Letters
Volume 190 - Issue 6

Management of kidney stone disease in New South Wales

Authors:  Robert J Davies, R Denby Steele and John Kourambas

Med J Aust 2009; 190 (6): 339. || doi: 10.5694/j.1326-5377.2009.tb02430.x
Published online: 16 March 2009
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To the Editor: Macneil and colleagues1 present evidence of how inadequate resourcing of acute kidney stone care for public patients in New South Wales is compromising their surgical outcomes compared with private patients. In our experience, the same difference exists elsewhere in Australia.

Macneil and colleagues show how poorly planned, under-resourced and badly coordinated acute surgical services lead directly to adverse surgical outcomes. All too often, a lack of appropriate modern lasertripsy equipment, staff trained to operate it, or provision of adequate emergency theatre time leaves public patients languishing with a double-J stent (inserted as a temporising measure) for an extended period. Not treating stones definitively at presentation (in cases where surgery is appropriate) adds unnecessary morbidity and necessitates readmission, further compounding the inefficiencies of an already overstretched public system.

Given such important findings, it is disappointing that the Journal chose only to publish Macneil’s study as a letter. The conclusions of this study should provide an impetus for addressing proper coordination and resourcing of surgical services in the public system throughout Australia.

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