SDHB'S 'pathetic failure'

CANCER patients are suffering because of Southern District Health Board's ‘‘pathetic’’ failure to fix its colonoscopy service and the Minister of Health needs to intervene, a leading surgeon says.

Christchurch general surgeon Phil Bagshaw made the comments after a review, released yesterday, came to many of the same conclusions about dysfunction within the DHB’s gastroenterology department as a review he coauthored 18months ago.

The report found several reasons for colonoscopy referrals being declined or delayed, including referrals not having the required information, poor relationships between staff having an impact on patients and long waiting lists.

Mr Bagshaw said based on the DHB’s response to previous reviews, including his own, he had no confidence they would take responsibility now.

‘‘There will be more reports and people running around with clipboards, and I have no confidence, and the Minister must have no confidence,’’ he said.

After the DHB’s ‘‘pathetic’’ response it was time for Health Minister Chris Hipkins to intervene and get rid of the staff responsible.

‘‘If the minister wants a list [of people to dismiss] I can provide him one instantaneously,’’ he said.

While the DHB conducted its latest review, patients continued to suffer unacceptable outcomes, and recent tragic stories had emerged.

It seemed the default position was to defer, delay and deny colonoscopies to somebody with symptoms, he said.

There had been five reviews since 2017.

‘‘They have been given every opportunity to put this right, they have been given all the advice they need on how to put it right, they haven't, now they must go.’’

Rather than action, it was ‘‘well, we will have another review’’, he said.

‘‘Money and personal prestige had been traded against human misery.

‘‘The time for being cautious about what we say is gone — this is a terrible burden to know nothing is happening here. It has to, it must.’’

A new finding of the latest review was that while other DHBs had increased their colonoscopy access by 45%, the Southern DHB had not increased it at all, he said.

Instead, it had ‘‘aggressively’’ gone for screenings at the expense of providing colonoscopies to symptomatic patients.

The latest report, written by Auckland colorectal surgeon and National Bowel Cancer Working Group chairman Ian Bissett and Rutherford Clinic general manager Kate Broome, found that the SDHB had a higher rate of bowel cancer in its district than elsewhere in New Zealand, but appeared to have a relatively low rate

of colonoscopies.

In a response, which will be discussed at next week’s meeting, the DHB noted several themes echoed previous reports.

It also proposed to urgently improve its referral template and provide greater oversight of patients through an Endoscopy Oversight Group supported by a project manager, and a Clinical Referrers' Group to ensure processes were being adhered to.

The DHB’s report aimed to review 102 patients, but only 50 were reviewed.

It also took longer than anticipated due to a variety of reasons, including the way records were kept and the impact of the Covid19 lockdown.

DHB chairman Dave Cull said the board was aware of the challenges in

the colonoscopy service and efforts to address those in recent years.

It would be considering the latest report at its board meeting.

“It would be inappropriate for me or others to comment on the recommendations or next steps until we have done so.”

Health Minister Chris Hipkins said during a standup yesterday that the fact the DHB had five reviews to make sure they were making progress was a ‘‘good thing’’.

But the fact there were still issues was concerning.

‘‘It clearly is not good enough, and the DHB acknowledge that it is not good enough,’’ he said.

He said the ministry would be watching to make sure changes were made.