An additional MRI scanner has now been installed at Dunedin Hospital. Photo:
A man who waited four-and-a-half months for urgent scan at Dunedin Hospital to check whether his cancer had returned now has a terminal diagnosis.
The Health and Disability Commission has just released a decision criticising Te Whatu Ora Southern for failing to provide the MRI scan within the acceptable time-frame of 31 days.
The patient, who had a history of melanoma, was referred for the MRI by an orthopaedic surgeon in late 2021 to investigate pain in one leg.
"However, in the man's case, the scan was not completed until 20 weeks after it was requested. The scan showed metastatic cancer in the man's spine, which had caused spinal cord compression.
"The man said: 'This delay meant further spread of the cancer through my spine and organs, resulting in the current situation whereby the cancer is now not survivable'."
Deputy Health and Disability Commissioner Dr Vanessa Caldwell said "the unacceptable delay in carrying out the man's MRI scan, and the missed opportunity for earlier diagnosis and treatment of his cancer, was not care of an appropriate standard and a breach of Right 4(1) of the Code".
Te Whatu Ora accepted the finding that its failure to complete the patient's scan within the clinically-accepted time-frame "indicated a systemic failure", and had breached his rights.
It advised that since this time, it had installed an additional MRI scanner at Dunedin Hospital, which had brought down the average wait time to four to six weeks as of March 2023.
It had also also updated its policy on urgent referrals to radiology, and was working with Te Aho o Te Kahu|Cancer Control Agency and Te Whatu Ora|Health New Zealand to explore a digital solution to improve tracking of the progress of cancer patients.
Dr Caldwell recommended Te Whatu Ora Southern provide a written apology to the man, and keep the Commission updated on its progress with digital solutions and current wait times for urgent MRIs.
Te Whatu Ora Southern chief medical officer David Gow said staff and management had "sincerely apologised to the patient and their family for the distress and impact caused".
"We appreciate that not receiving health care in an accepted timeframe is very concerning and stressful for any patient.
"Since this incident occurred, changes to practice have been made, and we would like to reassure our community that these changes will reduce the chances of our systems and processes failing in the future."
'Deliberate underfunding'
Sarah Dalton Photo: RNZ / Nick Monro
Association of Salaried Medical Specialists executive director Sarah Dalton told Checkpoint the man's horrific treatment was the result of a health system in crisis.
"That is a very human face of what we think is a deliberate underfunding and under-resourcing of our health system over a very long period of time.
"But does it have to take people missing out on care, being delayed care ... clearly the specialist treating this man knew there was some urgency. A 20-week delay is just awful. It's unacceptable. And our members who are often those specialists either seeking those diagnostic processes or treating patients they know day in, day out, they see people who aren't getting the care that's required."
"We need to get serious about what the public system really needs" - Sarah Dalton
The Southern District had "terrible access to cancer care", which led many to seek out private health insurance, she said.
Dalton said, in another instance, there was a man at Southern "who was put on an 84-week wait list for a cardiac MRI and he could have had that scan in 21 days if he had $3500 to pay for it".
"So that's the health system we're already in, which privileges those who have insurance or have the funds to pay themselves over those of us who don't."
The next government should pay heed to staffing and under-resourcing in the health system, Dalton said.
"It's not okay, and I think we need to get serious about what the public system really needs and what the real cost of providing good care is.
"I don't understand how we can have a government delivering tax cuts when there are people who can't ... get GP appointments, let alone specialist care and and a couple of years ago we were estimating that upwards of half a million New Zealanders ... were part of that unmet need, not even being seen.
"And then you've got hundreds of thousands more who've been seen but can't be, can't be treated anytime soon."