SDHB’s progress and setbacks
Things are tough all over for the nation’s district health boards. But even in this turbulent environment, the Southern District Health Board stands out as a spectacularly stormtossed entity. It takes some effort to bear in mind areas where progress is being made – though these do exist – when attention turns, as it simply must, to services struggling with failures and frustrations.
Most recently radiation oncologist Lyndell Kelly has assailed the ‘‘criminal’’ state of patients waiting in some cases two months to find out the extent of their cancer. The wait list to see a radiation oncologist has reached 157, the highest it has ever been and more than twice the board’s ideal wait list. The worst in the country.
In the first quarter of this year, fewer than half the patients referred as urgent because of high suspicion of cancer received their first treatment within 62 days, as they should have according to the Ministry of Health.
Access to scans is a large part of the problem and how hearts must sink with the report that a business case for a new, additional MRI scanner is expected – in December.
New chairman Pete Hodgson is emerging as a flinty hand at the tiller, and his reaction was plain impatience: this was intolerable, and if it’s evident a second MRI machine is needed ‘‘then buy the thing’’.
Among the most scrutinised and lamented aspects of the DHB’s operation has been colonoscopy services; long a nightmare of insufficient service, professional discord and too-little-too-late results.
The arrival of Crown monitor and former Medical Council chairman Andrew Connolly has brought demonstrable progress to endeavours in this area. The 386 patients overdue for surveillance colonoscopies at Southland Hospital last November was down to 186 by February, and we’re tracking towards a wait list of zero by September.
Coupled with pleasing reductions in the list of patients, this amounts to fine news for non-urgent patients, though sure enough Connolly warns it will take more resourcing if the improvements aren’t to prove temporary. It’s a theme. Such a theme.
Good news presented itself with reports that the board’s involvement in the National Bowel Screening Programme has resulted in a reported 235 cases of bowel cancer detected in people aged 60 to 74 in Southland and Otago in almost three years.
What’s not to like about that? The concern that, in a politicised climate in which the Government and public alike were demanding progress in the screening programme, some of this was, in effect, being achieved by pushing people who had already been found to have symptoms back down the queue.
The contention emerged in a paper published by surgeon Phil Bagshaw and public health medicine specialist Brian Cox, whose reproach is that the SDHB wasn’t permitted to join the screening programme before it had the proper capacity to do so without compromising services to do so.
This is gainsaid by the board’s chief executive, Chris Fleming, essentially citing the greatest good for the greatest number, with the detection of more than 235 cancers that wouldn’t otherwise have been picked up so early – while symptomatic patients were still being treated within the national indicator time frame.
Well, OK, this may well be the case. But the board has some reputational rehabilitation to do if it wants its reassurances to resonate. It has some form for being economical with the truth when it comes to reporting. The discomforting scrutiny from the likes of Bagshaw and Cox isn’t to be dismissed out of hand.
The board has some reputational rehabilitation to do if it wants its reassurances to resonate.