Patient Voice Aotearoa chairman Malcolm Mulholland says protest action is planned if the pause isn't reversed. Photo: RNZ / Jimmy Ellingham
Manawatū residents at a higher risk of developing bowel cancer are vowing to fight a pause on surveillance colonoscopies at Palmerston North Hospital.
Some have already gone private to ensure they get the procedure done, while Patient Voice Aotearoa chairperson Malcolm Mulholland said protest action is planned.
Health New Zealand, meanwhile, said it is taking steps to work through the waiting list.
But those steps have not come quickly enough for Palmerston North man Bruce Culley.
He is one of about 850 patients in the MidCentral region who late last year received a letter saying surveillance colonoscopies at the city's hospital were on hold.
"I was meant to be having a colonoscopy in January. I got a letter saying it was coming up, in October," he said.
"I got the other letter that everybody else got in December, saying it was paused."
Health NZ said it was prioritising people with symptoms, as regular check-up colonoscopies were paused for at least six months.
It has now told Checkpoint that from Saturday it will start some weekend sessions.
"Six more Saturday sessions are confirmed and booked, and it is our intention to continue with at least two full Saturdays each month," said Sarah Fenwick, Health NZ's group director of operations for MidCentral.
"Additionally, we are actively in the process of outsourcing further surveillance colonoscopy procedures and backfill lists."
Culley last had a colonoscopy five years ago and previous ones had found polyps, which can become cancerous.
He, at least, will undergo the procedure next week.
"I'm going to have it because I have got private health insurance and I'm going to hopefully use that, but I will have to pay $500 excess."
Culley was one of about 60 people at a public meeting in Palmerston North on Tuesday night, organised by Mulholland.
Mulholland is also affected by the pause.
"This should not be happening," he told the meeting.
"This is bad news. If this continues people will die and they will die of advanced bowel cancer, because you're already at high risk of having bowel cancer. That's why you have a surveillance colonoscopy."
Association of Salaried Medical Specialists executive director Sarah Dalton came armed with numbers outlining the situation.
Association of Salaried Medical Specialists executive director Sarah Dalton told the meeting about how under pressure the gastroenterology service at Palmerston North Hospital is. Photo: RNZ / Jimmy Ellingham
"We know that there are over 1600 people waiting for endoscopies here at MidCentral and we think about three quarters of those are colonoscopies.
"There are about 150 new referrals to the gastroenterology service every week and the number of new referrals that are being declined is about 25 every week."
There were about five specialists working in the service at Palmerston North Hospital, but significantly more were needed, she said.
Dalton spoke about the moral injury medical professionals felt when they could not offer a required service and said there was a danger staff would be overworked and burn out.
For example, staff at the service had built up about 280 days of unused annual leave.
She issued a call to arms, telling people affected to complain loudly.
"It is painfully obvious that what is available at MidCentral currently falls far short of what is acceptable."
Bowel Cancer New Zealand nurse support co-ordinator Victoria Thompson told the meeting about other options available to people waiting, but colonoscopies did not come cheaply, costing $3000 to $6000 in the private sector.
Herman Regan is another who had his appointment deferred. He went the to meeting with his wife, Maggie, and the pair said the pause affecting them spurred them into action.
For Doreen Farley, concern about people from families such hers, who were at elevated risk, persuaded her to attend.
She is one of seven siblings and is the only one who has not had cancer.
Mulholland said Health NZ was invited to the meeting, but nobody attended.
He told Checkpoint its initial steps to ease the backlog created by the pause were a drop in the bucket.
He was focused on further action.
"The first thing I'll be doing is reaching out to the minister of health [Simeon Brown] and having a sit down, asking him to help and roll his sleeves up to come up with some answers for the community.
"The second step will be to raise awareness through protests at a local level."
Other options debated at the meeting included seeing if a private provider would provide a discount for a bulk referral.
Longer term, a charity hospital to pick up the gaps in the public sector could be on the cards for the region, Mulholland said.
Group director of operations at MidCentral Health New Zealand Sarah Fenwick told Checkpoint they could not keep up with demand for colonoscopies.
"We took the really difficult decision to pause surveillance colonoscopy because of resource constraints, not funding cuts, but due to staffing shortages here at mid central."
"We needed to prioritise those who were acutely unwell and those who have symptoms, we felt it was really critical that we were honest and transparent with our community."
There were two vacancies within the service, and they were 50 percent down on staff, Fenwick said.
"We've been working to fill that as quickly as we can and that's where we thought it was a real priority to communicate with our patients about the waiting list for surveillance. Because of those gaps, we filled those gaps with locum."
She said the initial pause had not impacted any patients who had symptoms of bowel cancer.
The pause would be short and MidCentral Health was working hard to get back on track, she said.
MidCentral Health had been funding additional procedures through the private system, Fenwick said.
"We already have some outsourced capacity; we're actually looking to increase that significantly. But obviously we have to go through a procurement process for that."
She said she acknowledged people who were waiting were worried about their health.
"That's incredibly distressing and scary for people to hear. But what we are is incredibly committed to resolving this matter."
"I'm genuinely sorry for the distress that this is causing to patients. We do want to make this right and we're working really, really hard to do that."
They were hoping to get through the backlog of patients by the end of June, she said.
"Completely acknowledge that prevention is the best methodology, and it also saves on cost long term. But at the minute we have to work with the resources that we've got, which is why we've been prioritising those patients that are acutely unwell or who are symptomatic."
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