The public waiting list for one basic health screening test has blown out to 7200 people in the ACT, and at least two people have developed cancer while waiting more than a year to be seen.
Canberra health professionals say official waiting list figures reveal a "frightening" state of affairs when it comes to endoscopy examinations, and the government has thrown aside viable options to fix it.
Upper endoscopies can be used to diagnose stomach and oesophageal cancer, whereas lower endoscopies - otherwise known as colonoscopies - can be used to diagnose bowel cancer.
Public patients had a median wait time of 519 days to get an endoscopy examination in the ACT, according to the most recent data. One person had been on the waiting list for eight years - a matter which is under investigation by ACT Health.
"Given this very lengthy timeframe, the treating team is investigating to confirm details and understand how so much time has elapsed since the patient was first added to the wait list," an ACT government spokeswoman said.
"It may be that the patient has been treated elsewhere, or elected not to go ahead with the procedure, but not been formally removed from the waiting list."
The government spokeswoman said the median wait time was only 63 days for patients who'd been "actually seen" in the last three years - they would have been "priority" patients - but she admitted the wait time for many was too long.
Three years ago, less than 5000 people were on the waiting list and, according to targets, no patient who needs an endoscopy examination should wait more than a year for one.
One ACT gastroenterologist, who asked not to be named, said people on the waiting list must have been at greater risk of developing cancer, purely because they were on the waiting list and "there for a reason".
He said most on the waiting list had had colonic polyps, which could become invasive cancers.
The polyps could be detected with a colonoscopy and later removed, but people who had them should then have regular colonoscopies to make sure they didn't return.
Other people, too, had a genetic pre-disposition to bowel cancer.
"Say if a family member had bowel cancer at 45, then other members of the family should have been screened at 40," the gastroenterologist said.
"There are several types of genetic conditions that pre-dispose people to bowel cancers."
Another staffer, who also worked with endoscopy patients in the ACT and asked not to be named, said they were aware of at least two people who'd developed bowel cancer while on the endoscopy waiting list for more than 12 months.
"If they're waiting on that waiting list for years with rectal bleeding getting worse and worse, one of the things that they can be sitting there with is undiagnosed bowel cancer," they said.
The government spokeswoman said the process for diagnosing bowel cancer was a complex one, and it involved "multiple medical practitioners, screening tests and procedures".
She said clinical research had shown delays in diagnosis did "not necessarily lead to an adverse outcome", although Canberra Health Services was aware of two patients in 10 years "where possible delays in any part of this process between different care providers may have contributed to a delayed diagnosis".
"We know waiting times for endoscopy are a challenge for all jurisdictions. This is particularly due to the high number of referrals received through the National Bowel Cancer Screening Program ... [which recently started offering] two-yearly screening for all Australians aged [between] 50 [and] 74," the spokeswoman said.
"We are proactively recruiting more specialists to provide this service and exploring alternate options to create additional capacity such as possible weekend sessions.
"The ACT's health system will continue to ensure any patient in need of urgent attention will receive treatment."
The government spokeswoman said the territory had several initiatives to get wait times for endoscopy examinations down.
She said that, in the six months to the end of March 2021, 1085 overdue patients received endoscopies in the ACT.
She said the government had committed $16 million over three years to upgrade existing endoscopy facilities at Canberra Hospital, which would "allow for an extra 5000 endoscopy procedures each year".
But the ACT gastroenterologist who asked not to be named said that proposition was a "complete joke".
"Once you build a public hospital, it never stops being a building site because they never, ever plan for the future," he said.
"It's all a matter of whom they get, how they get them, how many they can do and the demand in the community, but they will never catch up with 7000-odd procedures."
The other staffer said the ACT government had legitimate solutions to the endoscopy wait list problem, but it tossed them aside in favour of leaving people "languishing".
One of those solutions was an agreement with Calvary Private to do endoscopy examinations for some public patients. That agreement ended last month.
Private providers ACT Endoscopy and Brindabella Endoscopy were also meant to start helping cut down the public wait list from March this year, but ACT Health said they wouldn't go ahead with that plan.
The government spokeswoman said: "The ACT Government considered a range of private providers to meet endoscopy targets. The targets were exceeded without the need to utilise these providers."
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