A unique partnership between a philanthropist, a private hospital and the Federal Government is facilitating cataract surgery within just a few weeks for people who might otherwise be on the public hospital system’s waiting list for years. Additionally, it is providing specialist surgical training for registrars in ophthalmology that would otherwise be unavailable. As part of that training, the registrars are able to volunteer their services for sight saving overseas development missions.
The first spark of this comprehensive cataract program was ignited back in 2012. Today over 600 eyes have received surgery.
It was Dr John Knight AM (known fondly to many as the media personality Dr James Wright) who got the cataract program off the ground. A general practitioner in Sydney, he had observed the long waiting lists for cataract surgery under the public health system, and wanted to provide patients in need with more timely cataract surgery via the private health network. He approached local ophthalmologist Dr Gagan Khannah from Eastwood Eye Surgery in Sydney, who agreed to help, and just 12 months later, 50 cataract procedures had been completed.
Funding for the cataract program was provided by Medi-Aid, a not for profit company that Dr Knight had established in 1973 using profits from his investments in real estate
Funding for the cataract program was provided by Medi-Aid, a not for profit company that Dr Knight had established in 1973 using profits from his investments in real estate. Today the Medi-Aid Foundation owns and manages approximately 800 residential units in Queensland and New South Wales, using any profits made to subsidise the rent of people in need and to support the cataract surgery program.
Two years later, the program was expanded in 2014 with the involvement of ophthalmologist Associate Professor Geoffrey Painter from Gordon Eye Surgery and Kerrie Legg RN, Hospital Director at Chatswood Private Hospital (CPH). They identified an opportunity to expand the Medi-Aid program and at the same time provide specialist surgical training for ophthalmology registrars, having recently secured a Federal Government Specialist Training Program (STP) grant for registrar training.
The STP program was established in response to the shortfall of specialist training for all medical professions, and a growing demand on services. While the STP program funds the registrar’s clinical training, A/Prof Painter, who operates at CPH as well as Royal North Shore Hospital, needed funds to offer registrars surgical training.
“We approached Dr Knight with the concept, and proposed that with his financial support we would be able to provide cataract surgery for those in need as well as provide training for ophthalmology registrars. This would significantly relieve pressure on the public system as well as provide training for an extra ophthalmologist per year.”
The program was initially run by the Sydney Adventist Hospital and was transferred to Chatswood Private Hospital in late 2017. So far, six of the registrars who have passed through the Med-Aid funded position have completed their training and are now ophthalmologists. The program is currently funded by the Federal Government until 2021.
The STP program was established in response to the shortfall of specialist training for all medical professions, and a growing demand on services
AN AMAZING OPPORTUNITY
Dr Dominic McCall was the third ophthalmology registrar in the Medi-Aid funded post. He recently completed the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) fiveyear fellowship program, graduating in February this year. He said the opportunity to undertake three months of his surgical training within the controlled environment of the private hospital system “was amazing”.
“I had access to state-of-the-art equipment, the support of well-trained nurses and allied health staff and the luxury of time that you don’t normally have in the public system. I was able to be involved from the beginning of the patient journey; from assessment and lens selection through to the consent process, the work up, the surgery and recovery. Right through that time I had my consultants at my fingertips with time to provide the support I needed to provide the best care my patients needed,” he said.
As a registrar, Dr Dominc McCall also had the opportunity to accompany A/Prof Painter and Mrs Legg (in her capacity as an ophthalmic nurse) on overseas missions to provide charitable cataract surgeries in the Philippines. “As a registrar, I ran the clinical side of things alongside the nurses and volunteers. It was amazing as I was able to spend time with the people and, as naive as it sounds, I really began to realise the impact low vision has on a person and their entire family, particularly in developing countries.”
He said experiencing the hardship people with low vision endure was humbling. “In the Philippines, we treat people at the Santiago City Adventist Hospital, which is a sister hospital to the Sydney Adventist Hospital. The patients travel long distances with their families to be seen. They arrive with nothing, and they sleep in the hospital church overnight so we can check them post-surgery. It is a reminder of how much more we can offer beyond simply providing a service within a city hospital.”
When mivision spoke to Dr McCall he was preparing to head back to the Philippines for his sixth time with A/Prof Painter, Mrs Legg and the team. This will be A/Prof Painter’s 34th international eye care trip, and Mrs Legg’s 18th.
the opportunity to contribute to a program that restores sight at no cost to people in need is particularly satisfying
Mrs Legg said the overseas visits provide invaluable experiences for ophthalmology registrars. “They are very inspirational for the registrars and many have expressed a desire to come with us. Two have had this opportunity and Dominic, who was the first registrar to come with us, has returned every trip since. Pleasingly, he is now qualified and this time he will be returning as a surgeon.”
REWARDS OF THE PROGRAM
Mrs Legg said the opportunity to advance ophthalmology in NSW by providing registrar training is something that CPH and its surgeons have embraced.
“The hospital believes in providing world class facilities for its patients and surgeons but it also believes that training is the future of ophthalmology. It has enrolled nurse and new graduate nursing education programs and is a teaching hospital for The University of Sydney,” she said.
Of course, like any training program, establishing the program was not without its challenges.
“The addition of registrar training in a busy private hospital setting is somewhat unique and brings its own challenges,” said Mrs Legg. “Initially, there is the human resources challenge of accreditation, with four different registrars coming per year. Logistically the allocation of theatre time is more complicated as the registrar in our post is a first year and hence fairly inexperienced and their surgery takes significantly more time.”
The biggest challenge however, was funding.
“In this aspect, the financial support from the Medi-Aid Foundation, medical device companies (especially Designs for Vision) and the doctors involved has been essential,” said Mrs Legg.
To date, Medi-Aid’s donations to support the cataract program since 2012 (and the STP since 2014), have totalled AU$1.5 million, enabling surgery on 626 eyes. Impressively, the organisation’s commitment continues to grow, with an initial donation of 50 cataract surgeries in 2014, growing to funding 100 cataract surgeries in the 12 months to August 2020. Patients who receive the Medi-Aid funded surgery need to meet specific financial criteria that includes living on a means tested pension, having no private health insurance cover nor the means to fund their own surgery.
LONG MAY IT CONTINUE
Dr Knight said the opportunity to contribute to a program that restores sight at no cost to people in need is particularly satisfying given his personal history. Born with keratoconus he has received more than one corneal graft, has had cataract surgery, and was recently treated for macular degeneration.
Speaking of the cataract program he said, “What we like about the cataract surgery program is that a person comes in and they are blind. With a few dollars and half an hour later they walk out and they can see soon after – there’s nothing else like it in my opinion.”
At the age of 92, and having contributed so much without any desire for public acknowledgement, Dr Knight said the best thing about accumulating wealth has been the ability to improve other people’s lives by giving it away.
“We don’t do it for any praise, although I do like receiving the occasional letter from a patient who might say, ‘I couldn’t see before, but now I can’.”
After living all these years and achieving so much, he says he has no words of wisdom for others. “I don’t give people advice, I don’t tell them what to do – they wouldn’t listen anyway,” he laughed. “People do their own thing and life moves on,” he said.
In 2023 Medi-Aid will celebrate 50 years of providing affordable housing for people in need. While Dr Knight is the Chairman, the organisation’s day-to-day operations are now in the very capable hands of joint CEOs Robyn Laidlaw and Dr Knight’s son, David. All going well, the Federal Government will continue to support the STP beyond 2021 and with Medi-Aid’s support, the cataract program will continue to have a ripple effect on patients in Australia and overseas, hospitals and registrars alike.
As Dr Knight says, “We’re happy to go on with this for the rest of time – we think it’s great.”