A woman caught in treatment delays at Middlemore Hospital has slammed a "ridiculous" lack of funding that has meant her life "is on stop mode again".
But Hayley Colling, 30, is full of praise for the staff at Counties Manukau DHB, including a surgeon who has gone above and beyond in helping treat her severe endometriosis, an inflammatory disease where tissue similar to the lining of the uterus is found outside the womb.
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Colling has had three operations in the past few years, including a hysterectomy. After that major procedure she "had a pretty good run", but recently her pain increased.
"My surgeon said, 'Okay, we possibly need to look at doing another surgery' but the process has gone from it being a three- to four-month wait, to more like nine months to a year."
She has other conditions and hasn't been able to work for the past six years. However, for a window of time after Colling's last surgery she was able to live more normally and step-up volunteering work. Now, she's back to battling side-effects from medications.
Middlemore Hospital has the country's busiest women's health service, and has had to prioritise surgery for the critically or acutely ill, or those with life-threatening conditions like cancer.
Other women with "non urgent" but nonetheless serious and often debilitating gynaecological conditions are declined because of a lack of capacity, including those with suspected endometriosis, incontinence, pelvic pain and prolapse.
"I'm in the system, so it's a lot easier for me to get appointments compared to someone who is going to their GP and trying to get in," Colling said. "From my understanding, all of us are going by the wayside because of cancers or obesity issues. And that [prioritisation] is needed. But the rest of us are out here going, 'Well, we can't live.'"
Middlemore staff "have a huge heart for patients, but they are stuck - my surgeon is paralysed to do anything else because of the way the funding is".
"I've been well enough to do stuff for a little bit of time - it's been really nice to have a year of life, to a degree. And now I'm just on stop mode again. I have to just shut life down. I can't plan one day to the next."
Another woman, who asked not to be named because she works in the health sector, was referred by her GP for a laparoscopy to diagnose and remove mild to moderate endometriosis and put on the waitlist in November 2017.
It was finally done in May this year, after the 24-year-old made a formal complaint about the delay and lack of communication. During the wait she took heavy-duty painkillers but struggled to function, often going to the emergency department in severe pain. At times she struggled to walk.
"I couldn't get out of bed. I couldn't unfold myself from the seated position, despite having enough codeine to knock out a horse.
"Honestly, if it wasn't for my GP I would still be waiting for that surgery. It got to the point where I was looking at the charity hospital."
A major problem at Middlemore is a lack of operating theatre capacity. The DHB has started outsourcing some procedures to private practices, including 150 hysteroscopies, which look for problems in the lining of the womb such as cancer, and more to follow.
Dr Sarah Tout, Counties Manukau's clinical director of women's health, acknowledged women's stories "describe the impact of prolonged waiting for surgery". Theatre waiting times were decreasing and more women were getting surgery, she said. About 80 to 100 cases are declined each month - roughly 8 per cent of referrals.
"It is important that we accept referrals only for women we have the capacity to treat. All women with possible gynaecological malignancies, those with urgent gynaecological conditions and those who present when acutely unwell are accepted for assessment and treatment."
Tout recently called on the Government to help, saying, "everyone is trying to do the best with what they have. But we don't have enough to do what we want, or need, to do".
Tout said that all public health services have cases or conditions that "would/may benefit from treatment but that our limited public health resource must prioritise the most urgent cases to be seen".
"With unlimited resources we would be able to provide assessment and treatment to everyone regardless of their clinical priority. We do not have unlimited resources therefore we have a responsibility to triage our work to those with the highest need. We will slowly and responsibly be opening the door to see Priority 3 graded gynaecology patients as we increase our capacity to treat these women."
Associate Health Minister Julie Anne Genter, who has responsibility for women's health, said Counties Manukau DHB got an extra $83 million in Budget 2019, "but we may need to do more".
"And I will be asking questions to ensure that the increase in funding is also getting through to women's health. We can't make up for underfunding in just one or two years.
"My heart really goes out to all those women that are suffering. I'm really committed to make sure our health system is in a position to better meet their needs."