Agency a vessel for progress

With great power comes great responsibility. But when the Government sets up an agency with great responsibilities, real power needs to come with it.

In the case of the new cancer control agency, this would mean the resources and corrective capacities to hold district health boards, the Health Ministry, and Government itself to account. None of which is a given.

The Government’s 10-year cancer action plan announced at the weekend includes, by the start of December, the much-anticipated creation of an agency that will join four existing cancer control networks into what’s intended to be a more cohesive and incisive entity.

Even though this was one of Labour’s campaign pledges there hasn’t exactly been a sense of sweet inevitability about it.

Much as Health Minister David Clark insisted the job was too important to rush, the passage of time led to mounting unease. Then came a couple of adrenalising jolts. National chimed in with its own plans for a national agency, and a headlinegrabbing pledge that it would fund $200 million for more dedicated cancer drugs.

And, from an unimpeachable grassroots level, came the spectacular petition campaign by Southland couple Blair and Melissa Vining, which swiftly gathered more than 140,000 signatures.

That petition carried a timely and potent message, amping up the volume of a nation drumming its fingers to something closer to the beating of war drums.

And here we are, at last. A new cancer plan that also includes $60m extra funding for Pharmac over two years. Less spectacular than National’s $200m for cancer drugs, but any impression the benefits might be nebulous dissipated with Pharmac’s swift identification of targeted areas of benefit, including

drugs for ovarian and breast cancer and leukaemia.

As things stand the creation of the agency has to be seen more as a vessel for progress than progress itself.

Will it have the functional ability to improve standards of detection and treatment, and address the brutal inconsistencies of service delivery nationwide? Or be merely a source of pallid encouragements and familiar lamentations?

It’s good news that quality performance indicators for most cancer groups are to be drafted. Feel free to discuss among yourselves why we didn’t have these already.

Then there’s the entrenched problem of the country’s shortage of skilled professionals to carry out this enhanced detection and treatment regime. They aren’t quick to train or, in the present environment, easy to retain.

Arguably there’s a lack of conspicuous scope for deficit-mired DHBS to fund these necessary positions – although progress would bring savings too, because all our failings of prevention and early detection create significant extra treatment expenses later on.

David Clark says the Government has listened to calls for strong central leadership. Funny he should say that.

Still to come is the broader review of New Zealand’s health and disability system by Heather Simpson who, lest we forget, was a largely anonymous, but heavy-hitting, part of the Clark-led government, contributing in no small part to its reputation for pragmatism over zealotry.

Inconsistencies of performance and inefficiencies of delivery will be high on her radar too and one of the many points of interest in her report – a draft is due soon and the final report in six months – will be how much more centralisation might be in the wind.

It’s good news that quality performance indicators for most cancer groups are to be drafted.