Problems revealed this week include Dargaville Hospital being left without doctors overnight – with nurses and telehealth required to cover the gaps – and waiting lists inNorthland are increasing for the likes of cancer treatment and specialist assessments.
Her diagnosis of colorectal cancer was delayed by two years after doctors at her general practice and Whangārei Hospital ED misdiagnosed her symptoms as piles.
She suffered from stomach pain and altered bowel movements, including extreme pain for nine months.
While Johnson’s GP had ordered a colonoscopy, there was a delay with this scope and it wasn’t until she went to White Cross that an urgent colonoscopy was ordered.
“We definitely do have a health crisis, as people are not getting the scans or scopes they are being referred for,” she said.
Other patients say the health system is failing them as they are unable to see their GP and end up going to ED instead.
Brenda Johnson is battling stage 4 cancer and fundraising for chemotherapy drug Avastin.
Far North patient Kaye White had no delays in her diagnosis of breast cancer late last year.
But as she lives in Victoria Valley, just north of Mangamuka, the closure of SH1 at Mangamuka Gorge has turned a two-hour trip to Whangārei into a three-hour drive each way.
White had to travel to Whangārei for oncology appointments, surgery, four rounds of chemotherapy and post-operative care to drain her wound. Each time was an almost 12-hour day.
“That was the hardest thing. The roads are atrocious ... it wasn’t a comfortable trip.”
White said she was unable to take the health shuttle, which transports patients between Kaitāia and Whangārei hospitals, because the timetable did not work with her appointments.
While Health NZ reimbursed 28c per kilometre, this amount barely covered petrol costs and took more than a month to be paid, she said. The amount has since increased to 34c per kilometre but White said it needs to be easier to apply.
When travelling to Auckland for radiation treatment, she flew with Barrier Air and stayed at the Cancer Society’s Domain Lodge, which was a “home away from home”.
While improvements could make the system more usable for Northland patients, White said the hospital professionals, from the oncologists to the receptionists, and volunteers were all “absolutely amazing”.
“I feel very blessed by the prompt medical care that has ultimately saved my life.”
‘I apologise to patients every day’ – oncologist
A medical oncologist position could not be signed off for Whangārei Hospital when a candidate was found, Dr Edmond Ang says. Photo / NZME
But Whangārei medical oncologist Dr Edmond Ang said it is only “acrobatics” by medical professionals that gets patients the treatment they need – not any support from Health New Zealand/Te Whatu Ora upper management.
Ang was distressed to read in the Northern Advocate comments from Te Tai Tokerau group director of operations Alex Pimm, who said vacancies had impacted waiting times for cancer patients.
Ang said a medical oncology position has been vacant for about 18 months but when a suitable candidate was found overseas early in 2023, managers further up the chain would not sign off the position.
The position was reviewed several times and has never been signed off, he said. The candidate ended up finding a job elsewhere.
“The response from managers was, ‘you’ve managed fine without it, you’re doing fine’. Doctors work ourselves to the bone because the money is not there,” Ang said.
“We see the harm caused by treatment delays, missed diagnosis, inadequate follow-up.
“We are failing to deliver so many of these aspects of patient care. I apologise to patients every day.”
Ang said he is contractually not supposed to talk to media but, with an obligation to care for his patients, he felt it would be wrong not to speak up.
Health NZ would not answer direct questions about recruitment at either Whangārei or Dargaville hospitals.
Mark Shepherd, who has just been appointed Northern deputy chief executive, acknowledged recruitment is not happening as quickly as Health NZ would like, putting it down to the challenges of attracting clinicians in rural areas.
There are plans to support rural hospitals in Te Tai Tokerau, including reviewing rosters, looking at other options to provide care as close to home as possible and investing in other professions such as nurses, he said.
Changes are coming, Shane Reti says
Health Minister Shane Reti says changes to Health NZ are moving at pace. Photo / NZME
Reti, who is also Whangārei’s MP and a doctor, was disappointed to hear an oncologist was not appointed in Whangārei when a willing candidate was found, as it is hard to find oncologists.
He is also concerned about the lack of overnight doctors at Dargaville Hospital, although he has been assured it is clinically safe for the hospital to run with its nurses, telehealth, and St John’s triage and transport service.
There are 10 budgeted doctor vacancies across Dargaville, Bay of Islands and Kaitāia hospitals, he said.
An ad for these was listed on Tuesday after media coverage highlighted the issues.
Reti said filling vacancies is an operational matter for Health NZ and there are a number of international recruitment agencies who work on this.
But he said it is hard to fill rural vacancies, even with an extra weighting in funding.
“It is fair to say in Northland, and Tairāwhiti and other rural areas, it is hard to recruit ... It is special people who enjoy all the other benefits, and privileges and pleasures that come from working in rural environments.”
Reti said in Northland, 14 specialists or junior doctors, 14 nurses and 22 allied health workers were recruited in May and June.
The wider issues, such as the disconnect between upper managers and staff on the ground, are being addressed by Health NZ changes, with new regional budget-holding deputy chief executives being appointed on Wednesday, he said.
“This is passing decision-making much closer to the regions.”
Reti said a workforce plan for primary care will be released in the next few weeks, with a focus on recruitment, retention and remuneration for GPs.
He has already announced a 4% increase in capitation funding and the ability for general practices to charge their patients more.
West End Medical Centre practice manager Iain Watkins said the funding and being able to increase charges will make a difference in helping keep his centre afloat.
But recruiting doctors is still challenging and involves competing against Australia where salaries are up to four times more, he said.
Incentives needed to be kept in Northland, including funding for professional development and payments to relocate from overseas, Watkins said.
Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.
