Jim Vause dreams of a health system where decisions are made for patients, rather than politicians
Nowhere in all the rhetoric about bowel screening has the glaringly obvious lack of colonoscopy provision capacity been addressed.
If there are existing delays in having colonoscopy for those meeting the referral criteria, what is going to happen to these high risk patients when legions of worried well with positive tests detected by a Faecal Immunochemical Test screening program begin to swamp the system?
Do we want highly trained surgeons and gastroenterologists leaving their usual clinical work to do more colonoscopies (thus increasing waiting times for cancer management) or should surgical registrars be doing colonoscopy clinics, or do we train Clinical Nurse Practitioners or even technicians to do the actual scoping? Are there enough colonocopes? Why are the regions with the highest rates of bowel cancer (eg Taranaki) going to be among the last to have a screening program introduced or are there political reasons for screening low incidence areas and populations?
Treating 23,500 elective day surgery patients in rural New Zealand is just part of the story. Education, training and workshops to support rural doctors and nurses is leaving a much bigger footprint
New Zealand Doctor