5 July 2002
Reports Show National Paid No Heed To Cancer Warnings
It’s time National leader Bill English “fessed-up” over claims about cancer patients, Health Minister Annette King says.
Ms King said today it was outrageous that Mr English was using cancer patients as a major plank in the health debate.
“I am sick of Mr English’s “porkies’ about cancer treatment. He continually lays the blame for cancer sufferers having
to go to Australia at the feet of the Government, when in fact the problem stemmed from National’s reckless disregard of
official advice on the need to increase the number of radiation therapists to provide treatment and the need to buy more
linear accelerators.
“Cancer sufferers who have to go to Australia for treatment can thank the hapless and heartless National government,
which repeatedly disregarded warnings that too few radiation therapists were being trained in New Zealand.”
Ms King said the previous government was warned as early as 1996, and continually for years after that, that New Zealand
was staring down the barrel of a cancer crisis unless it addressed the growing shortage of radiation therapists and the
need to replace ageing linear accelerators.
“Jenny Shipley, Bill English and Wyatt Creech didn’t treat the advice of their officials with the urgency required, and
now we are having to clean up their mess.
“It’s time Bill English takes responsibility for the delays in cancer treatment services.”
Ms King said reports in the 1990s showed long waiting times for cancer treatment, and that National looked into sending
patients to Australia and around New Zealand for treatment.
By 1999, the situation was so desperate, the Ministry of Health told the then government that “current radiation
treatment capacity in New Zealand is marginal and barely meets demand; current radiation treatment capacity will be
compromised unless there are adequate levels of key staff; eight of 17 linear accelerators are due for replacement by
the end of 2000; an additional three appropriately staff linear accelerators will be required in New Zealand to meet
radiation treatment growth over the next five years”.
Ms King said the Labour Government is moving as quickly as possible to address the long-standing shortfalls in radiation
therapy services, by training more radiation therapists and pumping money into radiation therapy treatment.
“Under a Labour Government, the number of radiation therapy students in training has almost doubled (from a low of 43 in
1999, to 82 this year), and we spent almost $5 million last year on radiation therapy treatment, as well as providing
funding for new linear accelerators in Auckland, Waikato, MidCentral, Capital & Coast, Canterbury and Otago.”
Late last year the Government also announced it would fund cancer treatment in Australia to ease pressure on waiting
lists, which has worked successfully. As of this month, the Ministry of Health has paid for 103 patients to receive
treatment in Australia.
Ms King said people expected more honest debate from politicians.
“I am prepared to back up the information I am releasing today with the reports given to, and disregarded by, the last
National government.”
For more information, contact Dionne Barton (04) 470 6851.
Note: Attached are reports to the then Health Ministers Jenny Shipley and Wyatt Creech warning them of the dire
situation in cancer treatment services, and a table showing the number of medical radiation therapists in training.
Manatu Hauora
MEMORANDUM FOR
The Minister of Health
URGENT
Date: 2 August 1996
Subject: Radiotherapy Services and the Waiting Times Fund
Attention: Hon Jenny Shipley
Radiotherapy Services and the Waiting Times Fund
North Health
North Health wishes to purchase 2500 attendances for 83 people for radiation oncology at a unit cost of $200 per
attendance ($6,024 per person). This application seeks total funding of $562,500 inclusive of GST and has already
received your approval in principle subject to the RHA committing to a sustainable threshold and negotiating a better
price.
North Health has submitted a second application to purchase full radiotherapy treatment courses for a further 124 people
at an average cost of $14,690 per person. The total cost of this application is $1,821,458 inclusive of GST.
The two North Health applications seek to clear the total backlog of 207 people who were waiting for radiotherapy
treatment on 7 May 1996. North Health has indicated that there are now 259 people waiting an average of 16.5 weeks for
radiotherapy and if the backlog is not cleared, by the end of December 1997, 292 people are likely to be waiting a total
of 17 weeks before commencing treatment. If the backlog is cleared as a result of these two applications, North Health
expects that the number of people waiting for treatment at any given time is likely to be 41 people waiting for 2 weeks.
North Health has not indicated whether this level is sustainable.
A booking system is in place and being used currently.
The second application from North Health at an average cost of $14,690 per person is significantly more expensive than
the first application because it involves sending patients and support people out of the region to Christchurch and
Melbourne. North Health has indicated that the 4 linear accelerators it has within the region are operating at full
capacity and the backlog of those waiting for treatment can only be cleared by sending people out of the region. North
Health has indicated verbally that it cannot purchase significant additional capacity elsewhere in the North Island but
it should be asked to confirm this in writing.
The price offered by North Health is not marginal and in fact, due to the need for out of region treatment, is
significantly more than the base contract price. North Health should be asked to review treatment options within the
North Island and negotiate a lower price.
North Health has also indicated that it would expect to treat 40 % of those waiting from its base contract. It is not
clear whether the 207 people identified as waiting are therefore the remaining 60 % of those who would not be treated
under the base contract or whether the 207 figure is actually all that are waiting and therefore the application should
be for only 60 % of this number ie. 124 in total. The RHA should clarify this in writing and confirm that it will not
use money from the Waiting Times Fund to purchase treatment for people who should receive treatment under the base
contract within a reasonable period of time.
If approved, these applications would see the total backlog cleared by December 1997.
REPORT
PURPOSE OF REPORT
To advise you on progress of the Working Party Report New Zealand Radiation Oncology
Treatment Services and seek you agreement to meet with representatives of the Working
Party to discuss the report.
EXECUTIVE SUMMARY
The Working Party Report New Zealand Radiation Oncology Treatment Services was requested by the previous Minister of
Health, the Hon Bill English to develop national guidelines for access and a strategic framework for radiation oncology.
This framework is being peer reviewed by Dr J Carter, Capital Coast Health and Dr R Griffiths of the National Health
Committee.
The report has significant financial implications for HHSs and the Health Funding Authority for investment in linear
accelerators and staff. The Ministry of Health is meeting with CCMAU and the HFA to see how the Working Party Report can
be implemented and how purchasing and ownership interests can be aligned in the longer term for radiation treatment
oncology services.
BACKGROUND INFORMATION
In October 1998 patients at MidCentral Health were experiencing difficulty in getting access to radiation treatment.
Ministry officials were requested to investigate the issue by the previous Minister of Health, the Hon Bill English. We
visited MidCentral Health and provided advice on resolution of the issue (Health report 981452).
At the request of the Ministry of Health, an external review of the radiation oncology waiting list at MidCentral Health
was carried out by Dr J Carter and Dr J Childs and a report prepared for the Chief Executive Officer. The report was
released publicly on 20 November 1998 and is attached in Appendix 1. The reviewers are also preparing a second report
concerning the overall performance of radiation oncology services at MidCentral Health as well as a strategic plan for
the service. We understand that this report will be available this month.
As part of our investigation it became clear that there were no nationally consistent guidelines for timely access to
radiation oncology services and there was no nationally agreed strategic plan for the investment in linear accelerators
and staff. Radiation oncology services are currently provided by six HHSs Auckland Healthcare, Health Waikato,
MidCentral Health, Capital Coast Health, Canterbury Health and Healthcare Otago Under the auspices of the Minister of
Health, the Ministry has facilitated a working party to develop national guidelines for access and a strategic framework
for radiation oncology services in New Zealand. The report of the Working Party Report New Zealand Radiation Oncology
Treatment Services is attached for your information.
Key findings of the Working Party:
- Current radiation treatment capacity in New Zealand is marginal and barely meets demand
- There is a significant annual increase (projected 5.4%) of new cancer cases requiring radiation treatment
- Current radiation treatment capacity will be compromised unless there are adequate levels of key staff
- 8 of l 7 existing linear accelerators are due for replacement by the end of 2000
- An additional 3 appropriately staffed linear accelerators will be required in New Zealand to meet radiation treatment
growth over the next 5 years.
- Clinical alliances must be developed between adjacent radiation oncology units to optimise resource use and enhance
clinical service provision. Alliances would be:
Auckland -Waikato
Wellington - Palmerston North
Christchurch - Dunedin
- A radiation oncology advisory group should continue to develop and review the national provision of radiation
treatment services.
Key recommendations of the Working Party:
1 That the Radiation Oncology Working Party continues:
(a) to fully develop, foster and implement a national strategic plan and to review this plan with time according to
changing circumstances;
(b) to encourage co-operation between all oncology centres to ensure the most appropriate, effective and efficient use
of the radiation treatment resources throughout New Zealand e.g. the clinical alliance concept.
2 That HHS's incorporate in their business planning, the requirements for linear accelerator replacement and additions,
including the staffing and development of support facilities.
(a) review establishments for supporting staff and infastructure to ensure current linear accelerators can be operated
to their required capacity;
(b) acknowledge the need to replace linear accelerators that are more than 10 years old;
(c) accept the programme for linear accelerator replacement and additions as detailed by the working party. Table 9;
(d) consider provision of spare bunker(s) to allow linear accelerator replacement without loss of capacity;
(e) because of the increasing incidence of cancer and increasing intervention rate and number of attendances needed for
each patient, a minimum annual 5% increase in1 workload should be built into planning assumptions;
(f) provide support and resources to continue the national working party and develop the clinical alliance concept.
Total Numbers of Medical Radiation Therapy Student Trainees (1998-2002)
Stage 1 Stage 2 Stage 3 TOTAL
1998 16 15 14 45
1999 16 14 13 43
2000 22 15 14 51
2001 26 19 17 62
2002 38 25 19 82