Bowel-cancer scheme faces staff shortages

New Zealand is facing a bowel-cancer crisis, experts say, as medical specialists struggle to keep up with the demand for screening and figures show the Ministry of Health is expecting to be able to recruit a little more than 40 staff over the next decade.

New Zealand has one of the highest rates for bowel cancer in the OECD, and the disease kills more than 1200 Kiwis every year.

The Government has said a national bowel-screening programme is inevitable, but results from a pilot programme in the Waitemata Health district have to be analysed first.

However, industry experts question whether staffing levels could ever be enough to cope with the extra work a national screening programme would bring.

A ministerial report shows the demand for colonoscopies already far exceeds the available supply.

"Estimate figures for the 2011-12 financial year show a total demand nationally of 40,926 colonoscopies with a shortfall of 9397 cases of unmet demand in that year," ministry officials said.

"If the Bowel Screening Programme pilot is rolled out nationally, this shortfall will be exacerbated. The main lever Government has to improve supply is growing the colonoscopy-capable workforce."

According to state figures, 608 medical professionals able to perform colonoscopies are employed across both the public and private health sectors. Only 109 of them are gastroenterologists with practising certificates - the rest are practising general surgeons who also have other duties.

It was predicted that workforce could be increased by 26 gastroenterologists and 21 general surgeons over the next 10 years.

A report released just last week showed that, by 2022, there would be a shortfall across the country of seven radiation oncologists, 30 medical physicists, and 25 radiation therapists.

Health Minister Tony Ryall has already said an extra 100 specialists would be needed, to perform the anticipated 30,000 extra colonoscopies a national programme would bring.

He has said any national rollout would have to be carefully staggered, and a rush-job could leave specialists across the country struggling to keep up with the workload.

Health Workforce NZ Planning manager Ruth Anderson said a high-level symposium was held in April to tackle the issue.

"A key outcome of this symposium was increased momentum for delivery of endoscopy services, including how the health sector can better work together to address future endoscopy workforce need," she said.

The ministry agreed to continue to work towards long-term, sustainable solutions, including increasing training of the endoscopy workforce and expanding the colonoscopy workforce through development of a new "nurse endoscopist" role.

New data released showed 160-plus people who had taken part in the Waitemata programme were found to have cancer.

In the first two years of the programme, more than 67,500 people completed a bowel-screening test and more than 4300 people with a positive result went on to have a colonoscopy.

"We know people are still waiting too long for a colonoscopy and it's critical that district health boards lift their game in this area so they could cope with the additional demands of a national programme," Associate Health Minister Jo Goodhew said.

"More than 40,000 publicly funded colonoscopies are performed each year, but every year, there is a shortfall. This shortfall will increase if there is a national bowel-screening programme."