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Christchurch Surgeon General Phil Bagshaw made the comments after a review, published yesterday, reached many of the same conclusions about dysfunction within DHB’s gastroenterology department as a review he co-authored 18 months ago. .
The report found several reasons why colonoscopy referrals were declined or delayed, including referrals that do not have the required information, poor relationships between staff that impact patients, and long waiting lists.
Bagshaw said that based on the DHB’s response to previous reviews, including his own, he was not confident that they would take responsibility now.
“There will be more reports and people running around with clipboards, and I have no confidence, and the Minister must not have confidence,” he said.
After the DHB’s “pathetic” response, it was time for Health Minister Chris Hipkins to step in and get rid of the responsible personnel.
“If the minister wants a list [of people to dismiss] I can provide you with one instantly, “he said.
Although the DHB conducted its latest review, patients continued to suffer unacceptable results and recent tragic stories emerged.
It seemed like the default position was to defer, delay and deny colonoscopies to someone with symptoms, he said.
There have been five reviews since 2017.
“They have been given every opportunity to fix this, they have been given all the advice they need on how to fix it, they haven’t, now they must go.”
More than action, it was “well, we’ll have another review,” he said.
“Money and personal prestige had been traded against human misery.
“The time to be cautious with what we say is up. It is a terrible burden to know that nothing is happening here. It has to be this way.”
A new finding from the latest review was that while other DHBs had increased their access to colonoscopy by 45%, the Southern DHB had not increased it at all, he said.
Instead, he had “aggressively” undergone screening at the cost of providing colonoscopies for symptomatic patients.
The latest report, written by Auckland colorectal surgeon and chair of the National Bowel Cancer Task Force, Ian Bissett, and Rutherford Clinic General Manager Kate Broome, found that SDHB had a higher rate of cancer than bowel in his district than anywhere else in New Zealand, but he seemed to have a relatively low rate of colonoscopies.
In a response, to be discussed at next week’s meeting, the DHB noted that several issues echoed previous reports.
It also proposed to urgently improve its referral staff and provide greater patient supervision through an Endoscopy Oversight Group supported by a project manager and a Clinical Referral Group to ensure processes are adhered to.
The DHB 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 President Dave Cull said the board was aware of the challenges in the colonoscopy service and efforts to address them in recent years.
You would be considering the latest report at your 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 meeting yesterday that the fact that the DHB had five reviews to make sure they were making progress was “a good thing.”
But the fact that there were still problems was worrying.
“It’s clearly not good enough, and the DHB recognizes that it’s not good enough,” he said.
He said the ministry would be vigilant to make sure changes are made.
