A key recommendation in reports aimed at improving the southern colonoscopy service may be scrapped as part of health system reforms.
The possibility has infuriated clinicians and community representatives, who have signed a joint letter published in the latest issue of the New Zealand Medical Journal, out today.
Measurement of how symptomatic colonoscopy patients were treated was essential, but it appeared that the Ministry of Health had deliberately discontinued it, the letter said.
The Southern District Health Board has charted progress of colonoscopy patients following recommendations in several highly critical reports on the performance of that service — shortcomings the board subsequently apologised for.
The ministry has a similar tracking system in place, "the guide to manage colonoscopy wait time indicator performance", but the signatories to the letter were furious to discover that, following an Official Information Act request, the measurement was to be scrapped.
"It no longer meets ministry expectations ... Replacement is not envisaged until after review of the health system," the ministry response said.
Independent researcher Paula Goodman, one of the signatories of the NZMJ letter, said the ministry’s decision was "stultifying and counterintuitive", particularly given the establishment last year of the Cancer Control Agency.
"An inability, or unwillingness, to measure a fundamental aspect of access does not bode well for the achievement of this goal," she said.
The other signatories to the letter were Canterbury Charity Hospital chairman Phil Bagshaw, former Southland Hospital surgeon Murray Pfeifer, cancer campaigner Melissa Vining, School of Medicine Emeritus Prof Gil Barbezat, Otago cancer researcher Brian Cox and Dunedin physician Dave McKay.
Ms Goodman said the group was motivated by a desire for better and equally accessible medical services to be available to the public.
They have now formed a lobby group to advocate for patients and families disadvantaged by problems caused by difficulty accessing services or inadequate clinical care.
The NZMJ letter said the southern district historically had among the highest incidence and mortality rates for colorectal cancer and given recent history it was essential all patients referred for colonoscopy be documented.
However, the ministry guide was taken down at the end of May.
"We have good reason to believe that this matter can be resolved, and patient management decisions improved, only by the collection of reliable data that is independently verifiable," the letter said.
"To claim that can now not be monitored ignores the obligation of care for symptomatic patients for each district health board while screening occurs."
Several of the letter’s signatories have already criticised the health system reviews, specifically the omission of a cancer treatment target in its 12 health system performance indicators.
Health Minister Andrew Little has said their concerns were due to a misunderstanding, and that the ministry would still be measuring DHB performance against cancer treatment targets.
