Improvement to the colonoscopy service in Dunedin will require funding and people working together constructively, national Gastroenterology Society president Associate Prof Susan Parry says.
There was "good potential" for the service under the proposals to redevelop the existing Dunedin Hospital endoscopy suite, but people would need to work together to solve problems and put the plans into action.
Funding was always constrained, but it was an important initiative, she said.
Prof Parry, of Auckland, was in Dunedin for the recent annual scientific meeting of the society and the gastroenterology nurses' section of the New Zealand Nurses' Organisation.
She said the collaboration between the University of Otago and Southern District Health Board over the proposed development of a gastrointestinal diseases centre of excellence was a great idea for Dunedin.
It had the potential to "catapult" Dunedin into "quite a different scenario" with regard to delivering gastroenterology services.
"It has only got to be good for the people in Otago."
Prof Parry said the centre would increase the possibilities for dialogue between gastroenterologists and surgeons and researchers and help stop "silo" thinking.
Problems with access to colonoscopy services at Dunedin Hospital hit the headlines about two years ago and while there has been some increase in the number of procedures carried out, there is a limit to what can be offered in the existing cramped endoscopy suite.
The district health board has allocated $1.82 million for redevelopment of the unit in this financial year and another $729,000 next year.
Prof Parry said the chief concern for all those involved with the upgrade had to be the people of Otago with symptoms of concern who might be waiting anxiously for the timely delivery of procedures.
Speaking about national bowel cancer screening, Prof Parry said it was "absolutely great" to hear that the first of the screening kits had been sent out in the pilot programme being run by the Waitemata District Health board this week.
She accepted there were critics of the length of time it had taken to get this far, but offering a safe, well-monitored, timely, quality programme was much more than offering the initial test.
Asked when she would like to see a decision made about a national screening programme, Prof Parry suggested the question be put to her again in two years when one round of the pilot would have been completed.
The Ministry of Health has consistently not given any decision date, but indicated it would follow analysis of the full pilot, which is expected to take two years.
At the final day of the conference last week, among the topics under discussion were nurse endoscopists, and whether flexible sigmoidoscopy was a better and possibly cheaper alternative to the faecal occult blood testing being offered in the pilot programme.
University of Otago cancer researcher and screening programme authority Associate Prof Brian Cox, who supports a one-off flexible sigmoidsocopy (FS, a procedure which internally examines the lower bowel) as a screening tool, showed how it could be introduced over a five-year period which would include time for training of extra nurse or GP endoscopists.
He suggested such a programme could save more lives and $67 million over 10 years.
His view was counteracted by gastroenterologist Dr Tim King who said an FS screening programme would result in more follow-up colonoscopies and impose a significant procedural burden for potentially relatively small gains.
Prof Parry said one of the concerns about FS was the expected lower take-up of the test.
She noted that the Waitemata pilot was the first screening programme involving men and it would be "very interesting to see how they respond".
On the issue of nurse or non-medical endoscopists, Prof Parry said the society had not yet made a decision about how to raise endoscopist numbers.
This was also a complex issue.
There was already a shortage of gastroenterologists, but they would be required to train the new endoscopists and there was the other issue of limited theatre space.
