A Palmerston North GP is raising the alarm over what she describes as a “dire shortage” of specialist staff in the city’s hospital gastroenterology department, warning that patients with serious bowel conditions are waiting dangerously long for care — and that some delays are putting lives at risk.
Dr Nicola Barrack, a GP at Feilding Health Centre, has spoken publicly after growing frustrated with conditions she says have made it nearly impossible to get timely help for patients with urgent digestive health concerns. The gastroenterology department at Palmerston North Hospital is funded for just under six specialist positions, but currently has only two doctors working full-time. Of those two, one was on the verge of leaving at the time Dr Barrack raised her concerns, and the remaining specialist has also signalled his intention to depart due to workload pressures. A few years ago, the department had seven gastric specialists.
The consequences for patients are severe. Dr Barrack says some people with red flag symptoms for bowel cancer — the kind of warning signs that warrant urgent investigation — have been waiting more than six months for an endoscopy. Others who require surveillance colonoscopies as part of ongoing monitoring for conditions such as polyps or inflammatory bowel disease have been waiting over a year.
“There are significant delays in investigations, in gastroenterology reviews and, as a result, increasingly long, stressful, and sometimes dangerous delays in diagnoses,” Dr Barrack said. “I have some patients who have been waiting over a year for surveillance colonoscopies, or patients with serious red flag symptoms for bowel cancer waiting over six months for endoscopy.”
The situation is compounded by a change in how GPs can access specialist advice. Previously, family doctors could call the hospital’s gastroenterology department directly when dealing with a patient in real time — a critical tool for making fast decisions about treatment or referral. That direct line is no longer available. GPs are now routed through a liaison service, which Dr Barrack says is falling well short of what is needed.
“We are no longer able to call and speak to gastroenterology at Palmerston North Hospital. Being unable to do this makes it very challenging to treat patients who are sitting in front of us, often with time-sensitive conditions,” she said. “The option we have now is to go through a liaison. When I tried that I got an answer machine.”
The practical effect of this, she says, is that GPs are being forced to make clinical decisions without the specialist input they need. “We are left making snap decisions in our consultations,” she said. “When I am desperate I have reached out directly to gastroenterologists I know personally for acute advice, in their own time.”
Adding to the difficulty is the absence of any private gastroenterology services in Palmerston North. In many other centres, patients who can afford to pay privately can bypass public waiting lists. In the Manawatu region, that option does not exist — anyone who wants private care must travel outside the region entirely.
Figures obtained from Health NZ reveal the scale of the backlog. As at 23 March, MidCentral had 214 patients who were overdue for surveillance colonoscopies. Since 1 July last year, 304 colonoscopies had been performed across the service — 146 of them outsourced to the private sector in an effort to manage demand.
Health NZ’s Interim Group Director of Operations for MidCentral, Katherine Fraser-Chapple, acknowledged the staffing changes but maintained that services have not deteriorated. “While there have been staff changes, the services provided by the gastroenterology department haven’t changed and acute services are being maintained, which is why GPs have not received communications on this issue to date,” she said.
Ms Fraser-Chapple said the organisation is working to address the shortage through several means, including bringing experienced specialists from across the central region to Palmerston North in the short term, outsourcing colonoscopies where suitable, and actively managing waiting lists. She also confirmed that Health NZ is recruiting overseas specialists and working with training colleges to build sustainable capacity. By the end of April, the organisation plans to introduce the Faecal Immunochemical Test for Symptomatic programme — a triage tool that uses stool testing to help prioritise patients most likely to have serious conditions.
Despite those assurances, Dr Barrack says GPs in the region remain deeply worried. “To say that we are worried about the potential of having no local gastroenterologists is an understatement. The service is so fractured with locum staff plugging the gaps. We need a functioning, sustainable service that is well supported so more gastroenterologists can be recruited to the region.”
She is clear that staying silent is not an option. “Doing nothing is not an option. We are here to help our patients and advocate for their care.”
The staffing crisis in Palmerston North is not an isolated problem. Provincial hospitals across New Zealand have struggled for years to attract and retain specialist medical staff, particularly in fields that are not well represented in private practice. Gastroenterology, with its high procedural workload and complex patient mix, has been among the specialties hardest hit in regional centres. Without significant changes to pay, working conditions, and support structures, the workforce crisis is unlikely to resolve on its own — and the patients caught in the gap are the ones bearing the cost.
The full story was first reported by RNZ.
Are you or someone you know affected by specialist waiting times in your region? 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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