By Rowan Quinn for RNZ
Thirty-five South Auckland women had their diagnoses of breast cancer delayed last year as Counties Manukau DHB struggles to see patients on time.
Wait times for the breast service appointments have blown out - and some women are waiting months longer than DHB's targets.
That had resulted in an increased clinical risk, including the delayed diagnoses, chief executive Margie Apa said in a report to the board.
Clinical director of cancer services Jon Mathy says the 35 were "surprises" from a group that was referred with a low suspicion of cancer, he said.
It was difficult to say whether the delay would have affected the outcome for the women but it was always best to identify cancer as early as possible, Dr Mathy said.
"It's having the capacity, the physical space and time in clinic to see those patients who don't necessarily appear on paper to have cancer but deserve a through investigation to rule it out," he said.
Women with the highest need were seen and treated quickly - even if it was a struggle to do that at times, he said.
Board chair Mark Gosche said the "triple whammy" of growth, poverty and obesity had contributed to the delays.
Māori and Pacific women had higher rates of cancer, and the Counties Manukau population had higher rates of obesity, he said.
"Our resources that are stretched anyway are further stretched by just the time it takes for our surgeons and staff to work with people is sometimes half as much again," he said.
The region had been underfunded for years and needed more operating clinics - and the staff to work in them.
The DHB's figures show most of those with a high suspicion of cancer were seen by a specialist within the two-week target, and some were seen two days later.
Those with a low suspicion of cancer would ideally be seen in 30 days, or six weeks at the very latest, but were taking between three and five months.
The breast service has put emergency measures in place to try to catch up, including Saturday clinics.
A third breast clinic was planned, but that would only help the problem in the medium to long term.
In her report, Apa said the Counties Manukau population and the rate of cancer were growing but the number of appointments funded had not increased since 2004.
When patients were treated, they went to a "one-stop shop" clinic that combined multiple appointments into one, meaning they could be diagnosed and begin a treatment plan on the same day, she said.