Surgeon calls out SDHB

Phil Bagshaw
Phil Bagshaw. PHOTO: SUPPLIED
Cancer patients are suffering because of Southern District Health Board's "pathetic" failure to fix its colonoscopy service and the Minister of Health needs to intervene, a leading surgeon says.

Christchurch general surgeon Phil Bagshaw made the comments after a review, released yesterday, came to many of the same conclusions about dysfunction within the DHB’s gastroenterology department as a review he co-authored 18-months ago.

The report found several reasons for colonoscopy referrals being declined or delayed, including referrals not having the required information, poor relationships between staff having an impact on patients and long waiting lists.

Mr Bagshaw said based on the DHB’s response to previous reviews, including his own, he had no confidence they would take responsibility now.

"There will be more reports and people running around with clip-boards, and I have no confidence, and the Minister must have no confidence," he said.

After the DHB’s "pathetic" response it was time for Health Minister Chris Hipkins to intervene and get rid of the staff responsible.

"If the minister wants a list [of people to dismiss] I can provide him one instantaneously," he said.

While the DHB conducted its latest review, patients continued to suffer unacceptable outcomes, and recent tragic stories had emerged.

It seemed the default position was to defer, delay and deny colonoscopies to somebody with symptoms, he said.

There had been five reviews since 2017.

"They have been given every opportunity to put this right, they have been given all the advice they need on how to put it right, they haven't, now they must go."

Rather than action, it was "well, we will have another review", he said.

"Money and personal prestige had been traded against human misery.

"The time for being cautious about what we say is gone — this is a terrible burden to know nothing is happening here. It has to, it must."

A new finding of the latest review was that while other DHBs had increased their colonoscopy access by 45%, the Southern DHB had not increased it at all, he said.

Instead, it had "aggressively" gone for screenings at the expense of providing colonoscopies to symptomatic patients.

The latest report, written by Auckland colorectal surgeon and National Bowel Cancer Working Group chairman Ian Bissett and Rutherford Clinic general manager Kate Broome, found that the SDHB had a higher rate of bowel cancer in its district than elsewhere in New Zealand, but appeared to have a relatively low rate of colonoscopies.

In a response, which will be discussed at next week’s meeting, the DHB noted several themes echoed previous reports.

It also proposed to urgently improve its referral template and provide greater oversight of patients through an Endoscopy Oversight Group supported by a project manager, and a Clinical Referrers' Group to ensure processes were being adhered to.

The DHB’s report aimed to review 102 patients, but only 50 were reviewed.

It also took longer than anticipated due to a variety of reasons, including the way records were kept and the impact of the Covid-19 lockdown.

DHB chairman Dave Cull said the board was aware of the challenges in the colonoscopy service and efforts to address those in recent years.

It would be considering the latest report at its board meeting.

"It would be inappropriate for me or others to comment on the recommendations or next steps until we have done so."

Health Minister Chris Hipkins said during a stand-up yesterday that the fact the DHB had five reviews to make sure they were making progress was a "good thing".

But the fact there were still issues was concerning.

"It clearly is not good enough, and the DHB acknowledge that it is not good enough," he said.

He said the ministry would be watching to make sure changes were made.

Comments

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Well done Dr Phil Bagshaw, it is time they are held accountable especially Cull the clown has wreaked havoc on Dunedin and Otago for way too long and hasn't been held accountable - time for Cull to go along with others, Cull is nothing more than a story teller who is sponging on the tax payers and previously the rate payers of Dunedin. Resign Cull

nothing to do with Cull, been going on for years.

Sorry Jan - Cull used similar phrases to that when he was Mayor. The fact is Cull is part of that board means he is accountable something he hasn't been before, if the board had an action plan with a way ahead it might be just ok, or if they had gone to the Government cap in hand for funding. To me Its more of this sweep it under the carpet, ignore it attitude that has been so common with Cull, he dodges the issues, wordsmiths things to make himself look good, never stands up and takes responsibility - he is a story teller and always has been, he is in a group or position on this board where peoples lives depend on the boards actions,

But at least the SDHB have been able to make a concerted effort at recommending pathetic parking options at the proposed Dunedin Hospital. #Priorities.

Spending money on paper and the ones that write to it, rather than those who can actually fix the problem. The handling of bowel cancer in Otago and Southland - the region of highest incidence has been orchestrated to be poorly attended to for years and governments. When does it become negligent manslaughter to allow services to not be provided to a region similarly to other regions?

An understandable oversight ! When your focus is on traffic flows around the city and the mode of transport people use, some things get overlooked. There are only so many hours in a day and the SDHB been focused in other 'health' related areas.
If you didn't pick it, that is a dig at where this little band elites choose to focus their time, gazing at their own colon instead of their knitting.
Thankfully, we STILL have doctors capable of showing them where the sun does shine.
That is a dig at our Uni who would rather doctors be political appointees rather than getting there on the their merits.

Lets be fair to the SDHB, they did improve the apology department.

I seem to recall DHB having a govt appointed commissioner to sort things out. What an expensive waste of money, nothing sorted and even bigger debts; as much use as a chocolate teapot. Same goes for Cull the clown. Ineffective as mayor and will be in his DHB role; just another gob on a stick. The gastro services problem won't be sorted until there are competent new managers in place.

It's been going on - and kept quiet - for over 10 years. I know this because my husband was refused testing in his late 40's because 'he was too young to have bowel cancer' and 'there was no family history'. He died at 51, diagnosed overseas after a rush trip to hospital emergency. It had been going long before then. I'm sad to see nothing has changed and lives are STILL being taken - and changed - needlessly. SDHB you need to start taking some responsibility for the grief you cause.

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