Concern at cancer rethink Violent preacher loses deportation appeal
Shifting cancer care out of hospitals has experts fearing patients will suffer. Marika Hill reports.
A BREAST cancer specialist is ‘‘very concerned’’ by the Government’s plan to bump cancer survivors from hospital beds to doctor clinics.
Cancer survival rates have reached an all- time high – the death rate for breast cancer alone halves every decade – and that has lead some to point to an increasing number of survivors clogging up hospital beds, as well as a looming shortage of oncologists.
The Ministry of Health has proposed drastic new measures to ease the pressure, including upskilling GPs and nurses to shoulder the workload.
But oncologist Anna Bashford, an adviser to the NZ Breast Cancer Foundation, said patients would get sub-standard treatment if shoved back into primary care.
‘‘ I would be very concerned about patients being referred back to their GP in the community who may not have the experience to be able to help the patient.’’
Dr Bashford said oncologists
I would be very concerned about patients being referred back to their GP.
were familiar with different treatments, experienced in dealing with medication side-effects, and kept abreast with the latest cancer developments. A doctor’s fee would also be too big a barrier for some patients to bear, she said.
The Government’s Oncology report, released last month, found cancer care services were ‘‘substantially stretched’’ and some cancer centres were struggling to cope. And the situation was set to worsen. The demand for cancer treatment over the next 15 years was expected to nearly double, according to the report, which proposed pushing lower-end care such as hormone treatment and mammograms to general practices and satellite clinics.
Oncologist Shaun Costello, who is leading the charge for change, said the number of cancer patients was rising faster than the number of new oncologists.
Greater survival rates, longer treatment times, and the ageing baby- boomer generation compounded the problem, he said.
The obvious question was where the cancer survivors would go. ‘‘ There is an inevitable conclusion. They primary care.’’
Costello, who is the Southern Cancer Network clinical director, said there were already informal changes occurring, but the time had come to make a more structured approach to change.
He said patients would benefit from the new approach by cutting waiting times for hospital referrals and improving access to treatment in regional areas.
However, a general practice owner in Auckland said the new approach would swamp already over-stretched GPs.
Auckland doctor Dr Phyllida Cotton-Barker said some general practices are already working to the max, so although the plan may look good on paper, it did not have the bricks and mortar to back it up. The Government’s Better Closer Sooner initiative made similar promises to move more patients to primary care, she said. ‘‘We thought that was going to be something amazing but it was the biggest fizzer.’’
The Ministry of Health did not respond to a request for comment. A Government- commissioned Cranleigh report first signalled the move away from the hospital- based model of cancer care last year.
The Government took on a number of the report’s recommendations, including splitting cancer treatment into four categories based on its complexity.
Specialist nurses, GPs and private clinics would alleviate the pressure on oncologists by managing the two lower levels of treatment. For example, nurses would manage complications and follow-up care, while rural cancer clinics could offer chemotherapy.
It is expected the new model of care would take effect in the next three to five years.
University of Otago research released earlier this year showed survival rates for cancer have increased across the board. Breast cancer and leukaemia had the biggest jump in survival rates over the past two decades.
For breast cancer, the rate fell 52 per cent each past two decades.
have
to
go
to death of the
Breast and colon cancer hit the most New Zealanders but lung cancer is the biggest killer. A PREACHER who viciously beat his wife for three years, including gouging her eye blind, has lost his fight against deportation.
Reti Falaniko, a preacher at the Penrose Assembly of God church in Auckland, pleaded guilty in 2010 to 11 offences of varying severity, all committed against his wife between January 2004 and May 2008.
Falaniko argued he should not have been deported because he had had a subcutaneous defibrillator – like a pacemaker – implanted in 2006 following a heart attack. He argued he could not get the pacemaker serviced in his native Samoa if there was a problem.
The Immigration and Protection Tribunal, which heard Falaniko’s appeal, said his violence against his wife began four months after they were married in October 2003.
Falaniko felt his wife ‘‘did not publicly give him the respect he felt ought to be accorded to his status as a preacher’’.
In January 2004 his wife became angry with him and walked out of church. ‘‘He followed her out and punched her several times in the face and body.’’ In July of that year he punched and stomped on her because she did not give a thank-you speech in church.
The assaults increased in severity. She needed seven stitches after he threw a coffee table at her head at her parents’ home.
On March 16, 2008, he accused her of having an affair and began assaulting her. ‘‘He said ‘Watch this. You’re going to die’ and either punched her or put his thumb into her eye.’’ Attempts to save the eye were unsuccessful.
The judge who sentenced him to four years in jail said: ‘‘You are a degree holder in theology, you are a pastor in a church which preaches peace and love, turning the other cheek . . . yet you repeatedly, over a five-year period, bashed your wife severely to the point where she is now functionally almost entirely blind’’.
The tribunal said Falaniko had a high risk of reoffending and his pacemaker could be maintained in neighbouring countries.