Cancer patient 'kept in the dark'

District health boards should tell patients about private health care options if public hospital specialists cannot see them within six months, the Health and Disability Commissioner says.

In the commissioner's office's first report on health-care rationing, Ron Paterson has criticised the Southland board, one of its former specialists and to a lesser extent a GP, over delays experienced by a patient in his 60s who was found to have prostate cancer.

Mr Paterson's report, released today, arrives amid National's ongoing attempts to embarrass the Government over waiting lists for elective surgery and assessments.

The report says the patient was referred by his GP to Southland Hospital urologist Sajan Bhatia in 2002. After looking at the patient's file and test results, Mr Bhatia assigned him "urgent" status. The patient waited for 22 months after the referral to be seen by the urologist before a locum for his GP referred him to a private specialist.

The report said the delays had the potential to endanger the man, but an expert quoted in the report found that ultimately they had not compromised his diagnosis, treatment or outcome.

Mr Paterson said that Mr Bhatia - whom he refers to anonymously as Dr D - assigned "urgent" status to more than half of the patients referred to him for assessment.

"Dr D did not fulfil his responsibilities in relation to prioritisation. He simply added Mr C to the ever-growing list of patients awaiting first specialist assessment. Dr D's high level of assigning patients to 'urgent' meant that he was not adequately differentiating between patients in this group."

He "must have known" that he could not see the patient within six months, yet he did not explain this in a letter to the man's GP. If he had, the GP might have been alerted to follow up on the referral letter after six months or to suggest private treatment.

But the health board carried the main responsibility for ensuring the patient and his GP were "given clarity" about when they could expect an assessment, Mr Paterson said.

If the number of patients referred to public hospital specialists was greater than could be dealt with, the health board was responsible for telling patients - and their GPs - whether they would be seen within six months.

Comprehensive information should be supplied, including the reason for any delay, the report said.

The GP should be told to re-refer the patient if his or her condition worsened or if other information affecting their priority became available.

"The patient and the GP should be given clear and specific advice about the option of seeking private assessment and treatment," Mr Paterson said.

The board's "total failure" to provide the required information was a breach of the code of patients' rights.

"District health boards cannot stand by passively while patients are denied timely treatment."

The Southland board said last night it had failed the patient concerned. Its management of the waiting list at the time was constrained by a number of matters, including "employment-related issues". It had subsequently implemented a range of changes which had reduced urology waiting times.

Mr Bhatia has since resigned from Southland Hospital but has been voted on to the board. He could not be contacted last night.