A Winton man with kidney cancer waited nearly seven months for surgery after his operation was cancelled without explanation — and nobody at Southland Hospital told him why.
David Evans undergoes surgery every three to four months to cut away the cancer. His January procedure at Southland Hospital went ahead. The May 14 one did not.
"They came and saw me on the day, very apologetic, saying that because of theatre overrun they would rebook me for the following week — which they did. But I received a phone call on the Monday to tell me that all surgeries had been cancelled and there was no follow up at all," Evans said.
He rang the hospital repeatedly. Each time, he was transferred to a voicemail at the urology department. Weeks passed.
"I just couldn't believe the lack of follow-up... I hadn't received anything until last week when, thank God, they said we've got a surgery booked in for this coming Thursday."
Nobody told Evans the real reason behind the disruption. He found out by reading the news: two urologists had resigned, a fact Health New Zealand had confirmed in March, followed by what the organisation described as "additional unanticipated absences". The region was left with no permanent full-time urologists.
"I need the three and four month operations... this is coming up to about seven months now. With time comes longer growth periods and I don't know how far the cancer has travelled," he said.
Even as he heads back to theatre Thursday, Evans doesn't know whether the cancer has spread or whether he can keep his kidney.
He was clear he bore no ill will toward the clinical staff. The failure, in his view, was higher up. "People are being sent home and are slowly dying because they cannot get into the hospital and that's tragic. It really is."
Health New Zealand declined to be interviewed but issued a statement. Southern group director of operations Craig Ashton said the organisation sincerely apologised for the delays Evans had experienced. His surgery had been postponed because of unexpected leave from the treating urologist.
"We acknowledge that any delay for surgery can be distressing and patients can be assured that surgeries and procedures are prioritised based on patient acuity and only deferred where absolutely necessary and only if it is clinically safe to do so," Ashton said. "The decision to defer or delay care is never taken lightly."
Health NZ confirmed two urology positions in Southland remained vacant. "We are exploring all avenues to improve our capacity, including ongoing recruitment efforts, seeking support from locums and Health New Zealand staff from other areas, and outsourcing where possible — both locally and in other locations in the South Island," Ashton said.
The backdrop is grim. Health NZ's latest quarterly report showed cancer patients in Southland had the second-longest wait times for treatment in the country, behind Canterbury. As of March, 18.9 percent of the region's patients were waiting longer than 31 days to start treatment.
Trish Wright, coordinator of the Southland Support Group of the Prostate Cancer Foundation, said she was devastated when the resignations came to light. "If they are eligible for surgery and if it's recommended, our two urologists would certainly have done it in a timely fashion in past. I can't imagine how long these guys are going to have to wait when there is no urologist down here or urology surgeon at least," Wright said. "It's mind-boggling what has what has happened with both of them going."
She said Health NZ appeared to have failed on succession planning. "We know how hard it is to get doctors down here anyway. Imagine how big the waiting list is going to be by the time they manage to get another urologist down here... things are just going to get worse."
Soutland Kidney Society president Nobby Clark said the pattern was familiar. "You don't have to go too far to find shortages in just about every area you want to go to and certainly Southland Hospital suffers from that," he said.
Cancer Society Southern chief executive Christine Prince said the problem extended well beyond urology. "There seems to be long, long, ongoing issues involved with resourcing and access of care for patients across Otago-Southland. This encompasses... bladder cancer, prostate, kidney cancer... it's quite significant," Prince said. "One of the key frustrations is people having to wait at a time of great uncertainty. Whether it's the first appointment, then being put on a wait list or getting treatments, it's ongoing."