NZ’s cancer care: Alarming inequalities, dire workforce shortages and ongoing calls for further screening

Alarming inequalities, dire workforce shortages and ongoing calls for further screening are part of a Government-funded report on New Zealand’s cancer system released today.

For the first time Te Aho o Te Kahu, the Cancer Control Agency, has published a detailed snapshot of the current state of the country’s cancer-care system.

Some of the key issues in the He Pūrongo Mate Pukupuku o Aotearoa 2020, The State of Cancer in New Zealand 2020 report, included:

• Issues with the sustainability of our cancer workforce, with a large proportion of most specialist workforces set to reach retirement age within the next 20 years.

• New Zealand’s cancer workforce does not reflect the population of Aotearoa and lacks diversity. Of the core specialities involved in providing cancer care, between 1 and 4 per cent identify as Māori.

• Inequities occur along every step of the cancer continuum and affect a number of specific population groups including ethnicity, socio-economic, mentally unwell and by postcode.

• Screening for other cancers such as lung cancer has significant potential to reduce inequalities.

• While the three screening programmes (breast, cervical and bowel) are well organised, they do not function equally well for all groups, especially Māori and Pacific peoples.

“We have many world-class aspects of cancer control in New Zealand, and the cancer workforce is full of highly committed and talented people, but if we are to improve our cancer survival rates compared to similar countries, focused action is needed,” chief executive of Te Aho Te Kahu Diana Sarfati said.

“There needs to be continued work in addressing inequities, strengthening prevention, expanding screening and improving diagnosis and treatment for cancer,” Sarfati said.

Cancer Society chief executive Lucy Elwood said the report provided a detailed snapshot on the current state of our cancer system but didn’t provide the pathway forward for addressing the shortfalls.

“The report did indicate the areas that have already been identified including progressing the recommendations of the Health and Disability System Review, looking at that Māori health authority as part of that and ensuring better and fairer access to Pharmac systems and the national travel assistance schemes.

Elwood said it suggested that we need to do more in terms of addressing this postcode lottery issue.

“The treatment you get shouldn’t depend on where you live in New Zealand, and then there should be more investment in cancer prevention and screening.”

Lung Foundation chief executive Philip Hope said there was a lot talk but it was time for action.

“We talk a big talk when it comes to smokefree 2025 but the reality is that’s an aspiration because we haven’t funded the supporting structures and wrap-around services.”

Hope said before introducing screening for lung cancer we must first be reimbursing all standard care treatments.

“It would be unethical to not. We see more than 1800 dying prematurely each year because they are not getting access to standard treatments in the public system.”

The agency would be monitoring the diagnosis and treatment of cancer patients via a Quality Performance Indicator Programme which would identify key problems and disparities among DHBs and clinicians.

Along with the Ministry of Health and the Health Research Council, Te Aho o Te Kahu is also funding research to investigate the appropriateness and feasibility of lung cancer screening in New Zealand.

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