Bowel cancer: High-risk patients in Manawatū affected by halt on colonoscopies, minister told

Malcolm Mulholland was among 850 people who were told in December their surveillance colonoscopies were being put on hold in the MidCentral region. Photo / Mike Scott

• The MidCentral region paused surveillance colonoscopies in November because of high demand and staff shortages.
• About 60 people at high risk of bowel cancer were among those affected.
• Health NZ is now clearing the backlog by outsourcing to the private sector and running weekend lists.

Patients who were at high risk of getting bowel cancer were among those affected by a pause on routine check-ups.

Palmerston North Hospital paused surveillance colonoscopies late last year because it could not keep up with demand, while continuing to offer the procedure for symptomatic patients.

It has now resumed surveillance colonoscopies and is running extra appointments on weekends to cut waiting lists. It has also outsourced nearly 200 operations to the private sector.

A briefing to former Health Minister Shane Reti, released under the Official Information Act, said MidCentral’s gastroenterology service had been impacted by increased demand and senior staff taking leave unexpectedly. The service covers the Manawatū district – about 190,000 people.

The gastroenterology department had attempted to relieve pressure by recruiting more staff, referring patients to other regions, outsourcing and holding extra sessions on weekends.

Despite these measures, wait lists had continued to grow, leading to the “difficult” decision to pause surveillance colonoscopies in November. Symptomatic colonoscopies and bowel screening colonoscopies, in which disease was more likely to be detected, continued.

The briefing showed that the pause affected a group of people who had been identified through the National Bowel Screening Programme as needing a surveillance colonoscopy once a year. This group of about 60 patients was deemed high-risk for developing colorectal cancer.

“Consequently, these high-risk [bowel screening] participants are among those patients awaiting a colonoscopy and are adversely impacted by the decision to pause surveillance in MidCentral,” the briefing to the minister said.

Officials said there was a “clinical risk” in not offering a surveillance colonoscopy for people with a history of polyps or a family history of bowel cancer.

Patient Voice Aotearoa chairman Malcolm Mulholland was one of about 850 patients who received a letter in December to say their colonoscopy was on hold.

He said he was particularly concerned about the 60 patients identified as high-risk of developing colorectal cancer.

“I sincerely hope that no patient awaiting a surveillance colonoscopy has subsequently been diagnosed with colorectal cancer, or worse, died,” he said.

The Herald asked Health NZ whether the high-risk group had since received colonoscopies.

In a statement, MidCentral group director operations Sarah Fenwick did not directly answer questions about this group. She said surveillance colonoscopies resumed in February, including additional lists on Saturdays at least twice a month.

The gastroenterology department had also outsourced 187 colonoscopies to the private sector, with 80 getting their operation so far.

In February, Health NZ said there were two specialist vacancies at the service. These roles were still being filled.

“Priority has been given to locum gastroenterologist support, and we are actively recruiting to fill our workforce vacancies,” Fenwick said.

The briefing to the minister said other regions were also under pressure to stop surveillance colonoscopies, but MidCentral was the only region to go ahead with a pause.

Health NZ data showed that about 66% of patients in the region were waiting more than the maximum recommended time for a colonoscopy (120 days for a surveillance colonoscopy) – the highest rate in the country.

It comes as the Government plans to extend the age range for bowel cancer screening nationwide.

The screening age will be lowered from 60 years old to 58, beginning with two regions in October.

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