“Not good enough” Patient Voice Aotearoa calls for independent pathology inquiry

Patient Voice Aotearoa is calling for an independent review into pathology services in the lower South Island following a damning Health and Disability Commissioner (HDC) investigation into the delayed diagnosis of a Southland woman’s stomach cancer.

The call follows the release of an HDC report into the care of a retired Southland nurse who died in 2022 after gastric adenocarcinoma present in earlier biopsies was missed by Awanui Labs pathologists.

Deputy Health and Disability Commissioner Vanessa Caldwell found both a lead pathologist and Awanui Labs breached the Code of Health and Disability Services Consumers’ Rights, with the failures resulting in a “significantly delayed diagnosis”.

A hindsight review later found gastric adenocarcinoma had been present in two previous biopsies taken in 2021.

Patient Voice Aotearoa Chair Malcolm Mulholland said the findings raise broader concerns about pathology services and workforce pressures in the South.

“This smacks of a corporate cover-up,” Mr Mulholland said.

“A case of a public service being privatised, so much so that the cuts that have been made to New Zealand’s pathology service to make a quick buck are now impacting harmfully on the health of patients.

“I hope there has only been one misdiagnosis, as no-one wants to see another Cartwright Inquiry when system failures result in premature death.”

Questions have also been raised about the closure of histology services in Invercargill in 2021, with the workload shifted to Dunedin pathologists already facing significant pressure and staffing shortages.

At the time, Apex union staff employed by Awanui Labs undertook strikes and protests over workload concerns and pay issues. In 2023, the New Zealand Institute of Medical Laboratory Science warned pathology services were in the worst state seen in decades.

Mr Mulholland said more questions needed to be asked about why the closure of histology services in Invercargill was not disclosed during the HDC investigation, and what staffing levels for pathology services in the lower South Island looked like during that period.

“But the investigation needs to be fully independent. We as a public have been short-changed,” he said.

A spokesperson for Health Minister Simeon Brown told the Otago Daily Times the Minister had not been advised by Health New Zealand “on any matters relating to histology services in Invercargill under the previous government”.

The spokesperson also stated that “any decisions on a review into funded sector-provided services would be a matter for Health New Zealand”.

Mr Mulholland rejected that response.

“You can’t just fob it off because it happened three years ago,” he said.

“I think it’s important that Health New Zealand, as well as the Minister, ensure that this inquiry happens for patients who were diagnosed or had tissue samples taken during that period of time.”

Patient Voice Aotearoa says only a fully independent review will provide certainty for patients and families concerned about whether diagnostic failures may have extended beyond the case examined by the HDC.