Radiologists are describing a crisis across the country of short staffing, old scanning machines and millions spent on outsourcing.
Waiting times for semi-urgent and non-urgent scans are highest, putting patients at potential risk of disease progression. Photo: 123RF
The public "would be amazed if they knew the level of bureaucracy we have to go to, to get a machine we know is dying, replaced", said national secretary Dr Deborah Powell of the Apex union, which represents medical imaging technicians.
It was a bad situation made worse by Covid-19 and years of lobbying government without success, the Royal Australian and New Zealand College of Radiologists said.
"I would say we are not confident or satisfied with the outcomes that have been achieved so far," said college president, clinical associate professor Sanjay Jeganathan, of Perth.
Waiting times for a outpatient MRI, CT or ultrasound scans at some hospitals are staying stubbornly high after rising during the pandemic, though many hospitals are keeping them down around or below the optimum six weeks for outpatients.
The Health Ministry told RNZ that "over the last six months of monitoring there has been no significant additional increase, and we're actively exploring ways to ensure these are reducing".
"The Ministry has continued to work with DHBs to ensure diagnostic services, including radiology imaging are continued with priority being given to patients with the highest clinical need and urgency."
The real chokepoint is for semi-urgent or non-urgent scans - which if not done on time, could tip someone into an urgent position.
The extra millions of taxpayer dollars being spent sending outpatients private, are not necessarily denting the public hospital queues, with Wellington hospital set to lengthen wait times - "unfortunately", it said - despite $5m budgeted for outsourcing this year.
At Waitematā DHB, though, it may be working, on one level anyway: Private company Horizon Radiology was open last Saturday, working through ultrasound referrals from the North Shore and Waitākere Hospitals, and Waitematā also outsources all its nuclear medicine scans - and it has relatively low wait times.
Less money for public services
Yet millions spent this way leaves less for public radiologists' pay, and public hospital technology upgrades.
Waikato Hospital is outsourcing all its MRI scans, as it grapples with a shortfall of medical imaging staff of 17 percent - though Apex contends the real number is 38 percent.
"We're seeing rapidly escalating vacancy rates at the moment, probably about 15 percent across New Zealand," said Powell, who also represents registrars working in scanning.
Four had just left Counties Manukau DHB for Australia where they get three months paid accommodation and 30 percent higher salary.
"Radiology is almost one of those touchstone areas ... every patient goes through radiology, diagnosis for cancer treatment, strokes, you know, everyone goes through radiology, if there's a blockage of radiology, then the whole system gets blocked and patients get delayed."
Both Apex and the Radiologists' College said there was reason for hope that Health NZ would do better, when DHBs shut up shop in two weeks.
"My plea to anyone listening, is not to lose faith in the system, but go for the appointments and make sure you get the scans as required," Jeganathan said.
"But at the same time at the local level, to talk to the politicians and the ministry and the MPs to make sure that help and investment in health priorities are top priority for the government."
Powell said it would be a "very, very difficult" six months on the staffing front, until the next new graduates come out in December.
At least the centralised Health NZ might be able to be held more accountable for slashing the bureaucracy, she said.
"What we actually need is Wellington to catch up with the rest of us."
Red tape meant it often took ages to replace old machines.
"This happens across the entire of the sector, the bureaucracy, the number of committees that this sort of capital expenditure has to go through.
"With the newer machines, we can do so much better and improve outcomes for patients."
Wellington Hospital is putting in its first biplane scanner today, two-and-a-half years after the tender. It blames Covid-19.
Jeganathan said the result was multi-million dollar scanners being pushed beyond their 10-year working life, with the skill of technicians having to make up for that.
"It is a nationwide problem ... primarily due to underfunding.
"It is similar to driving an old car versus a new car. Still, it'll get you from A to B, but it is just that it [new tech] adds further value in terms of .... the images we get."
The risks was more around having to wait, he said.
DHB papers refer to a scan delayed being a disease enabled.
Wait times vary a great deal for outpatient scans, according to DHB information released under the OIA to Apex.
Some of the worst examples are: It takes 10 to 11 weeks for an MRI or CT at Dunedin hospital and similar at Hutt Hospital - and a very long 200 days for a non-urgent mammogram.
Children at Starship are waiting 94 days on average for a non-urgent MRI.
But other parts of Auckland DHB are much less, and Canterbury, too, has its wait times in check though it is 20 percent down on staff - while Tauranga Hospital looks good for staffing and wait times.
The ministry said waiting times would be in part tackled by $285m over three years being put into planned care delivery.