Gastrointestinal centre of excellence

A New Zealand centre of excellence for gastrointestinal diseases will be established in Dunedin.

The long-awaited upgrade of Dunedin Hospital's endoscopy suite will be part of a Southern District Health Board and University of Otago collaboration.

Gastroenterologist, academic and former hospital department head Emeritus Prof Gil Barbezat, who will chair the centre's establishment board, said the centre would be a first for New Zealand.

It aims to be a centre of excellence for gastrointestinal diseases, providing high-quality clinical services as well as supporting excellence in research and training.

Service for patients using the centre should be "as good as if not better than national requirements", he said.

He is excited by the development, although a little nervous about the fact the group has been told it needs to have its draft plans for the centre (on the eighth floor of the hospital's ward block) on the health minister's desk by August 6.

The group was going "helter skelter" in order to meet the deadline, although much of the work had already been done.

It is likely the new centre will cost millions of dollars, but no details are available on cost or funding sources.

Poor access to colonoscopy services at the hospital was highlighted in 2009 when it became public knowledge general practitioners were upset some patients with accepted signs of bowel cancer were being denied a colonoscopy.

A gastroenterology project board was set up following an audit of some of the patient referrals, funding was allocated for extra colonoscopies, and an upgrade of the endoscopy suite was announced at the end of last year.

Before it could proceed, however, negotiations had to take place with the Dunedin School of Medicine because the area sought was occupied university space.

The hospital, with its cramped conditions, has found it difficult to attract gastroenterologists and has not been able to keep up with its planned colonoscopy numbers during the last year - one of the issues which led to the National Health Board's recent review of hospital systems. The board's report is expected next month.

Prof Barbezat, who retired as department head in the mid-1990s, said concerns about the adequacy of the facilities dated back to his time.

Two endoscopy rooms were needed, and the new centre would also require space for undergraduate and postgraduate teaching and research.

Prof Barbezat has been appointed for six months initially, with another three months if necessary.

He said the disciplines of gastroenterology and surgery had been quite close over the years, with combined management of some illnesses, including cancer and inflammatory bowel disease.

Despite that, for many years the two areas had "never developed as a combined force" and the centre would be an opportunity for that.

Prof Barbezat said the centre would also "tackle" how to provide a better service to the community with better links between the hospital and general practices so that there was clear understanding about referral criteria and who would qualify.

The centre would use the national criteria for those with symptoms and also for those requiring surveillance colonoscopies - people with a familial risk of bowel cancer and those requiring follow-up after surgery.

After the establishment phase, the centre will be run by its own governance board.

Prof Barbezat expected the centre leader's position would eventually be advertised internationally.

elspeth.mclean@odt.co.nz

Board's tasks
• Provide direction on changes and facilities
• Define university and Southern DHB relationship
• Develop and recommend goals and strategies
• Recommend terms of reference for, and manage transition to, new board