No quick fix for oncology ‘train wreck’

Lyndell Kelly. PHOTO: ODT FILES
Lyndell Kelly. PHOTO: ODT FILES
There is no quick solution to the "train-wreck" that is oncology services in the south, a former clinician says.

Retired radiation oncologist Lyndell Kelly said not only was there a staff shortage, the exclusion of a new oncology department from the new Dunedin hospital build meant conditions would be a hard sell for experts who could work elsewhere.

Her reaction follows last week’s release of an explosive report by Health and Disability Commissioner Morag McDowell about waiting times for cancer treatment in Otago and Southland, which found that hundreds of people suffered harm.

Assessing how the Southern District Health Board (now Te Whatu Ora Health New Zealand Southern) delivered its non-surgical cancer treatment services from 2016-22, the report said it was clear the care provided was not adequate.

The former health board chief executive and former chairman both defended the board’s efforts, and said the main issue was a lack of specialist oncology staff available.

Dr Kelly, also a former board member, said the major problem was a failure to act on clinicians’ concerns that went back more than a decade.

However the report did not give the board enough credit for changing things from 2020 on, she said.

HNZ Southern apologised following the Health and Disability Commissioner report and said it had taken immediate action to address the concerns highlighted.

This included recruiting for up to three more radiation oncologists in addition to Southern’s current four, a step Dr Kelly said would not be easy.

There should be at least 7.7 fulltime-equivalent radiation oncologists serving the southern region.

In two years, no-one had been recruited, one had left for elsewhere and she herself had retired.

"I have no faith that three ROs can be pulled out of thin air when Australia pays twice the salary NZ does."

Another hurdle to recruitment was that oncology services were set to remain in their present building on the corner of Hanover and Cumberland Sts, rather than being incorporated into the new Dunedin hospital build.

The building was too small already, and demand for services would only grow in coming years, she said.

For example, there were now about 20 specialists compared with six when the building opened and all needed work spaces.

Staff had expanded into a disused floor of the building next door, a "difficult" site with windows that did not work.

"In 10 years' time, it will be worse. This was short-term thinking and will be difficult to sustain."

She questioned how highly-valued staff could be recruited to such a site.

When the new hospital opened, it would also be much harder to check on inpatients and to collaborate with other staff to make treatment decisions.

"The people who decided that this building is young enough to be kept had no idea that oncologists work in an integrated way with other specialties."

Most importantly, it would be hard on the inpatients who needed to be transported for radiotherapy.

"Clunking them around the traffic in an ambulance will be so much worse for them than wheeling the bed along a corridor."

She was very sad about the state of oncology, as were other Southern staff, although management was much more engaged than previously.

However, the issue of how to attract staff remained.

"I think there is no quick solution to this train-wreck".