Palmerston North Hospital no longer has a single permanent gastroenterology specialist on its books, leaving digestive health care for a large slice of the lower North Island in the hands of locum and temporary doctors brought in from elsewhere.
The hospital is funded for just under six full-time gastroenterologists, the specialists who diagnose and treat conditions of the gut, liver and bowel. It now has none in permanent roles after Dr James Irwin finished up on 19 June, having watched colleague after colleague walk out the door over the past couple of years. Health New Zealand Te Whatu Ora says it wants to reassure people that services are still running and that recruitment is under way, and senior managers are fronting a public meeting in the city on Monday evening to explain how.
The meeting has been organised by the senior doctors’ union and will hear from Health NZ representatives, Dr Irwin and others. It comes after a long run of warnings about the state of the service, including a pause on surveillance colonoscopies that residents vowed to fight, and earlier fears for patient care as the last expert prepared to leave.
Dr Irwin, who spent more than a decade at the hospital, returned last week to tie up loose ends and became emotional when he spoke to RNZ about his decision to go. He blamed workload pressures rather than any loss of loyalty to the place.
“I feel really guilty about having resigned, for the patients I looked after and all the staff who are still at the hospital, particularly all the nursing staff there,” he said.
“It wasn’t a situation in which I felt I could continue working in any capacity for any reasonable length of time.”
Irwin said the core problem was not money for its own sake but the difficulty of drawing New Zealand-trained specialists to smaller provincial centres, where doctors carry more on-call work and have fewer colleagues around them for support. Bigger cities, with larger teams and lighter rosters, are simply an easier sell. He wants to see that change.
“I’m hoping that Health New Zealand are able to make some changes to the way they recruit to provincial hospitals in New Zealand, to alter the landscape,” he said.
Notably, Irwin has the intestinal fortitude to stay put, with no plans to leave the region himself. He told RNZ that moving to a bigger city held no appeal, and that he intended to stay in Manawatū, do some work at a private hospital and in research, and keep pushing for a fairer deal for the area. He was blunt about where he thought the responsibility sat, arguing that a state health service has a duty to provide good care everywhere, even when that costs more.
“I value fairness and I’m a strong advocate for the community that I’m a member of here in Palmerston North,” he said. “I want to fight for the people of this region and try to encourage Te Whatu Ora to treat us fairly and give us a similar service to what’s provided elsewhere.”
For patients with long-term conditions, the worry is less about a single missed appointment and more about losing the doctor who knows their whole story. One of them is Julia Russell, who is 37 and has been under the care of gastroenterology specialists in Palmerston North since she was a teenager. She moved back from Auckland four years ago to be closer to family, and managed to see Irwin shortly before he left.
Russell has irritable bowel disease, a condition that needs careful, ongoing work with a specialist to weigh up treatments and manage side effects and symptoms. She told RNZ that the value of that relationship was hard to replace with a rotating cast of temporary doctors.
“With your consultants you build up a partnership and trust. With a new doctor or locum coming in, there’s a lot of history to learn,” she said. Explaining that history from scratch, she added, would eat up a good chunk of any appointment. “I’m unsure, uncertain. I’d be scared if I had to go to hospital now.”
Health NZ says it has a plan to hold the service together and improve access over time. It has recruited a specialist from overseas who is expected to start in September, though the department will still lean on locum and temporary staff while it tries to fill the other roles. In the meantime it says it is drawing on specialists from nearby regions, sharpening its referral and triage so the most urgent patients are seen first, and outsourcing much of its endoscopy work.
The executive regional director for the central region, Chris Lowry, said patient safety remained the priority. “We want to reassure our community that essential gastroenterology services are continuing, and patients with the most urgent clinical need are being prioritised and cared for,” she said. “We acknowledge that this has been a challenging period, and we are focused on strengthening the service and improving access as quickly as possible.”
Lowry accepted that recruiting to MidCentral was hard and said the organisation was throwing what tools it had at the problem. “We are continuing to explore all options to attract clinicians to MidCentral and build a sustainable workforce for the future,” she said. “We are currently offering an onboarding allowance and an allowance paid at the end of 12 months while we review remuneration for provincial services.” She said Health NZ understood the strain on patients and their families and was committed to keeping them informed.
The public meeting is being held at 5.30pm on Monday at the Massey University Sports and Events Centre on Albany Drive in Palmerston North, with doors open from 5pm.
Are you a Manawatū patient affected by the gap in specialist cover, or do you think provincial hospitals get a fair shake on staffing? Get it out of your system 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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