Clark: Embarrassing cancer-care ‘lottery’ must be stamped out
Big differences in cancer care are “embarrassing” for the worstperforming district health boards and must change, Health Minister David Clark says.
In an exclusive interview with the Weekend Herald, Clark said having regional disparities on show for the public might be difficult for some DHBs but it was essential to put an end to healthcare’s postcode lottery.
“Perhaps it might even be a little bit embarrassing for some DHBs to see they aren’t performing as well as others but it enables us to put supports around those areas that aren’t performing as well and make sure we raise the standard.”
Clark spoke to the Weekend Herald as part of a special investigation examining New Zealand’s cancer care — set to be overhauled through a new national agency after patients-turned-advocates, such as the late Blair Vining, raised issues.
The minister said Heather Simpson’s governmentcommissioned review into the health and disability sector asked all the right questions.
“[We should be thinking] about what value are Primary Health Organisations adding in their current form?
Is a reduced number of DHBs a way to get through greater efficiency in the system or is it through more shared services or some other mechanisms?”
Clark said he hadn’t met anyone who strongly disagreed with the findings from the interim report and was eager to see the recommendations in the March report.
“Our system is good at addressing local demands and pressures but it’s not as good as it could be at sharing learning across the system. There’s stuff that needs to be done on workforce, there needs to be a greater focus on primary care, there’s a whole lot of things.”
He had heard too many stories of people choosing not to travel for cancer treatment because they couldn’t afford it or couldn’t leave their family
responsibilities. “That’s not acceptable and I do think we can do better.”
Clark said the cancer agency was working to create standards that would make sure all New Zealanders with the disease got better equality of outcomes and access.
Asked whether specialised centres were being considered, he said those leading the cancer space would make that judgment.
“Whether cancer outcomes would be improved by concentrating down to a few specialist areas or focusing on the access question, that’s what they are working hard to address. [Gathering] best practice seems to be where the easy wins are, that’s where the opportunity lies to make sure that all surgeons, and others providing cancer care, are performing at best practice levels and are supported to do that.”
Our reporting in the series will explore:
● how New Zealand’s cancer treatment can catch up to countries like Australia and Canada, which would save about 800 lives a year;
● what will be done to end postcode lottery care;
● concerns the ambitious new national cancer agency could be held back by funding shortfalls; and
● what our treatment will look like by the end of next year and in 10 years’ time.
Today, we speak to one terminally ill Auckland mum, Kim Girbin, who reveals her chance to fight the deadly disease was taken away when she was let down by the health system nine times.
“I was young, fit and healthy so I was put on an eight-month waiting list unless I paid, which I did and was seen the next day.
“Literally, they couldn’t even get the camera into my bowel, the tumour was that big,” the 42-year-old said.
Her story was labelled horrendous and “absolutely tragic” by Diana Sarfati, chosen by Clark to lead the new national cancer agency. She said it showed some of the systematic weaknesses that must be overcome.
“By and large we have a good health system . . . professionals who are working to the best of their patients but that doesn’t stop people from missing out on the care that they need. I am personally absolutely committed to improving the way that New Zealand manages cancer.”