Samples of a colon biopsy to be sent to a laboratory. Photo: A. BENOIST / BSIP
The reduction in the number of colonoscopies outsourced to the private sector last year was due to a temporary "surge" the year before - paid for by leftover Covid funding, Health NZ says.
However, despite the spike in private outsourcing, growth in publicly-funded colonoscopies was levelling off, compared with previous years, before going into reverse in 2024.
Wait times for all types of colonoscopies (urgent, non-urgent, surveillance and screening) increased last year, as the number of procedures shrank from 62,957 in 2023 to 58,447 in 2024.
That equated to 4510 fewer patients getting their procedures through the public system.
Health NZ has previously blamed higher demand and workforce shortages.
However, Bowel Cancer NZ said the data suggested it was also the result of "reduced delivery".
In a follow-up response to RNZ, Health NZ national chief medical officer, Dame Helen Stokes Lampard, said the spike in 2022/23 was due to a temporary increase in planned care funding.
"Surplus funding was made available following the closure of the Covid-19 Response and Recovery Fund in late 2022.
"Some of this money was used to target planned care waitlists - especially for people who had been waiting for 12 months or longer. This included colonoscopies."
Financial year Outsourced Colonoscopy (day case and Outpatient only)
2019/20 6389
2020/21 7753
2021/22 7552
2022/23 10,325
2023/24 9577
Overall, there was "an upward trend" for outsourced colonscopies, with "a spike" in the 2022/23 financial year, Stokes Lampard said.
However, Health NZ data showed that despite the bump in outsourcing, the growth in the total number of publicly-funded colonoscopies (in both public and private) was slower in 2022 and 2023, compared with previous years.
Comparing calendar years, year-on-year growth increased 8.8 percent between 2017 and 2018, then 12.8 percent (2019), 4.3 percent (2020), 6.3 percent (2021), 3.7 percent (2022) and 3.4 percent (2023) before decreasing 7.2 percent in 2024.
Bowel Cancer NZ medical director Frank Frizelle said the drop in 2024 came on top of the loss of "the usual increase for changes in population demographics, i.e. the ageing population".
Based on the average increase of 6.4 percent over the previous six years (range 3.4 percent to 12.8 percent), that would have meant 4000 more procedures, he said.
"So one might say Health NZ Te Whatu Ora is actually providing in total 8500 less colonoscopies (4500 reduction from previous point plus 4000 from the failure to continue growth for population changes) than the previous pattern would suggest we need."
