgent had waited more than the recommended one month. "We have two theatres empty every day, and that is purely funding, not staffing," Professor Morris said, blaming "lethargic" hospital administrators. "In fact, 56 per cent of [the most urgent cases] did not get their surgery within one month - these figures are likely to deteriorate further because the only administrative approach to budget overruns is to cut elective surgery."

But the head of South East and Illawarra Area Health Service, Deborah Picone, said the hospital had no record of patients dying while on the waiting list and that many patients classed as urgent were often wrongly classified by doctors who either did not understand the categories or were eager to push their patient up the list. People waiting for carpal tunnel and varicose vein operations as well as haemorrhoidectomies were on the most current urgent list, she said, but would be removed when they were properly classified as less urgent. "From time to time the list blows out and we have to put in a concerted effort to bring it in," Professor Picone said. "We are doing the same amount of surgery as we were doing this time last year ... and we are going to move to do additional lists over the Easter period."

A dispute over funding for specialist surgery known as a peritonectomy, for metastatic colorectal cancer, is fuelling the debate over St George waiting times. Professor Morris told the Herald he was "struggling" to get funding from the state and federal governments to develop his new surgical program. Other experts, such as the head of the NSW Cancer Institute, Jim Bishop, have called for more evidence before the procedure receives further funding.

The chairman of the NSW Government's surgical services task force and the director of surgery for Wentworth Area Health Service, Patrick Cregan, said that while there were "enormous problems with waiting lists" it was a unique situation to have people dying while waiting for surgery. "This is not the universal experience," Dr Cregan said. "The big problems are in the less urgent categories." The task force was examining ways of improving the system to ensure patients' conditions were correctly classified and that their social situation was considered. "The current classification system ... is a fairly crude implement," he said.

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