(file image). Photo: Gorodenkoff Productions OU / 123RF
Radiology services are under increasing pressure from workforce shortages, ageing equipment and rising numbers of patients needing treatment, according to a just-released report.
A survey by the Royal Australian and New Zealand College of Radiologists has found the number of full-time specialists has risen 9 percent in ten years - but this was outstripped by a 29 percent rise in radiation therapy courses, resulting in doctor case loads going up 19 percent.
Its president Professor John Slavotinek said the report starkly outlined challenges, which had developed over the decade.
"The truth of the matter is that we are not training enough radiation oncologists to meet current, or future, service demand or to replace those practitioners who plan to retire, and urgent investment is required to fix this problem.
"We are keen to work closely with the New Zealand government to sustainable increase the number of trainee radiation oncologists and develop strategies to keep radiation oncologists in the country."
The report noted it was only by staff's "dedication" that the treatment gap was not worse.
"However, putting out endless fires is not a cause for celebration and it does come at a price. The 2020 survey by the Association of Salaried Medical Specialists (ASMS) showed radiation oncology as the speciality with the highest burn out scores."
Ageing equipment
The report also highlighted what it called "a worrying trend" of ageing equipment.
Of the 31 linear accelerator machines nation-wide, 55 percent were more than seven years old, the age that they should be replaced, said the College.
Furthermore, there were not enough of them.
The number of machines equates to 6.1 per million population, less than the optimum ratio of 7 per million population and lower than a decade ago when it was 6.4 per million.
The Royal Australian and New Zealand College of Radiologists president John Slavotinek. Photo: Supplied / Council of Presidents of Medical Colleges
Professor Slavotinek said New Zealand was falling behind comparable countries and there was a pressing need to upgrade and increase equipment in radiation oncology facilities.
"The College will work closely with stakeholders to encourage appropriate funding mechanisms for the timely replacement of older LINACs and necessary expansion of machine numbers to meet demand."
According to the report, the percentage of privately-owned radiation therapy facilities has gone from 25 percent in 2011, to 40 percent in 2021.
Clinicians working in the public sector have previously expressed fears about potential conflicts of interest, and the risk of the system being "gamed" to funnel outpatient work into private practice.
One Wellington radiologist told a review back in 2017 that: "Increased outsourcing of easier scans will lead to a stronger private system in the long run, a weaker public system, and a more expensive health care model."
One positive finding from the latest report was that radiation therapy courses were becoming shorter, due to the adoption of evolving evidence-based practice.
Professor Slavotinek said treatment times for individual patients had changed over the decade due to advances in radiation therapy.
"With radiation therapy estimated to be involved in 40 percent of all cancer cures, we cannot underestimate its importance in the fight against cancer."
The report itself said the adoption of new technology by radiation oncology professionals, coupled with advancements in treatment complexity were bringing encouraging outcomes for patients.
"However, there is real concern that the last survey in particular may indicate a system under strain needing to decide between quality and quantity. The substantial departure of skilled individuals seeking better working conditions in Australia and overseas, coupled with the limited investment in the facilities and the growing technological redundancy of the current equipment, presents a concerning challenge."
The report recommends:
- Increasing the number of radiation oncologists and other health professionals
- Ensuring sustainability through training
- Encouraging timely replacement of equipment and investment
- Monitoring trends in treatment to ensure staff levels keep up with workload demands