Palmerston North Hospital’s gastroenterology department is down to a single permanent specialist, and that doctor is leaving next month, according to RNZ reporting on Saturday. The service is funded for 5.6 full-time-equivalent positions, meaning the hospital is heading into June at less than a fifth of the workforce its budget allows for.
Labour MP for Palmerston North Tangi Utikere has written to Health Minister Simeon Brown demanding urgent action. In a letter released to RNZ, Utikere told the Minister that “this is a critical service, and the situation it is currently in is just not good enough” and that “solutions need to be found urgently and it needs to be sorted now”. He warned that “this rapid decline in gastroenterologists will result in a severely reduced service that is further unable to manage demand”. Hospital management, he added, “have acknowledged that gastroenterology is one of the biggest risks for Palmerston North Hospital”.
Gastroenterology is the medical specialty that diagnoses and treats diseases of the digestive system, including the oesophagus, stomach, intestines, liver, pancreas and gallbladder. The service runs colonoscopies that screen for and detect bowel cancer, one of the most common cancers in New Zealand, and manages chronic conditions such as Crohn’s disease, ulcerative colitis, coeliac disease and liver disease. Without a stable specialist team, surveillance colonoscopies for patients already diagnosed with high-risk lesions can drift past their recommended intervals, and new referrals can sit on waiting lists while symptoms progress.
Palmerston North Hospital is run by Health New Zealand and serves the Manawatū-Whanganui region, drawing patients from a wide rural catchment that stretches from Levin in the south to Taihape in the north and across to the East Coast. For many of those communities the hospital is the only gastroenterology service within a reasonable drive, and any reduction in capacity is felt across thousands of square kilometres rather than in a single town.
Utikere told RNZ that “our community should not be in this situation” and that “it is unacceptable that MidCentral is relying on locums and outsourcing”. He said the “necessary management of wait lists means many are waiting far too long for an appointment”. Surveillance colonoscopies were delayed last year because of staffing issues, according to the same report, and the situation has deteriorated further since then.
The Minister, in his response, said he had “made it clear to Health New Zealand that addressing these workforce challenges must be a priority” and that “I want to be clear that it is my expectation that people in Palmerston North have access to a sustainable gastroenterology service”. Brown also said he had been “advised by Health New Zealand that access to gastroenterology services is being maintained” through a mix of temporary and locum cover, outsourcing of colonoscopies, prioritising waiting lists by clinical need and drawing on specialists from elsewhere in the central region. One new doctor is due to start in September and further offers of employment have been made.
Health New Zealand has also pointed to longer-term work that includes recruiting specialists from overseas, working with the training colleges to increase the number of gastroenterology trainees coming through the New Zealand pipeline, and exploring ways to make regional centres more attractive to senior medical staff. The agency told RNZ it was using specialists from other hospitals in the central region to keep the Palmerston North service running while permanent recruitment continued.
The shortage at Palmerston North is part of a wider pattern. Around 70 percent of new doctor registrations in New Zealand each year are now overseas-trained, and small specialist services in regional hospitals are particularly exposed when one or two senior staff retire, resign or move overseas. Gastroenterology is a highly trained specialty that requires a basic medical degree, several years of internal medicine training and then a further three years of advanced training, so a vacancy cannot be filled quickly from within the country if the trainee numbers are not there.
For patients in Manawatū-Whanganui the practical questions over the next few months are how long they will wait for a first specialist appointment, whether their planned colonoscopy will go ahead on time, and whether they will need to travel to Wellington, Hawke’s Bay or Taranaki for procedures that would normally be done in Palmerston North. Locum and outsourcing arrangements can keep urgent cases moving but they tend to push routine and surveillance work down the queue, which is the part of the service where missed cancers and late diagnoses do the most damage.
Utikere has asked the Minister for a clear plan and a timeline, not just a reassurance that services are being maintained. The test of whether the situation has been “sorted” will be visible in the data over the coming months, in the number of permanent gastroenterologists actually working at Palmerston North Hospital, in the colonoscopy surveillance backlog, and in how long ordinary patients in places like Levin, Dannevirke and Taihape are waiting for an appointment.
Has your gastroenterology appointment at Palmerston North Hospital been delayed, rescheduled or moved to another centre? Do you think regional hospitals are being adequately supported to keep specialist services running? Share your experience in the comments below.
This article was written by AI, briefed to report the facts, hopefully without some of the bias people bring to the job 🙂
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