The Bowral orthopaedic surgeon said his patients were already being taken off Bowral Hospital’s waiting list and sent letters telling them to find another hospital at the same time as he was raising funds for the Daffodil Day fundraiser on April 18.

“So it is a complete slap in the face that they have taken me up on the daffs and money, and then shafted me,” he said.

The News revealed earlier this month admission forms for straight-forward procedures, such as cataract surgery, had been rejected by the Sydney South West Area Health Service (SSWAHS).

More than 50 patients have or will be receiving letters from Bowral Hospital general manager Denis Thomas informing them their procedure can’t be done at Bowral due to insufficient theatre time.

Ophthalmological surgeon Peter Macken, along with orthopaedic surgeons Dr Hartnell and Andrew Leicester, disagree and said their patients were being asked to find another surgeon and hospital because of bureaucratic decisions made by SSWAHS heads Mike Wallace and Teresa Anderson.

The bone surgeons are only allowed to do 110 joint replacements a year and a SSWAHS spokesperson said, as of June there were 203 patients on the waiting list, 126 of which were for joint replacements. There were 175 on the ophthalmological list, most of them for cataracts.

The waiting list has no limit, but all patients on it must be treated within a year.

Dr Hartnell said Bowral was one of the best hospitals for joint replacements and the waiting list cap had no logical base.

Mr Leicester said he wasn’t aware of any other surgeons in NSW who were restricted by a cap.

“So far for the year we have done 130, which proves the cap is ridiculous. It’s an arbitrary number pulled out of a hat,” Dr Hartnell said.

Bowral was one of the best performers at the last joint replacement audit in areas such as length of stay, completion rate and a low infection rate, Dr Hartnell said.

He and Mr Leicester had gone to Mr Wallace and Ms Anderson to work out cheaper, more efficient ways of doing more joint replacements, but their suggestions had fallen on deaf ears.

The pair were instead told to “re-educate” their GPs on sending patients elsewhere.

Dr Hartnell said SSWAHS wanted to move patients to RPA in Sydney because it had a shorter waiting list. He said it made more sense to transfer funds to Bowral rather than parcelling off patients to RPA.

“The argument that we are over budget is complete crap,” Dr Hartnell said.

Hospitals are obliged to treat patients within 12-months of receiving an admission form. By rejecting the admission outright, SSWAHS was ensuring the list didn’t go beyond 12 months. This was despite surgeons saying they had the time to do more procedures.

“We can provide the service and treat people within 12 months, but they won’t let us,” Dr Hartnell said.

Dr Hartnell and Mr Leicester each operate one day a week for eight hours a day, but both said they could do more operations if the hospital gave them more theatre time.

Mr Leicester said most of his elderly patients were in pain while they waited on the list.

“It’s very frustrating and upsetting for patients. I haven’t met one who is happy to go to another hospital,” he said.

“There are no problems with resources at Bowral, it makes no sense.”

He also said denying people surgery at their local hospital contradicted government policy and the health act.

Dr Hartnell said Mr Thomas’ argument – that an influx in out-of-area patients being part of the reason for booting patients off the waiting list – held no water.

“Only two are from the South Coast – the so-called out of area patients. So that is, roughly 3.5 per cent of my list is out of area,” Dr Hartnell said.

“The only reason I have these two is the surgeon in Nowra does not do hip replacements. So the argument of out-of-area patients is irrelevant.

“If you look at my patients of, say, 63 needing replacements in the area, the figures for the cap are based on completely wrong assumptions and I alone could do the 110 cap in one year.”