File photo / NZ Herald
Nearly half of patients on "urgent" public hospital waiting lists for a procedure to check for suspected bowel cancer are seen within the target time of two weeks, the Ministry of Health says.
"Just under a third of those requiring semi-urgent colonoscopies receive them within the six week guideline," said the ministry's manager of bowel and prostate cancer Mhairi Porteous.
The ministry was responding today to sharp criticism by Beat Bowel Cancer Aotearoa when the charity released statistics it had obtained under the Official Information Act.
It said the data on delivery of potentially life-saving bowel cancer diagnosis and treatment was "alarming" and showed that district health boards had been unable to meet the targets for urgent or semi-urgent patients.
The charity's chief executive, Megan Smith, said the data, covering the year to January, "confirms what we have been hearing from patients and families for a while, but the scale of the problem is bigger than we feared.
"This problem has been building incrementally and the minister needs to sort this out urgently. This problem of capacity requires leadership at a national level, and significant investment of resource."
The ministry, however, said there had been considerable recent investment by Government in efforts to improve colonoscopy delivery.
This included $3.5 million this year in one-off funding for DHBs to perform more than 3000 extra colonoscopies prioritising patients most in need. The number of colonoscopies delivered each year had increased significantly - by 20% in the past five years to 41,000 in 2012/13.
There was also $1.8 million over two years (2012/14) for quality improvement in colonoscopy services within DHBs. An extra $8 million was announced in this year's budget to further reduce waiting times.
Consistent access to colonoscopy was improving with the introduction of nationally agreed referral criteria early last year, the ministry said.
Ms Smith said hospitals' own data showed few were able to meet the targets.
Health Minister Tony Ryall has acknowledged problems in colonoscopy services but has said improvements are being made. A year ago, around half of patients requiring urgent colonoscopies met the then new waiting time indicator of 14 days.
The Government announced in the Budget this month that it would spend an extra $8 million on colonoscopy over the next five years.
Ms Smith said the data her organisation had obtained, which covers the year to January "confirms what we have been hearing from patients and families for a while, but the scale of the problem is bigger than we feared.
"This problem has been building incrementally and the minister needs to sort this out urgently. This problem of capacity requires leadership at a national level, and significant investment of resource.
Hospitals' own data showed few were able to meet the targets, Ms Smith said.
"The New Zealand government has earmarked less than $2 per New Zealander of new money to address the problem of bowel cancer. In contrast, $307 million was allocated to road safety, when bowel cancer is killing five times the national road toll. The numbers don't stack up".
Bowel cancer survivor and public health researcher Dr Sarah Derrett, an executive member of the charity, said: "Some New Zealanders will have the money or insurance to opt for private colonoscopy, but many New Zealanders are not in a position to self-fund and the identified regional inequalities are stark. In New Zealand, where each year bowel cancer kills as many people as breast and prostate cancers combined, such inequity is something we should all care deeply about."
New Zealand has a pilot bowel cancer screening programme running in the Waitemata DHB in Auckland. In 21 months, 107,637 people were tested and 129 were diagnosed with bowel cancer and a further six were diagnosed after choosing to have a private colonoscopy. Most diagnosed in the pilot were found to have early stage disease, a positive predictor for increased chances of survival.
"Every expert agrees that bowel cancer screening saves lives, and that colonoscopy capacity is the rate limiting step. Why has it taken until the third year of the pilot to start to talk about capacity? The same problem has been faced in every country that has considered screening and the answer is the same - to build capacity, you need investment. Anything else is a stalling tactic," said Smith.
"The data obtained by Beat Bowel Cancer Aotearoa confirms our understanding and the feedback we've had from Kiwis who either themselves or people close to them are dying unnecessarily from this cancer. Depending on where you live, you can expect different levels of access to bowel cancer diagnosis and treatment services. We call on the government to report on rates of access against the targets and to work with DHBs to provide prompt solutions to the identified problems in terms of workforce and colonoscopy service capacity."