Unfunded chemotherapy drugs should be offered to paying patients in the public sector in Otago and Southland, rather than by doctors "profiteering" in the private sector, says Dr Chris Jackson, the medical oncologist making the case for the Southern District Health Board's controversial proposal.
The board wants approval for its proposed pilot offering unfunded chemotherapy drugs for patients.
In March, the board asked Health Minister Tony Ryall to consider its case, but he is yet to make a decision.
Last week, Mercy Hospital said it expected to offer a comprehensive chemotherapy service for the first time later this year, subject to its board's approval next month.
A spokesman for Mr Ryall confirmed Mercy's plans were a "complicating factor" when considering the health board's case.
One of the main planks of the board's "Bridging the Gap" proposal was the unavailability of private-sector chemotherapy in Otago or Southland.
Dr Jackson said the public sector was the best place to offer unfunded drugs to patients without it costing "a fortune".
"I strongly urge the minister to find a public-sector solution rather than a private-sector solution."
Doctors ended up "profiteering" from providing their services to the private sector, Dr Jackson said.
Also, if it went ahead privately, chemotherapy in Dunedin would not address the issue of the lack of a service in Invercargill, Oamaru, Queenstown, and other provincial centres.
Dr Jackson said it was an issue for small centres New Zealand-wide.
The public sector had the infrastructure to deliver the "top-ups", rather than expensive duplication in the private sector.
Dunedin had three medical oncologists and they were all behind the Bridging the Gaps scenario, he said.
The "consensus" of the oncologists was a commitment to the public sector and setting up a service from which they would not profit.
He did not believe Mercy would be able to set up without engaging the services of Dunedin's public-sector oncologists.
Dr Jackson said he would be very surprised if Mercy made the decision to proceed before Mr Ryall's ruling.
Clinicians would "look at other options" if the board did not get permission, which included working for Mercy.
Public submissions on "Bridging the Gap" were overwhelmingly positive considering the controversial nature of the proposal, with about two-thirds in favour, Dr Jackson said.
Paying for "top-ups" was not an unusual concept overseas, he said. It was important to remember the proposal was a pilot, not a "wholesale" change to the public sector.
Mercy Hospital chief executive Richard Whitney would not discuss the medical oncologists' staffing issue, aside from saying initial discussions had taken place.
Mercy's establishment of comprehensive chemotherapy was unrelated to the board's proposal.
Board chief executive Brian Rousseau said he hoped Mr Ryall did not reject the board's scheme before the establishment of Mercy Hospital's proposed programme.
If Mercy's scheme went ahead, the board's case was weaker.
"One of the key reasons ... was to ensure that patients in the Southern DHB region could access services locally and would not have to travel to the North Island to access private treatment.
