Speech to Faster Cancer Treatment Forum, Te Papa, Wellington

  • Jonathan Coleman
Health

Introduction

It’s great to be here to open the very first Faster Cancer Treatment Forum.

Thanks for taking the time to be here to share how we can further improve cancer services.

Cancer rates

Obviously cancer is a critical health issue for New Zealanders. It’s the country’s leading cause of death - cancer accounts for nearly a third of all deaths, and is a major cause of hospitalisation.

Internationally New Zealand performs well in terms of overall cancer outcomes. The OECD results for 2011 for breast, cervical and colorectal cancer shows our five year relative survival ratios for all three were above the OECD average.

While our cancer survival rates in New Zealand continue to improve, there is still work to be done.

Government priority

Improving cancer outcomes is a long term commitment. As our population grows and ages, we cannot afford to be complacent.

Delivering better cancer services is a top priority for the Government. We’ve made significant progress since 2008 and patients are getting better faster cancer care.

We’ve invested almost $63 million on the wider faster cancer treatment programme over the last six years – a period marked by fiscal restraint.

Cancer target

Before the Government introduced the shorter waits for cancer treatment health target in 2008, patients could wait over eight weeks to receive radiation treatment, with some patients even being sent to Australia.

Now all patients across the country who are ready for treatment wait no more than four weeks to receive radiotherapy or chemotherapy. This is the international gold standard and is a great achievement by our dedicated cancer teams and services.

The shorter waits target has also shown the significant impact that focusing on a particular part of the system can have.

As a result of this success and to help further reduce waiting times, the Government introduced a new faster cancer treatment health target in October last year.

New 62-day target

We know that prompt treatment is more likely to ensure better outcomes for patients.

The new 62-day faster cancer treatment health target puts the lens right across the cancer pathway.

Under the target, by July 2016, 85 per cent of patients are to receive their first cancer treatment within 62 days of being referred with a high suspicion of cancer. This increases to 90 per cent by June 2017. 

The new target will provide a general measure of how well the health system is performing overall for patients with cancer.

The first results against the target were published in February, and it was pleasing to see overall national performance was 66 per cent. This is comparable with other countries when they have introduced a similar new target.

DHB performance varies widely, from 50 per cent up to 82 per cent. For a number of DHBs achieving the target will be a challenge.

I know that service improvement takes time - however, I’m unapologetic about setting ambitious targets and I expect DHBs to work hard to improve their performance against the target.

NZ Cancer Plan

The new 62-day target is a key focus of the New Zealand Cancer Plan which I launched at Wellington Hospital in December.

The Plan outlines the activities that need to happen over the next three years to ensure people with cancer receive even better faster care.

We are focusing on areas where we know there are disparities, and introducing strategies to deal with them. This includes the development of national tumour standards for 11 of the most common tumour types which will help to reduce the risk of patients receiving poor quality care.

Other initiatives – Cancer Service Improvement Fund

Under the Cancer Service Improvement Fund $11.2 million is being allocated over five years to projects run by DHBs and regional cancer networks to streamline and improve the quality of care, and to ensure patients are seen within the new target.

The first round funded 23 initiatives which are currently being implemented. Projects include: developing a single point of access clinic for patients with lung cancer in the Northern region; upskilling scientists to speed up reporting times for cancer lab tests in Auckland; developing local pathways for GPs when referring patients across Capital and Coast, Hutt Valley and Wairarapa DHBs.

I know some of the presentations today are on the first round initiatives. I’m sure the learnings will be of interest to you all - especially with the second round of the Fund now open.

I encourage you to consider how you can best use the funding to make real and sustainable improvements to your cancer pathways.

Cancer Nurse Coordinators

The Government has also invested $4 million a year for at least one dedicated cancer nurse coordinator in each DHB.

There are now 60 cancer nurse coordinators working in full and part-time positions across the country. I know some of you are here today.

Cancer nurse coordinators fill a very important role - acting as a single point of contact for patients and families. They help to improve patient outcomes by coordinating care, making sure assessments, diagnostic tests and treatment occur in a timely and seamless manner.

Improved psychological and social support

Budget 2014 allocated $4.5 million a year for improved psychological and social support for cancer patients including a clinical psychologist in each of the six cancer centres, and up to 20 psychological and social support workers across the country. 

Service design work for these roles is progressing and DHBs have been asked to work together to develop a regional plan outlining how the new roles will build on existing services.

A national lead is due to be in place from next month, and will be available to assist DHBs in introducing these roles later this year.

Bowel cancer

The $24 million bowel screening pilot at Waitemata DHB is providing valuable learnings for a potential national bowel screening programme. Early results from the pilot are positive.

The largest constraint to a national bowel screening programme is the workforce to do the colonoscopies. 

There are a number of initiatives underway to address capacity issues. In Budget 2014, the Government also provided an additional $8 million to help reduce colonoscopy wait times.

I’ve asked officials for further advice on increasing colonoscopy capacity and the next steps for the bowel screening programme.

Conclusion

In conclusion, I believe that significant progress has been made in improving our cancer services – delivering better outcomes for patients.

I would like to acknowledge and thank you all for the considerable work and effort that you put into achieving this. Keep up the great work.

You can be confident that the Government will continue to place a top priority on delivering better cancer services. I look forward to the opportunities that lie ahead as we work to achieve even better faster cancer care.