Some patients waiting for heart scan given death sentence due to delays, cardiologists say

Some patients waiting for a heart scan to diagnose potentially life-threatening conditions have been given a death sentence as a result of huge delays.

The situation is so grim a group of doctors wrote an open letter to Prime Minister Christopher Luxon late last year begging for help to improve cardiac health care.

According to The Heart of Aotearoa New Zealand Kia Manawanui Trust, at least 15,000 patients around the country are currently waiting for an echocardiogram - an ultrasound scan used to diagnose heart conditions - for cardiac and cancer treatment.

Trust medical director Dr Sarah Fairley said Waikato and Wellington were among the worst affected regions.

In Waikato alone there were 7500 patients in line for echocardiography.

About 80 of them were urgent cases but instead of being seen within two weeks, patients were waiting between three and four months.

Semi-urgent patients would wait about a year instead of six to eight weeks, unless they paid $800 to go private, and routine cases were not even being booked.

In Wellington, the wait was 10 months. Fairley said patients were suffering as a result.

"I know from colleagues that have spoken to me recently that they are aware of cases where patients have come to harm on the waiting list.

"And when we are talking about harm we're talking about the condition that has progressed to being very high risk, potentially untreatable, and also we're talking about death."

In the open letter dated 14 October 2024, Fairley and trust chief executive Letitia Harding said the health system was failing Kiwis with heart disease.

The pair described echocardiography as the gateway to therapy for people with heart failure and vital in the diagnosis of patients with suspected valve disease.

"Prime Minister, waiting lists have blown out of control. We cannot stand by and let this happen," they wrote.

"The system is broken, and New Zealanders are paying with their lives."

They asked for more cardiac beds, staff, and funding to ensure quicker access to critical tests, as well as investment in theatres, diagnostic procedures and access to life-saving medications and essential medical equipment.

The trust reiterated its wishlist on 16 December but Fairley said capacity had not improved.

"We had no direct response or communication from the Prime Minister or Minister of Health or their relevant staff after the open letter."

Trust cardiologist advisory member and Cardiac Society New Zealand division chairperson Dr Martin Stiles said patients were being advised to pay and go private to progress their treatment, but many couldn't afford it.

"Undoubtedly there has been harm to patients.

"I've heard some stories of patients who've been arranged to have a three-month echocardiogram to prepare for surgery but the echo's been delayed over a year and then the surgery becomes much more difficult or in fact impossible to perform because things have just progressed too far."

Stiles said Lakes, Tai Rāwhiti and Taranaki - which make up part of the Midlands region that falls under Waikato Hospital - were among the worst hit.

"These regions have poorer access to cardiac healthcare than other regions in the country.

"They're also some of the most deprived regions and they have the highest Māori and Pacific Island population in New Zealand. So this is a real problem of equity for us."

He said the added delay on reporting the scans was causing extra workload for doctors because patients were turning up to appointments before their results did.

"We need more people training to do the scans, we need more people training to read the scans.

"We don't need to be told to work more efficiently. Frankly, we're fed up with that. What we need is more resource for the patients to get the care they need."

Call for creative solutions

Otago University professor of clinical sonography Dr Gillian Whalley said part of the delay was caused by non-heart patients who needed an urgent echocardiogram.

Whalley, who does clinical work in Northland where there were also waits, said the system needed creative solutions.

She said many patients who needed the scan were actually having cancer treatment or needed anaesthesia but those clinicians weren't trained to do the scans.

"With the advent of artificial intelligence we've got systems now that could really make it possible for an oncology nurse to do a very good quality scan and get the answer they need in a more timely manner for them as well as freeing up spaces for us."

Whalley said better IT infrastructure would also help to prevent patients needing more than one scan.

"If we could access each other's images we'd be able to reduce some of the repeat scans.

"Cos' sometimes it is just so difficult to see an image from another hospital or even just from the ED on the floor below us that it's easier just to repeat the echo.

"So that's another slot that then gets taken up and isn't available to other patients."

Te Whatu Ora Waikato head of cardiology Dr TV Liew said there was a growing demand for services from people with increasingly complex needs and acute services.

"There are also ongoing workforce pressures, and we are always looking for ways to train and recruit staff with the specialist skills we need.

"At our peak capacity we have been delivering around 11,000 scans per year."

Liew said it was a continuous process to deliver the most urgent cases ahead of those able to wait.

Waikato's action plan to improve wait times included recruiting, creating its own specialists including training four sonographers, outsourcing, a business case to increase cath lab capacity, and improving co-operation and better use of cath labs in the region.

Cause for concern

Te Whatu Ora Central acting deputy chief executive Mat Parr said Wellington was bringing in locums, training specialist staff locally, and recruiting internationally to reduce its waits.

Health Minister Simeon Brown said the high wait times were a concern for him.

He said Waikato had a plan in place to reduce wait times but he'd also requested a briefing from officials on what more could be done.

"I welcome correspondence on this issue, and particularly ideas or proposals on how we can address these challenges."

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