Damning review of Southland access to colonoscopy service

ODT: Limited colonoscopy access slammed

A claim of “inter-service warfare” has emerged in a damning review of Southland access to Southern District Health Board’s colonoscopy service.

This is kind of close to home for me. Southland is a wee from here, but on Tuesday night as I awaited diagnosis and treatment for lower abdominal pains I contemplated the possible need for a colonoscopy – I was relieved it ‘only’ turned out to be kidney stones.

A leaked draft of the review calls for an urgent overhaul of the way the board manages colorectal cancer.

It says limiting access to colonoscopy has gone too far and there is evidence this has had “adverse consequences for patient care”.

Undue delay in diagnosis or treatment was found in 10 of 20 Southland cases reviewed.

In a confidential survey in 2017, 15 senior doctors using the board endoscopy services indicated they were aware of patients they thought had come to harm as a result of having an endoscopy referral declined.

Most of the seven Southland Hospital staff interviewed in the review showed signs of distress and some were on the verge of tears, the auditors said.

The report recommended clinical and management staff should be offered trauma counselling immediately.

Although the Southern DHB population has the third-highest rate of colorectal cancer in the country, the report says the board’s poor performance against standards for the management of such cancer indicates serious problems with the control of the disease .

It has one of the highest rates of cancer diagnosed only after it has spread beyond the bowel, one of the highest rates of emergency surgery for bowel cancer, but one of the lowest colonoscopy rates.

It’s hard to imagine how things could get this bad when the health and lives of people are at stake.

Also: Colonoscopy concerns: Review restricted

Auditors reviewing Southland cases where concerns had been raised about colonoscopy access through the Southern District Health Board decided to limit their review because it was taking too long to get complete clinical records.

Although they had been informed of a list of 101 cases involving declined or delayed colonoscopies, and heard of more cases during interviews, they confined the audit to 20 cancer cases to avoid “further frustrating delays”.

They found 10 of the cases had an undue delay in reaching a diagnosis or treatment, ranging from three months to three and a-half years.

Six cases met the guidelines but were refused colonoscopies.

They expressed “serious concern” about the number of cases with local advanced disease at the time of initial treatment.

If an illness like rectal or colon cancer is treated soon enough it can prevent the need for much more extensive treatment – and of course it can prevent death.

ODT (March 2019):  Southland surgeons’ frustration evident

As early as 2016, Southland Hospital general surgeons considered “alarming” information about access to diagnostic colonoscopies was being ignored.

In a May 23 2016 letter Mr Pfeifer told Dr Millar “our concerns are well known and are of long standing”.

“Attempts have been made in the past to call attention to our problems and to voice our concerns, but we feel that we have been simply ignored.”

The concerns related to the application of the national guidelines for direct access colonoscopy across the whole of the Southern District Health Board.

In October last year the matter became public when a September letter to DHB chief executive Chris Fleming, written by five general surgeons – Mr Pfeifer, Paul Samson, Konrad Richter, Julian Speight and Jerry Glenn – was covered by the ODT.

The letter showed the surgeons were fed up with the delays to the review and had lost confidence in the endoscopy service.

Dr Millar, speaking then about the review, said the surgeons’ “significant concerns” were being taken seriously. In his emailed response to the September letter, Mr Fleming noted the surgeons’ request for “unfettered access”.

“This indeed may or may not be a recommendation from the review.”

It would be essential, if there were changes recommended, that there was no return to the previous situation which he understood to be a three-year waiting list.

This “frankly, is a significantly unacceptable risk in its own right”, he wrote.

A three year waiting list seems more than unacceptable, it is outrageous.

The deep south?

Maybe some people up north see everything south of Wellington as ‘the deep south’, but when Otago is referred to as the deep south it bemuses me.

Stuff: Otago’s defence stands tall in successful Ranfurly Shield raid against Waikato

The Ranfurly Shield is heading to the deep south for the summer as Otago matched their successful 2013 raid in Hamilton by holding on for an enthralling 23-19 win against Waikato in the Mitre 10 Cup.

It seems similar to including Auckland in ‘the far north’. Otago to me is just Otago.

If there is a ‘deep south’ then surely it is Southland. Or Fiordland.

ODT:  NZ’s most remote place is in the deep south

Where do you go in New Zealand to be farthest away from civilisation?

Hamish Campbell, a software engineer who works at Koordinates in Auckland, said he used a range of open-source data tools to pinpoint the place which was farthest from any structure, including far-flung conservation huts.

He started by using a Land Information NZ map which showed the location of every building in the country – 653,358 in total.

That quickly narrowed his search to Fiordland, on the south-western edge of the South Island.

After a bit of digital wizardry, he found what he believed to be New Zealand’s most remote spot. It is the south end of a bay which the Coal River empties into, and is south of Doubtful Sound.

Fiordland is certainly the most inaccessible region in mainland New Zealand, except by boat or by helicopter.

But parts of Otago are further south than the bottom of Fiordland, and further south than Invercargill, and further south than Bluff.

File:Position of Otago.png

 

That shows Otago stretching almost as far south as the southernmost point of the South island, Slope Point (incidentally the southern Catlins is a great area to visit).

It also shows that Lumsden is north of Dunedin! And Kaka Point is about as far south as Riverton, and Milton is as about far south as Gore, and Tuatapere is north of Balclutha.

Quite a lot of Otago is north of parts of Canterbury. Lakes Wanaka and Hawea are completely north of parts of South Canterbury. Makarora is actually north of Timaru (about the same latitude as Temuka).

But to me Otago generally is not the far south. That’s Southland. We are just south-ish.

Catlins shark attack

A body boarder was attacked by a shark at Porpoise Bay in the Catlins (near the southernmost point of the South Island) yesterday. Her leg injuries don’t seem too serious.

ODT: Shark attack response praised

A Frenchwoman in her 20s was left with a gash in her leg after a shark came “out of nowhere” while she was bodyboarding in the Catlins yesterday.

The woman was flown to Dunedin Hospital after she was bitten by the shark just after 2pm at Porpoise Bay, which is next to Curio Bay.

The attack left her with a moderate-sized bite wound on her leg and lacerations to other parts of her body.

She remained calm after the attack and “handled it very well”.

“She was conscious the whole time, but had a pretty good gash on her leg.”

Porpoise Bay is a popular place, well known for it’s resident Hector dolphins – I’ve been in the surf there with dolphins riding waves within meters of us.

Department of Conservation marine scientist Clinton Duffy said a range of shark species could be found in that area, including great whites, mako, blue sharks and broadnosed seven-gill sharks.

“And the species most likely to be involved in an attack is either going to be a seven-gill or a great white shark.”

It remained extremely rare for swimmers and surfers to encounter sharks in the wild, let alone be attacked by them.

An attack was reported in 2014 in Porpoise Bay, and another attack. Stuff: Shark attacks Southland surfer

A surfer has suffered three shark bites to his leg in an attack in a Southland bay.

The surfer, 28, was on his board about 50m out from Porpoise Bay Beach, near Curio Bay, last night when the attack happened, police said.

The man was bitten from his thigh to his calf and there was “lots of blood”, a police spokesman said.

A St John spokeswoman said the man had deep lacerations to his leg but was transported to Invercargill Hospital in a stable condition.

The Department of Conservation have been notified, and notices are being put up at Porpoise Bay to warn people of the attack and advise them not to swim there until further notice.

Two weeks ago Invercargill doctor James Grant was also attacked by a shark in Southland’s Garden Bay.

He fought off what was believed to be a sevengill shark, and stitched himself up before his friends took him to hospital.

Garden Bay is 60 km west of Invercargill at the bottom of the South Island, near Colac Bay (not far from  Riverton)

Porpoise Bay is 80 km east of Invercargill.

 

 

 

Retrolens historic images

This may be of interest to some people – a library of historic aerial photographs, currently for the Waikato, Bay of Plenty, Hawkes Bay, Nelson, Malborough, Canterbury and Southland.

Retrolens Historic Images – Map

Also on aerial images, I see that Google Maps have updated images, at least of my area. It’s interesting to see new plantings and growings and cuttings and landscaping.

From Retrolens About:


Retrolens is made up of a treasure trove of aerial photographs that have been taken since the 1936 through to 2005. It is a Crown archive and contains 500,000 images.

This Historic Image Resource came about as the result of a scanning project that was started in 2015 by partnerships between the Local Government Geospatial Alliance (LGGA) and Land Information New Zealand (LINZ). The two organisations were concerned that the treasure was deteriorating and with fewer and fewer scanners worldwide able to read the images, something had to be done quickly before this significant slice of our cultural and geospatial history was lost forever. An initial pilot was undertaken to test out the viability of a full scanning project for the whole archive, then the project itself, led by LINZ began.

The project began with three partner regions (Canterbury, Waikato and Bay of Plenty). Council partners continue to join the project progressively from across NZ as different areas became aware of the project and have funding to be able to join the initiative. It is estimated that the scanning of the Crown archive will be completed by 2021.

The photos were taken for a range of reasons such as land management and mapping. The value of these images is in showing change across New Zealand. Key drivers for having the images scanned broadly speaking are better decision making, complying with regulatory requirements and cultural heritage with specifics including using the images to support potential identification of “HAIL” contaminated land sites, accretion and recession of coastlines, changes in areas of significant vegetation and changes in river pathways.

 

Local bodies try political activism

The new Dunedin City Council has continued it’s predecessor in political activism, influenced by a new intake of councillors and ongoing activist pressure and lobbying.

The council voted by 9 to 4 to call on the Government to place a moratorium on deep-sea oil and gas exploration and extraction.

ODT: Council green as grass on oil exploration issue

The incoming Auckland council did similar recently – see Auckland Council votes against deep sea drilling.

Not exactly core business for councils, nor a productive use of their time and council resources.

As these symbolic moves can in no way be seen as representative of all city residents the Government can safely ignore them, and they probably will. They are local body and activist posturing on national issues.

Another attempt was made with the Southland regional Council yesterday but was voted down – but a Southland Times article hides that in what looks largely like an activist promotion.

Stuff: Environment Southland urged to oppose oil and gas exploration in the south

Environment Southland has been urged to oppose oil and gas exploration in the region.

Opponents of oil and gas exploration addressed councillors at an Environment Southland committee meeting on Wednesday, saying the fracking industry in the US was damaging natural resources, contaminating drinking water and using exorbitant amounts of water.

Invercargill resident Nathan Surendran, speaking in the public forum of the meeting, said councils around New Zealand were opposing the government’s oil and gas exploration block offers in their submissions.

Those councils opposing the Government have done so without a mandate from their residents and ratepayers.

Reverend Denis Bartley, a former oil industry engineer for 30 years, supported Surendran, telling councillors an increasing number of community groups and organisations had divested from the fossil fuel industry for environmental, climate change and economic reasons in the past four years.

Peter McDonald told councillors that environmental and social risks shadowed the drilling industry; he questioned whether the drilling industry shared Environment Southland’s vision for the region.

Jenny Campbell told councillors the biggest contributor to the global temperature rise came from the burning of fossil fuels.

When they had finished speaking, Environment Southland councillor Robert Guyton moved a motion for the council to oppose the Government’s 2017 block offer proposal for two oil and gas permits in Southland.

This is how it is done – orchestrated activist lobbying, and they claim popular support because they outnumber people who don’t get involved – most people have no idea about the political games being played.

He received voting support from councillors Maurice Rodway and Rowly Currie, but they were out-voted by councillors on the strategy and policy committee.

So while they get most of the article publicity they failed in their bid.

Environment Southland chairman Nicol Horrell, who believed there were insufficient substitutes to fossil fuels at this stage,  said if the council opposed the Government’s block offers now it would take it out of discussions further down the track.

“It’s appropriate to remain neutral at this stage.”

Southland, Dunedin and Auckland would be stuffed if they didn’t have ongoing supplies of fossil fuels. We should do what we can to reduce use, but we are a long way from the activist ideal of being oil free.

And ‘oil free’ is what activists want. From the ODT:

Oil Free Otago’s Brooke Cox said her group was relying on councillors to be ”a voice of reason”, to take a strong stand and say ”no” to the block offer.

”It’s time to think about how you are remembered as a council.”

And it’s not just activists outside councils. Stuff:

However, a council staffer said the council would still be able to make submissions on the issue in future.

ODT:

Council corporate policy manager Maria Ioannou said in a report councillors resolved in 2015 to call on the Government to place a moratorium on exploration in New Zealand waters.

”However, this position may no longer reflect the views of the new council following local government elections earlier this year.”

What is a ‘council corporate policy manager’ spending time working on ‘oil free’ activism?

The Christchurch City Council has also voted to oppose offshore drilling.

There appears to be increasing attempts by local body councils to lobby Parliament on behalf of small activist groups with the growing involvement of Green and Labour parties.

Most people don’t know and/or don’t care so the activist groups and activist councillors get to promote their agendas, which is not the core business of local bodies, nor a good use of their time and resources.

Wellington to Invercargill: “Small shithole town. Fuck them”

That’s not from the Government, who have agreed to spend $30 million on keeping the Tiwai smelter going at least until 2017.

It’s not from David Farrar at Kiwiblog, who is expresses his disappointment relatively reasonably.

Rio Tinto screws taxpayers for $30 million

I’ve got no problem with the pricing agreement between Meridian and Rio Tinto, as that is a commercial contract.

But bloody annoyed they screwed $30 million from the taxpayers as a subsidy. I think the Government shouldn’t have given them a cent. If the smelter closes, so be it. It is not the job of taxpayers to subsidise unprofitable industries.

I can understand that from an ideological point of view and have some sympathy for Farrar’s sentiments. But Farrar lives and breathes in Wellington.

But most of the other commenters on Kiwiblog are more angry and more blunt. Especially one Wellingtonian, RRM (he lives a bit of a train ride out of Wellington but works in the capital).

I commented at Kiwiblog:

Don’t forget that Bill English is Clutha/Southland MP – and he will be (or should be) well aware of the growing anger in the south over jobs being moved north and the amount of money being spent of things in the North, especially Christchurch (much of that is understandable) but particularly Auckland.

If Tiwai closed English may not want to venture south, there would be a huge outpouring of angst and anger.

Then an outburst comes from RRM:

Huge?

Population of Invercargill = 53,000 according to Google.

It’s no secret that it’s a small shithole town at the arse end of the world, with limited employment opportunities, it’s always been that.

The aluminium smelter is a lucky score for them but by rights it should be nothing more than a service centre for the dairy farmers and a few fishing boats.

You’d have to be mad to move there. mad, or retired.

Fuck them.

I replied: RRM – that’s pretty much the Wellington attitude that many down here presume. Perhaps you should start building a lot more windmills. And hope that cold says aren’t calm.

RRM:

When you say it like that, I realise how selfish I’m being. OF COURSE I should continue to subsidise the lifestyle of Invercargill people. If they want to be basically morally equivalent to beneficiaries or prison inmates, let’s formalise that with a cheque for thirty million dollars.

There, now we own you, you mangy Catholic Scots dogs. Show us a little highland fling now. Go on.

That’s from someone who’s livelihood is in a city that is far more supported by Government spending than any other. Who commutes to work on Government subsidised transport.

And from the thumbs up responses, his views are shared by others from the north.

No wonder the South is getting very annoyed at the gutting of the provinces. Just this wek sightly to the north Dunedin mayor has called for a summit over the announcement the agricultural research in the south (centred at Invermay) is going to be moved north.

Unemployment surges

Southland’s unemployment rate has increased by more than 50 per cent from the March quarter to the June quarter, new figures show.

Invercargill Deputy Mayor Darren Ludlow said the increase in unemployment was a disturbing trend and reflected the flow-on effects of job losses at the Tiwai Pt aluminium smelter.

Southland businesses continued to struggle after the global financial crisis, he said.

It’s hard enough with the downsizing of the Tiwai workforce.

Slightly further north:

Otago unemployment up 37% on year ago

As Otago struggles with layoffs and reduced hours for manufacturing workers, the region’s unemployment rate continues to climb, rising 37% in the year to June.

“Small shithole town. Fuck them.”

And there’s a common feeling that this is how Wellington views the south in general – as well as other regions like the west Coast, the East Coast and Northland.

And they wonder why agriculture and horticulture has trouble attacking New Zealanders to work down here.

If Tiwai closed there would be a huge outpouring of angst and anger from the south. And the frustration and annoyance is growing regardless. The Tiwai news is a relief, but just a pause in the growing concern.

Southerners are already murmuring about politics – see Call for South to form own party. Will they get annoyed enough with Wellington to say “Big shithole Parliament. Fuck them!”