Chris Fleming, who held the position between 2016 and 2022, said the key issue which saw the area rank last and second-last out of 20 health districts for treating cancer patients within two government-prescribed targets was an inability to find staff.
Former board chairman Pete Hodgson also echoed the difficulty of finding oncology staff and said board engagement was "very significant".
This follows yesterday’s release of a damning report by the Health and Disability Commissioner, which examined delivery of non-surgical cancer service by the board — now Te Whatu Ora Health New Zealand Southern — between 2016 and 2022.
Hundreds of people in Otago and Southland were harmed as repeated calls to address wait times for cancer treatment were ignored, the report said.
"Te Whatu Ora Southern failed to recognise and respond to the clinical risk created by the lack of capacity."
Poor clinical governance systems, inadequate quality-control measures and a poor relationship between doctors and management combined to create the situation.
Mr Fleming said the board took steps to address the situation, increasing service capacity as much as it could.
There was some dysfunction between departments, and in hindsight they could have come to an earlier realisation of the issues, he said.
The main limiting factor was not money, but rather an international lack of specialist oncology staff to spend it on.
He believed some of the money allocated to Southern remained unspent due to the inability to recruit, as not enough oncologists were being trained either nationally and globally.
"The thing I took the most exception to in the report was the suggestion that management and the board were not taking it seriously."
"We simply could not magic up the resources out of thin air."
Mr Hodgson said he had been chairman for 18 months, and it had taken him about three to realise the difficulty cancer services were in.
He flagged a shortage of experts as the key issue, especially as staff neared retirement.
The board had "lived and breathed" treatment statistics, and took steps such as using locum staff and sending people elsewhere for treatment.
When the DHB system came to an end in July last year, it had also been scouring internationally for radiation oncologists, with "very little progress".
More oncologists urgently needed to be trained in Dunedin to prevent this from continuing as a problem in future, Mr Hodgson said.
The commissioner’s report said the lack of investment in staffing — needed to cope with the rising demand for services in Southern — had occurred over a number of years.
"This lack of investment stemmed largely from the deficit status of the DHB leading to a focus on fiscal management rather than avoidance of patient harm."
Concerns raised were discounted, and no meaningful intervention occurred until a Harm Register was established in 2021, an initiative of clinical staff.
A quick response occurred once the degree of patient harm was recognised.
Responses included $2 million in unbudgeted funding for cancer service staff, and commissioning a report from consultancy firm EY on how to improve provision of treatment.
However, the conservative recommendations of the EY report had not led to significant action according to clinical directors, the report said.
There was also an inevitable delay in recruiting the necessary staff.
Patient advocate Melissa Vining, whose initial complaint about Southern cancer treatment waiting lists sparked the commissioner’s investigation, said those from the Minister of Health down to board members all knew people were being harmed due to under-resourcing.
"Appropriate action would have been paying more and recruiting when the doctors raised the concerns of labour shortage and increased patient numbers," she said.
Current Health Minister Ayesha Verrall declined to comment on the situation.
