Staffing woes pause cancer services in the south

Wednesday, 12 July 2023

Te Whatu Ora Southern has had to stop providing key cancer services because of staffing shortages.

Some specific tumours – like brain tumours and gynaecological cancer – were being treated at Christchurch Hospital, Wellington Hospital, and some private facilities.

Minister of Health Dr Ayesha Verrall said this was mainly because of workforce constraints at Dunedin Hospital and that these temporary measures would remain in place until Southern could resume services.

In the meantime, a national radiation oncology forum had been set up to help fix the situation in Southland and Otago.

On Monday, Health and Disability Commissioner Morag McDowell called for Te Whatu Ora Southern to audit 500 radiology results from the past six months to confirm they were acknowledged by responsible clinicians within acceptable time frames.

She released findings that the system at the former Southern District Health Board had in 2019 failed to support clinicians to follow up critical MRI results showing cancer for a discharged patient.

This comes as Te Whatu Ora Southern, formerly known as the Southern District Health Board, was due to respond to another damning investigation by the Health and Disability Commissioner on Wednesday.

In April, McDowell found that the DHB breached the Code of Health and Disability Service Consumers’ Rights (the Code) in its provision of non-surgical cancer services between 2016 and 2022; because it failed to recognise the clinical risk associated with lack of capacity, leading to patient harm.

Cancer care advocate Melissa Vining, who pushed for the review, said the decision showed “we’re not being melodramatic”.

“People are dying on the wait list.”

Vining started her advocacy journey when her husband Blair was diagnosed with terminal cancer, and although he was told he had only six to eight weeks to live without treatment, he had to wait eight weeks for his first oncologist appointment.

“It’s still happening now. It’s breaking my heart. I’ve been raising these issues for more than four years,” Vining said.

In April, National's Health Spokesperson Dr Shane Reti asked Health Minister Verrall about the situation through Parliamentary Written Questions.

He did so because the community had been raising their concerns with him, he said.

“Cancer services in the south are a problem and staffing is a big part of that,” Reti said.

While he acknowledged it was important for New Zealand to train its own health professionals, immigration was the quickest solution to staffing shortages, he said, adding that New Zealand needed to be a welcoming environment for foreign staff to attract them.

Te Whatu Ora’s Te Waipounamu regional director for hospital and specialist services Dan Pallister-Coward said 90% of patients were starting treatment within expected time frames.

The health agency was addressing its workforce challenges, he said, with two locums set to join the current team of six radiation oncologists on three-month terms.

Outsourcing arrangements were in place with private providers and Te Whatu Ora was working to set more up with other Te Whatu Ora cancer centres, Pallister-Coward said.

The agency was working with theRoyal Australian and New Zealand College of Radiologists to maintain its accreditation for training radiation oncologists and the college had helped it recruit a head and neck consultant from Australia who would join the staff for four months.

Pallister-Coward acknowledged that some patients were waiting longer than the idea’ for their first specialist appointments, but said wait lists had dropped from 164 patients in May 2021 to 143 in March 2023 and 105 this week, because of outsourcing.

Some patients were being offered the option of a first specialist appointment over phone or video call with treatment in Dunedin.

Less complex cases were being offered the option of being treated outside the district, with Te Whatu Ora reimbursing them for travel and accommodation.