Written by - Dr Richard Newbury, Gastroenterologist Rotorua Hospital.

Outside our major centres—Auckland, Christchurch, and Wellington—there is an alarming shortage of gastroenterologists and Specialist IBD nurses. People with Crohn’s Disease and ulcerative colitis in outlying regions sometimes wait months before seeing a specialist. In some instances, they are not seen at all.

One of Te Whatu Ora’s objectives was to improve access to specialty services across all regions, but, a year and a half after the agency was created, there has been little sign of change. National audits of IBD care in the UK and Australia clearly demonstrated the need for national standards of care. Few would argue that the situation in NZ is any different. For diseases that have such an impact on quality of life, there appears to be little appetite for any conversation to do away with the “post code lottery” when it comes to equity in accessing specialty care.

There is some cause for hope. In areas like Tauranga, Waikato and Taranaki, advocates for better access have gained support internally from their Chief Executives. But there are areas, like Tairawhiti, Wairarapa and Whanganui, where access is extremely limited. Even relatively larger centres like Rotorua, Nelson, Marlborough and Northland are understaffed when we look at full-time specialist doctors and nurses per 100,000 population. These are all areas where we should be focusing on providing equity for our country’s most vulnerable populations.

What is often overlooked is that these hospitals have medical teams working hard to improve access for their patients but are having business cases ignored and calls for more active recruitment of specialists dismissed. We need help from national organisations that have the ability to enact change and assist Te Whatu Ora to progress its pledge to address the postcode lottery.