Conjuring up cancer care

Health and disability commissioner Morag McDowell this week revisited her scathing assessment of southern cancer services, a year on from her original, highly condemnatory report.

There were some small things which residents of Otago and Southland can take comfort from, but the bulk of the report was as alarming as — if not more alarming than — her 2022 investigation.

To start with the positives, it is pleasing that southern health administrators in particular, and Te Whatu Ora Health New Zealand generally, took Ms McDowell’s report seriously, and worked hard to try to implement as many of her recommendations as they could.

Ms McDowell acknowledged that considerable work had been undertaken, and also that Te Aho o Te Kahu Cancer Control Agency had worked closely with all parties to try to improve what has for years been an increasingly desperate situation for southern cancer patients and their families.

Better support systems are now in place, or being introduced, for those stranded on waiting lists as they anxiously linger waiting to see a specialist.

But this is the nub of this crisis — the availability of much-needed specialists to see that patient.

Oncology specialists are a rare breed and are sought after world-wide.

New Zealand in general and the South in particular face the challenge of better-paying, more glamorous locations where these clinicians can work, with only the enticements of our scenic beauty and appealing lifestyle to offer.

It is dispiriting that these have not proven to be enough to recruit the staff that the southern cancer service, and the people of this region, need.

"It appears that Te Whatu Ora has been active in seeking solutions to enhance the senior medical officer workforce," Ms McDowell said.

"I am sympathetic to the disappointing outcomes of significant efforts to recruit radiation oncologists."

But what is desperately disappointing is that a clinician spoken to by the commissioner felt that a year on, despite everyone’s best efforts, that the service was more at risk than it was 12 months ago.

"I am acutely aware that cancer outcomes are potentially compromised by a delay in treatment," Ms McDowell said.

Photo: Getty Images
Photo: Getty Images
"For this reason, it is critically important that progress continues to be made, and that patient safety remains the focus of actions taken."

We can only echo the commissioner’s words.

Put bluntly, people are dying at worst, or having their life expectancy compromised at best, while this dangerous situation continues.

The stress on the patient, their family, and also the doctors who know that treatment would help these people but that it cannot be provided, is huge.

Where possible, southern clinicians have transferred patients elsewhere in New Zealand for treatment, but the need to leave town places added stress on patients and families.

Yes, it is better than nothing, but the South is far from being the only part of the country which is facing these issues.

Ms McDowell said that such measures should only be interim and short term and we agree: growing the southern cancer workforce is imperative.

Ending what has come to be called the "postcode lottery" in the health system was an election promise made by all political parties. Now it is a pledge which those who make up the governing coalition need to deliver on.

One heartening aspect of this otherwise depressing situation is that the commissioner has not forgotten us. In 2022 she vowed to keep a close eye on the service and she has done just that.

Furthermore, she has said that she remains concerned about the situation, which should mean it will remain under close scrutiny.

Ms McDowell’s final point is one which should resonate with decision-makers: that cancer rates are only going to increase, and that patients will demand new, advanced treatment options be made available to them.

Just this week the government announced an extension to the age limit for free breast cancer screening.

As a health initiative this is commendable, but more screening means more cancers being detected and more people waiting anxiously to see a specialist oncologist, a person whom our health system cannot conjure out of thin air.