The Government has released its ten-year Cancer Action Plan aimed at improving cancer care and outcomes and ensuring care is accessible to all New Zealanders.
One of the key actions of the plan is to make more medicines accessible for more people through a funding boost for PHARMAC and there will be increased emphasis on prevention and screening. Quality Performance Indicators that are specific to cancer will aim to improve equity of care.
A Cancer Control Agency will also be established to ensure consistent standards throughout the country. A National Cancer Control Network will also be created, led by a National Director of Cancer Control. Leading public health physician and cancer epidemiologist Professor Diana Sarfati has been appointed to this role on an interim basis.
“Modernising our approach to cancer care and improving survival rates is a long-term challenge, but there are a number of things we can do to make a difference straight away,” Prime Minister Jacinda Ardern said, on the release of the plan.
“The first step was the announcement earlier this month of funding for 12 new Linear Accelerators for radiation treatment, including plans to put machines into Hawke’s Bay, Taranaki and Northland for the first time.
“Today we’re also announcing an extra $60 million in funding for PHARMAC ($20 million this year and $40 million in 2020/21). PHARMAC has advised us this will mean it can fund a range of new medicines, including several new cancer treatments,” said Ardern.
PHARMAC Board Chair Steve Maharey says the announcement is “great news for New Zealanders”.
“The $60 million boost means we can make real inroads into funding medicines on our priority list.
“Consultation has gone out today on proposals to fund three new cancer medicines. The new medicines are olaparib (Lynparza) for ovarian cancer, fulvestrant (Faslodex) for breast cancer and venetoclax (Venclexta) for chronic lymphocytic leukaemia,” says Maharey.
Ardern says from next year, PHARMAC will also speed up its decision making by considering applications for funding at the same time as Medsafe assesses the safety of new medicines, rather than waiting until that work is complete as it does currently.
Health Minister Dr David Clark says an immediate priority will be establishing quality performance indicators for specific cancer types.
“This will mean we can measure progress towards consistent care across DHBs.
“We are also combining the four current regional cancer control networks into a National Network to help remove regional variations in care,” Dr Clark said.
Professor Gregor Coster from Victoria University of Wellington’s Faculty of Health has described the Government’s action plan as “exciting and timely”.
“Recently New Zealand has been falling behind in its performance for cancer treatment compared to a number of other countries. And the disparities in cancer outcomes for Māori and Pacific peoples leaves us ashamed of our failure to make any headway there.”
Indeed, Māori Cancer Leadership Board Hei Āhuru Mōwai, which worked with the Health Ministry on the development of the plan, says achieving equitable cancer care for Māori is an urgent priority. Chair, Dr Nina Scott says that while the new National Cancer Plan is promising, the group believes that accelerated Maori partnership is critical to ensure the plan can be translated into action.
Professor Coster welcomes the Quality Performance Indicators.
“But it will be important that DHBs have the health workforce, including cancer specialists, radiologists, radiotherapists, oncologists, cancer nurses, and many others, to enable these services to be delivered.
“We know that New Zealand has a shortfall of these cancer treatment professionals, and that filling the gaps has a long lead time. In addition, there is much to do in ensuring DHB hospitals are properly equipped to deliver cancer treatment services. This is linked to funding, and we know that DHB deficits for the year ending June 2019 are likely to exceed $500 million. How are DHBs going to deliver better services with these workforce and funding pressures?
“It is a shame that it has taken so long for a Government response to the calls from cancer patients for action, but on the positive side we can now see light at the end of the tunnel and look forward to some real action,” says Coster.
But National’s spokesperson for Health Michael Woodhouse has described the plan as “too little too late” and “a watered down regurgitation of work we already had under way”.
“Commitments including prevention, screening, treatment and palliative care are meaningful objectives, which can be found in the already established New Zealand Cancer Plan 2015-2018.
“Rather than progress the strategy already put in place, the Minister has played politics and ground cancer development to a halt. The consequence being that 13 of 20 District Health Boards have shown poorer performance against the Faster Cancer Treatment target under this Government. Despite this, the Government’s plan makes no reference to targets for faster cancer treatment,” says Woodhouse.
However, the Association of Salaried Medical Specialists (ASMS) welcomes the plan, particularly the new Cancer Control Agency and increased funding for cancer drugs.
Executive Director Ian Powell says one of the most pressing tasks facing the new agency is devising a workforce plan to address long-standing shortages.
“ASMS surveys indicate a nationwide 22% shortage of specialists in public hospitals. Long-term planning is the only way these entrenched shortages can be fixed,” Mr Powell says.
Specialist shortages affect oncologists, surgeons, and other specialties involved in the diagnosis and treatment of cancer.
“DHBs have been struggling to provide adequate cancer care, which has led to inconsistent access to services throughout the country.”