The current Dunedin Hospital. Photo: RNZ / Nate McKinnon
Health bosses desperate to recruit new cancer doctors to crisis-hit Dunedin Hospital will need to sell them on cramped spaces and shuttling up and down the street most days, once the city's new hospital is a reality.
Te Whatu Ora has pledged to fix radiation oncology services in Dunedin after the health and disability commissioner panned it over years of specialist shortages and delays to patients getting treatment.
But Lyndell Kelly, who retired recently after 16 years on the 'rad-onc' team there and a term on the Southern District Health board, expects that will be tough going when they have been largely left out of the hospital's billion-dollar-plus rebuild.
Instead, the cancer services get to stay behind in an old, small building 500 metres away from the new inpatient block - with a regular shuttle bus laid on.
"Going from the outpatient building to meetings, or to the ward, probably be two or three times a day," said Kelly. "If you've got sick patients in the ward, it might be more."
It would take 15 minutes by shuttle to cover the 500m stretch. An electric hire-scooter would probably be quickest, she said.
"Waiting for a shuttle to come back in quarter of an hour, and then drive you through how many sets of traffic lights? I mean, it's just gonna be awful."
If the recruitment drive - which has been going on for two years unsuccessfully - actually snared a specialist to come and have a look, Kelly said "they'll be shown an office in a floor of the old, old, old children's building with windows that don't open or shut" with "no air conditioning".
They would have to share an office - suboptimal for radiation oncologists who used their offices to decide on treatment, which demanded "intense concentration".
To see an outpatient, they would have to go downstairs and next door to clinics that were built for six specialists, but which now cater for 20 chemotherapy, haematology and radiation oncology doctors.
"Oncology was excluded from the new hospital because the current building is only 35 years old," but it was "far too small", Kelly said.
The new recruit would be faced with working much longer hours than in Australia for half the pay.
If they had to see an inpatient in the ward, they would have to walk or shuttle - and if patients needed treatment, an ambulance would be needed.
"It's much worse for them than just going down the corridor," Kelly said.
"They're often having radiotherapy because the cancer's damaged their bones, turned their bones to eggshells, and here they are being clunked around in an ambulance."
When the prospect of radiation oncology being left out on a limb was outlined by the new build's designers, clinicians opposed it, she said.
"We did, we did. And it was not listened to."
Plans for the new hospital. Photo: newdunedinhospital.nz
The $10m of cuts to the Dunedin rebuild the government reversed last week - being used for an MRI machine and a shared workspace - was "chicken feed", she said.
Though the hospital's senior management was far more responsive now than the regime the health and disability commissioner criticised strongly, the whole situation remained "very, very depressing", Kelly said.
"We have to somehow attract people to work here. They say that they're recruiting three [to add to the current four radiation oncologists] - yeah well, we've been recruiting three or more for two years.
"What are they doing differently that will mean that they are successful at recruiting now? We haven't been told that."
Te Whatu Ora said it has recently hired 24 staff for cancer and hematology in the southern district, though these are below the level of specialists. It also has a new national expert group working on the radiation oncology shortages.