Urology crisis not an isolated case

News yet another Southern District Health Board service has been examined by independent experts and found to be sorely wanting is a profound disappointment.

Last week, the Health and Disability Commissioner released a deeply concerning investigation into the SDHB's urology service, which depicted a department marching its way lemming-like towards a crisis but seemingly having no way to stop before falling into disaster.

The commissioner instigated the report on his own initiative after receiving 38 complaints about urology services within a short period of time; the problems racking the department may well have been worse, as not everyone complains to the HDC.

As well as slating the service and its management for its sloth-like reaction to impending trouble, the commissioner singled out four individual cases.

HDC cases do not identify individuals, both to encourage clinicians to participate without fear of repercussions and to protect patient confidentiality.

However, two of the four patients - Andrea Woodford and Stephen Hoffman - waived their anonymity to tell the Otago Daily Times of the pain they had suffered following their treatment by the urology service.

Ms Woodford cannot work due to incontinence and severe pain; avoidable delays in treating her bladder symptoms properly placed her in this situation, yet she has still endured delays having follow-up scans performed within acceptable timeframes.

Mr Hoffman also had to give up work after constant procrastination in treating his prostate cancer symptoms; his cancer subsequently spread elsewhere in his body, and he knows he will live a shorter life than he should.

Both told their story in the hope other people would not go through the agonies they have; the SDHB has promised to put things right, and it absolutely must do so.

The crisis in urology services should not be seen in isolation.

This is not the first SDHB department to have found itself dealing with a crisis largely of its own making in recent times.

The HDC released an alarmingly similar report last year on the SDHB's ophthalmology service, which said people's sight had been irreparably damaged by delays in receiving treatment.

More recently, an independent review of the gastroenterology service found some people had been inappropriately declined endoscopy, which had led to delayed cancer diagnosis.

Inappropriate rationing also meant some patients in the SDHB area were less likely to receive endoscopy for the same symptoms than patients living in other areas.

There is also the sad story of Blair Vining, an SDHB bowel cancer patient who spent his last months fighting for better cancer care treatment for all.

Both the urology and ophthalmology departments have made determined efforts to tackle waiting lists; their progress is welcome, but it must not be forgotten that "super clinics" and weekend clinics staffed by out-of-town clinicians are catch-up programmes which were avoidable had proper management of waiting lists been in place beforehand.

In some cases, SDHB bosses are copping the fallout for mistakes made under earlier regimes. The organisation says it has learned from its mistakes and is now more reactive to possible problems, particularly concerning waiting times.

Services identified as facing potential issues are now placed under an intensive management regime, in the intention of dealing with an issue before it becomes a problem, and stopping any problem becoming another crisis.

The effectiveness of that tool remains to be seen, but in bravely coming forward, Ms Woodford and Mr Hoffman are reminders, like Blair Vining, that failures in health services are not abstract events; they cause immeasurable harm to real people, their families, friends and workmates.

The newly elected SDHB has much work ahead of it to regain the confidence its community has lost in it following a depressing litany of failures, apologies and promises to do better in future.


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