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Home / New Zealand

Neurologist shortage causes long waits for treatment

By Amy Wiggins
NZ Herald·
10 Jul, 2017 10:30 PM5 mins to read

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Multiple Sclerosis Society of New Zealand vice president Neil Woodhams became involved with the organisation when his wife, Erin, was diagnosed with MS. Photo/File

Multiple Sclerosis Society of New Zealand vice president Neil Woodhams became involved with the organisation when his wife, Erin, was diagnosed with MS. Photo/File

Multiple sclerosis patients are being forced to wait up to 15 months for a follow-up appointment with a neurologist and six months for the results of an MRI in some parts of the country, an advocate says.

Multiple Sclerosis Society of New Zealand vice president Neil Woodhams said there was a major shortage of neurologists which was having a big impact on MS patients.

An Official Information Act request made by the society showed specialist assessments, MRIs and other diagnosis and monitoring procedures were not provided in a timely manner by many health boards, he said.

As at May 26, some MS patients in Canterbury were waiting more than six months for MRI results.

Acting chief of radiology Dr Mike Hurrell said the current waiting time had fallen to 22.5 weeks for a routine MRI but urgent cases could be seen within 48 hours.

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Clinical status guidelines meant even the least urgent MS patients should be seen within four weeks, according to the district's written response.

Additional shifts had been added and some MRIs and reporting had been outsourced in an attempt to shorten wait times.

Hurrell said a rapid increase in population and new funded drugs for MS, which required an MRI to determine suitability, had put pressure on radiology resources.

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In Taranaki and South Canterbury people were waiting four months for an initial appointment - the maximum time Ministry of Health guidelines allow for first specialist assessments.

Taranaki District Health Board chief operating officer Wendy Langlands said some patients would have to wait up to four months for a first appointment in order to allow those with the highest clinical need to get treatment first.

Woodhams said the waiting times for people to see a neurologist were "unacceptable".

"In Palmerston North we have reports of people waiting 15 months for a follow-up.

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"Delays can mean that a person with MS cannot access the treatment they desperately need in a timely manner which may result in disease progression and disability."

Woodhams believed the delays were caused by under-resourcing of the specialty because of a lack of funding.

"New Zealand only has 37 full-time equivalent neurologists employed in DHBs across the country. This figure is a disgrace," he said.

An article in the New Zealand Medical Journal in August 2015 found 74 full-time neurologists were needed to cope with demand at that time, with the pressure only expected to increase.

The journal also found about half of the current workforce would hit retirement age by about 2027 but, on average, only one new New Zealand-trained neurologist was entering the country's workforce each year.

"DHBs need to allocate more funding to employ and retain both New Zealand-trained and international neurologists. As a result of these shortages, neurologists, MS nurses, and other staff are being placed under intolerable pressure to try to provide an adequate service."

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Woodhams, who became involved with MSNZ when his wife, Erin, was diagnosed with the disease more than 20 years ago, said delays could have a major impact on MS patients because in some cases the disease progressed quickly.

"The latest evidence is that the sooner you are diagnosed and the sooner you get on to treatment, the more likely the drugs that are available in New Zealand for treating MS will be successful."

There were no treatments available when Erin Woodhams, 68, was diagnosed with MS in 1994. Since then she had lost the ability to walk and was confined to a wheelchair.

She said it was vital for people to be diagnosed and treated quickly because the drugs often stopped the disease progressing and cleared up many of the symptoms.

Prompt treatment was important "to keep your life going", she said. "Especially if you have young kids. "The drugs are there. Why not use them."

She said more funding was needed to "give people a chance" at a normal life.

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Association of Salaried Medical Specialists executive director Ian Powell agreed there was an under-supply of neurologist positions in the country's public hospitals.

"These are not so much advertised positions but positions not advertised leaving existing staff to cover. This means overstretched neurologists, delays in specialist assessments and delays in necessary follow-up treatment."

Ministry of Health group manager for Health Workforce New Zealand (HWNZ) Claire Austin said she was aware of the pressures on the neurology workforce that were driven by the age of neurologists, the rising burden of neuro-degenerative disorders and new treatments for people with strokes.

The role of neurologists was changing to become more focused on diagnostic skills, which would help to ease workforce pressures, while nurses and other specialists including occupational therapists, physiotherapists and speech language therapists also worked with patients, she said.

Austin said HWNZ funded the training of neurologists and, as at September 2016, had three trainees.

Neurology was not currently on the ministry's voluntary bonding scheme as a hard-to-staff speciality, but consultation was under way to identify what specialities to include in the scheme for 2018.

About Multiple Sclerosis:
●MS is a progressive disease of the central nervous system, for which there is no cure at present.
●MS affects 2.3 million people worldwide.
●About 4000 New Zealanders live with the disease.
●More women than men have MS, with a global ratio of three women to one man.
●Diagnosis of MS is generally between 20 and 40 years of age, although onset may be earlier.
●MS attacks the nervous system. Symptoms can include sight loss, pain, fatigue, incontinence and disability.

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