Cancer operations postponed across New Zealand as health workforce shortages, winter burnout hits

Health workforce shortages and winter burnout have hit cancer surgery, with operations being postponed across the country. 

A general surgeon who specialises in bowel surgery told Newshub it's got worse in the past two months. 

General surgeon Professor Frank Frizelle, who is also Bowel Cancer NZ's medical advisor, is normally found in the theatre operating on a patient, but instead, he's holed up at home with COVID-19. But he's clear that it's not just COVID-19 causing staff shortages, it's long-standing vacancies and burnout. 

"I've never seen a time like this at present. It's the worst I've ever seen."

He said it's not just planned care, like hip or knee replacements, being pushed back. Cancer surgery like breast, bowel, and liver cancer operations are too and it's got worse in recent months.

"Once you've cancelled those that aren't cancer, you've got no choice but to cancel those with cancer," Frizelle said.

At Christchurch Hospital, where Frizelle works, elective or planned surgery postponements have been climbing since March 2020. The total number of delayed surgeries since then is at around 1200 with numbers rising sharply from April this year.

For delayed cancer surgeries, there have been more than 400 postponements since May 2020.

The Government's Cancer Control Authority confirmed to Newshub: "Some cancer patients [around New Zealand] have experienced minor postponements to their surgery or treatment given the current pressure on the health system."

But Frizelle said there's nothing minor about any sort of delay, saying some cancer surgery and colonoscopies are being delayed repeatedly. 

"There's delays all the way along. So it's like a series of dams that stop people moving through the system. At every step, there are delays," he said.

"The Minister's comments that he fails to see a crisis really outlines the fact that he must be looking in a different direction."

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In February this year, research found around 60 percent of breast cancer patients were not getting surgery within 31 days of diagnosis. The Breast Cancer Foundation believes it's only got worse in recent months.

And that has significant impacts. 

"It's the most stressful time in that patient's life already and any delays just further increase that anxiety," said Ah-Leen Rayner, CEO of the Breast Cancer Foundation.

"Any delays can actually have life-changing consequences, whether it's cancer that is harder to treat or potentially even life-threatening."

She said there aren't enough frontline staff.

"We've heard of surgeries being cancelled. We know there's a massive constraint on anesthesiologists, nurses."

Frizelle said they need better leadership in health management.

"The senior management team in health need to look at what they're trying to deliver and get on with it properly."

And he said that starts with getting more staff and improving infrastructure, such as more operating theatres and more beds including in ICU. 

Health Minister Andrew Little told Newshub that he's aware of some delays with cancer surgery and said "it's my expectation that it is as brief as possible and doesn't compromise the outcome for patients".

On the staffing crisis, he said the Government's added 5500 extra staff to the public health system. 

Health New Zealand is about to launch what Little called a "high impact" recruitment campaign for more staff. 

But Frizelle said this situation was entirely predictable. His hospital in Christchurch is 150 nurses short most days and he feels health care has been neglected by successive Governments.  

Health New Zealand also acknowledged delays to cancer surgery. 

"We acknowledge some New Zealanders, including some cancer patients, have experienced postponements to their surgery or treatment given the current pressure on the health system. We are conscious of the impact this has on patients and their whānau," a spokesperson said.  

The agency said the number of deferred or cancelled surgeries "hasn't significantly changed" in recent months. 

In Budget 2020, the Government allocated funding of $282.5 million over three years to enable the former DHBs – now districts – to lift the levels of planned care delivery to support the COVID-19 backlog and to reduce waiting lists.