System lets down cancer patients

Every hour, at least one New Zealander dies from cancer. Every hour. Almost 800 New Zealanders who die of cancer each year could be saved if they lived in Australia. That’s 8000 lives needlessly lost.

Despite cancer costing our health system more than $1 billion every year, New Zealand has some of the worst rates of improvement for cancer survival (for those aged 75 and under) in the developed world.

Bowel cancer is one dreadful example. Three-quarters of cases are curable if caught early, but only 60 per cent of New Zealanders diagnosed with the disease survive. About 1200 New Zealanders diagnosed each year will die harrowing deaths before the eyes of their families and loved ones.

Today, the Herald starts a new series examining New Zealand’s cancer care, which has been spotlighted by patients-turnedcampaigners — such as the late Blair Vining — and is set to be overhauled through a new national agency in three weeks’ time.

Because of our so-called “post code” differences in care — a situation Health Minister David Clark calls “embarrassing for some DHBs” — residents of Whanganui are three times more likely to die from bowel cancer surgery than Aucklanders. At least the minister recognises this disparity, but he, and all of us, should be ashamed.

So what should be done? To a large degree, we already know.

The Herald has previously called for an overhaul of district health boards to address the glaring disparities in care across regions. There is no need for a nation of our size to have 20 separate district health boards. At last, Clark has signalled an intention to act, but this cannot come soon enough given the amount of time it will take to change and any improvements to manifest.

There is no need for health boards to compete to host cancer services, for the funding and prestige they may bring. Specialists in various types of cancer can be established across the boards and patients transferred to the clinical care they need.

Diana Sarfati — the interim head of the new cancer agency, who has a background of international experience improving cancer care — told the Weekend Herald this method had made gains in Canada, United States, Europe and the United Kingdom.

Gains are desperately needed here. Clark has pledged to deliver the new Cancer Control Agency by December 1. Its stated purpose is “to ensure consistent standards nationwide”. To do this, it must be

Three-quarters of cases are curable if caught early, but only 60 per cent of New Zealanders diagnosed with [bowel cancer] survive.

well managed, fully funded and resourced to deal with the crisis that is blighting our response to cancer.

Given our appalling rates of treatment and survival compared with other nations, it is essential standards do not drop in any region while making gains in others. We need to lift the performance of our worst while maintaining the standards at our best.

Cancer survivor and advocate for urgent action David Downs recently wrote of the importance for the new agency to avoid the pitfalls of politics. One key focus, he wrote, was not to be distracted by seeking to cure cancer.

“Plenty of people globally are working on that — we have to work out how to bring those cures to New Zealand, and quickly, and to apply global knowledge to our context.”

This is life or death for far too many New Zealanders. We have the capacity to choose life — let’s do this.