National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

The new French High Commissioner to French Polynesia has heard calls for support and compensation for atolls close to the test sites of France’s nuclear weapons tests.

High Commissioner Eric Spitz has been on his first tour of the outer islands since arriving from France last month to discuss France’s efforts to overcome the test legacy in line with an undertaking of President Emmanuel Macron to “turn the page” over the tests.

Spitz has been visiting Mangareva and Tureia, which are among the inhabited atolls closest to the former test sites of Moruroa and Fangataufa, used for more than 190 tests between 1966 and 1996.

The High Commissioner is travelling with the project manager for the French prime minister on the consequences of nuclear tests, Michel Marquer, and the head physician of the monitoring Department of the Nuclear Test Centres of the General Defence Directorate, Dr Marie-Pascale Petit.

The government delegation has been updating the atolls’ residents on the latest findings about residual radiation and the risks emanating from the test sites, weakened by dozens of underground detonations.

The mayor of Tureia, Tevahine Brander, said she would like to have support from France because some locals had given their lives for France while it was developing its nuclear deterrent.

“Perhaps the French state has taken a big step today on the nuclear issue, but my people will always remain vigilant on this subject. Our elders have endured a lot of suffering,” she said.

The mayor of Rikitea on Mangareva, Vai Gooding. also called for compensation, with locals telling the visitors of ongoing concerns.

‘Victims who have died’
Jerry Gooding, who is with the anti-nuclear organisation Association 193, told Tahiti-infos that “in Rikitea, there are victims who have died, and their children have cancer too, although they were born after the nuclear tests.

“This is why the association is asking for a transgenerational study into the genetic impact of the tests.

“Macron went to ask forgiveness in Algeria but did not ask forgiveness from the Polynesians. He must come and apologise to the Polynesians,” he added.

A resident, Benoit Urarii, said “everyone knows that Hiroshima was catastrophic, and everyone knew that it was dangerous for the population. General De Gaulle was aware and chose Moruroa because there were fewer people.

“But it is close to us, so we are the first victims. The first test in 1966 was catastrophic for us Mangarevans. And we got infected. Nobody can deny that.

“We were not asked for our opinion, and we knew exactly how dangerous nuclear tests were.”

The medical expert Dr Petit said there was cancer before nuclear testing.

‘Cancer not only due to nuclear tests’
“It will exist afterwards, and we all know that cancer is not only due to nuclear tests. Nobody is able to say that this is a cancer due to nuclear testing or not. We do not yet have a marker that will make the difference,” she said.

Concern was also raised about a possible collapse of the test area on Moruroa atoll, but Dr Petit said movements were gradually diminishing, leaving a very low probability of a sliding of a sediment plate.

She said whatever happened, the possible swells were likely to be weaker than what Tureia had already experienced.

Doubt persists as residents point to the complex and expensive technology in use to monitor the area around Moruroa, which is still a military “no-go” zone.

Until 2009, France claimed that its tests were clean and caused no harm, but in 2010, under the stewardship of Defence Minister Herve Morin, a compensation law was passed.

Plans are afoot to build a memorial site in Pape’ete, but a resident in Tureia said it should be on his atoll.

“The centre should be here, it’s more honest. But not a memorial for those who have taken advantage of all these years of nuclear testing to enrich themselves and stuff their bank accounts,” he said.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

The chair of the board of French Polynesia’s social security agency CPS has called on the French state to pay for the medical costs caused by its nuclear weapons tests.

Patrick Galenon, who is also a leading trade unionist, has written to the French Overseas Minister Sebastien Lecornu as France plans a high-level roundtable in Paris next month on the legacy of the nuclear weapons tests in the South Pacific.

Galenon said that since 1995 the CPS had paid out US$800 million to treat a total of 10,000 people suffering from any of the 23 cancers recognised by law as being the result of radiation.

He said France needed to reimburse these expenses if it wanted to restore trust.

A 2010 French law recognised for the first time that the nuclear tests were not clean but compensation to successful claimants was only made on the basis of national solidarity, not because the French state recognised any liability.

Galenon said France’s liability had to be anchored in law as the rest was just sentimentality and politics.

He said France should also assume paying for ongoing oncology services, which cost the CPS more than US$50 million a year.

Between 1966 and 1996, France carried out 193 nuclear weapons tests in French Polynesia.

The test sites of Moruroa and Fangataufa remain excised from French Polynesia and are French no-go zones.

• More than 2000 nuclear tests have been conducted since the first American test, Trinity, in 1945, according to the Swedish Physicians against Nuclear Weapons. More than 500 tests have been done in the atmosphere, under water or in space. The rest have been tested underground.The US is responsible for around 1000 of these tests, the Soviet Union conducted about 700, France 210 (including 17 in Algeria), China 35 and the UK about 30 tests. India has conducted six tests, Pakistan five and North Korea one nuclear test.

Article by AsiaPacificReport.nz

The United Liberation Movement for West Papua (ULMWP) has sent prayers for the recovery of the former Prime Minister of Papua New Guinea, Sir Michael Somare, who is critically ill with pancreatic cancer.

Sir Michael, who served as prime minister four times in Papua New Guinea, is also the founder of the Melanesian Spearhead Group (MSG). He is a figure who has played an important role in supporting ULMWP to become a member of the group.

Now 84, Sir Michael is being treated at the Pacific International Hospital in Port Moresby, as reported by Asia Pacific Report.

PNG’s The National newspaper said that Cardinal Sir John Ribat had celebrated a special Eucharist with Sir Michael and his wife, Lady Veronica, at his hospital bed.

ULMWP mengirimkan doa bagi kesembuhan mantan Perdana Menteri Papua Nugini, Sir Michael Somare yang dikabarkan sakit. #PapuanLiveaMatter https://t.co/yWfvKA9VTp

— jubi.co.id (@jubidotcom) February 22, 2021

The executive director of ULMWP in West Papua, Markus Haluk, said the movement and the people of West Papua also sent prayers for the recovery of Sir Michael Somare.

“The people of West Papua [send] healing prayers for Sir Michael Somare,” Haluk told Jubi yesterday.

Haluk said that the news of Sir Michael Somare’s health condition reminded him of the meeting between ULMWP leaders and Sir Michael Somare at the MSG forum in Port Moresby in February 2018.

‘Look to the future’
“I remember a message from Sir Somare, ‘West Papua don’t look at the past, but look to the future. I have opened my heart, you [ULMWP] are not alone anymore,” said Haluk.

Haluk also remembers that a few minutes later the Prime Minister of Papua New Guinea at the time, Peter O’Neill, came to the MSG meeting venue.

ULMWP leaders were standing and chatting with Sir Michael Somare.

Haluk, realising O’Neill had arrived, wanted to turn around and greet the prime minister, but Somare prevented him.

“Sir Somare grabbed my shoulder, winked at me, telling me, ‘Don’t turn to face PM O’Neill. Later he will come in your midst ‘. I also followed Sir Somare’s body language,” said Haluk.

What Sir Michael Somare said came to pass. After Peter O’Neill greeted all invited guests, ambassadors and MSG delegates, O’Neill went to Somare’s circle with the ULMWP delegates.

“I spontaneously greeted PM O’Neill. ‘Nopase waaa… waaa… waaa…’ (Papuan greetings to an honourable figure). Sir Somare gasped at my greeting. O’Neill greeted, ‘waa… waa… waa… Thanks Bro ‘.

“Then we shook hands with PM O’Neill,” said Haluk.

‘That’s Papuan politics’
Haluk said he was very impressed with the meeting.

“That’s Papuan politics, Melanesian politics. Everything flows from our hearts. [We] understand each other, acknowledge each other. You are important to me. We both need each other. Continue to keep the fellowship alive,” said Haluk.

Haluk said the West Papuan people remember the stories and services of great figures such as Sir Michael Somare.

According to Haluk, the people from Sorong to Samarai sent prayers for the recovery of Sir Michael Somare.

“Commemorating all the great services and sacrifices for the Papuan people, from Jayapura, West Papua, we send sincere prayers for healing to Sir Somare. I hope you get better soon,” said Haluk.

This article has been translated by an Asia Pacific Report correspondent from Tabloid Jubi and published with permission.

Article by AsiaPacificReport.nz

by Bryce Edwards

Should cancer be politicised? And, should the debate about it be personalised, with a focus on the role of politicians in running the system being held to account for their decisions? 

There have been some deeply personal, sad, angry, and highly-politicised statements coming from cancer patients and their families in recent weeks as frustration mounts over cancer care in this country. Much of it makes for uncomfortable listening, particularly for government ministers who are being asked to personally acknowledge and justify the consequences of their decisions.

For the most recent example of a heart-wrenching and hard-hitting challenge to those running the country, see Elizabeth White’s must-read Dear Jacinda Ardern, my mother could die because of you.

Here’s the key part, in which White challenges the Prime Minister to think about the state’s provision of cancer treatment in personal terms: “What if it was you? Or your mother? Your sister? Your best friend? Your aunt? What if it was your daughter, Neve? What then? I can’t imagine you settling with the current treatment plan. I doubt you’d demand more trials (despite there already being successful ones) and fail to allocate specific funding to cancer treatment. I don’t think you would still be waiting for funding approval two years on from those promises when the life expectancy of ABC is 18 months. If you did you could already be dead! Do you see how ridiculous it is now? And now I’m going to get personal. Do you know how it feels knowing that in a year your mother could be dead because the Government she’s lived and worked under since she was a child won’t give her the support she needs?”

For those inclined to write off such pleas as lashing-out by someone going through an extremely difficult personal situation, White makes a very strong case for why the issue is political and not just personal: “Let me remind you that during your campaign you promised all New Zealanders world class cancer treatment. In case you’ve forgotten (because it seems you have), you also promised that ALL New Zealanders get the same standard of cancer care no matter where in the country they live. You said cancer patients would be supported with Labour’s $8 billion health investment. You vowed to streamline cancer care in New Zealand by establishing a National Cancer Agency. It’s almost two years later and so far all you’ve done is let us down and another 1200 families like mine have had to bury their mum. How many more have to die before their time?”

White concludes by telling Ardern that “cancer is not political but somehow you’ve made it just that. You hold the power and the key to peoples’ lives. Because of you people will either live or die.” She adds that it is “shameful that my father, who is desperate to help his wife, can’t even get an email back from the Health Minister.”

For another plea to the Prime Minister, from a young daughter whose mother has advanced cancer, see Kirsty Lawrence’s article, Teen disappointed by prime minister’s prosaic response to cancer funding plea. Her father is also disappointed by the lack of communication from the Government: “I would have hoped the prime minister would have taken some time to read Molly’s letter and respond in person… The prime minister talks about kindness and we are on the eve of the Wellbeing Budget, but the handling of other issues today speaks otherwise.”

David Clark, the Minister of Health, was blasted a few days ago at a cancer conference he attended, by the wife of Blair Vining, who was diagnosed with terminal bowel cancer last October. Melissa Vining, had this to say: “Minister of Health, it is great to see you here today. However, you have failed Blair. You have failed me and my children and you have failed many other New Zealanders’ by not having a cancer plan”.

For more on Blair Vining’s story, see Karen Brown’s report from the conference: Terminally ill cancer patient works on hatching nationwide plan. Vining explains how his experience of cancer illustrates major problems with the public health system.

Vining, who has bowel, liver, stomach, lung, and lymphatic cancer gave his story of a “dysfunctional” public health system, and why he was forced into the private health system: “I got told I had six to eight weeks to live without treatment, and I got a letter in the mail saying I would be eight to 10 weeks on the waiting list… If I’d gone public, I would have died before I had been seen.”

TVNZ’s Kate Nicol-Williams also reported on the Vining family’s experience, with Melissa Vining saying that “as taxpaying citizens they had complete trust in the public health system before he was diagnosed” but were now speaking out to help fix the system in order to save future lives – see: Government’s plan for dealing with cancer criticised at conference.

The problems of a postcode lottery system of cancer treatment

Vining’s key criticism is that the DHB system is too fragmented. This leads to all the different hospitals in the country operating separately and differently in terms of cancer treatments. The result is that patients receive different levels of care depending on where they live in New Zealand.

Andrew Little, when he was leader of the Labour Party, spoke out about his own experiences of cancer, and stated “What really worries me is that cancer care can be a ‘postcode’ lottery”.

Little’s criticism of the system is now being widely used by those lobbying the Labour-led Government to do more. The Cancer Society’s Dr Chris Jackson has focused on inequality of access as a major critique. According to health reporter Karen Brown, “He said instead results for patients varied depending on where they lived, their ethnic group and cultural and socio-economic factors. He also hinted at a lack of ownership of the problem” – see: Terminally ill cancer patient works on hatching nationwide plan.

The politicians simply don’t seem to be interested enough in the problems, going on the fact that so few bothered to attend last week’s cancer conference. Jackson says: “Unfortunately we invited every member of the health select committee and spokesperson to any part of this meeting, including the opening in our own backyard, and we had responses from two: The minister and one other. That could potentially reflect part of the problem.”

Jackson is reported in another article as explaining the problems of a fragmented health system: “We need strong central leadership, and we need change. Individual DHB’s do their own thing, and we can’t have that in a small country… We need to pool the expertise and the resources. All of New Zealand needs access to the same technology no matter where they are” – see Vita Molyneux and Sam Farrell’s Terminally ill man demands reform of New Zealand’s cancer plan.

Speaking on TVNZ’s Breakfast, Jackson called for the Government to adopt a national plan for cancer treatment, and complained that little progress is being made: “We were on your show this time last year saying that 2500 New Zealanders died of cancer who would have survived if we had Australia’s treatment success rates and very little has happened since that time” – see 1News’ ‘You can’t fight cancer without a plan’ – specialist demands national strategy to improve health of Kiwis.

According to this news report, Jackson “says we need to look at something similar to countries like Australia and Canada that have a national cancer agency and a national-based approach to coordinating cancer care, prevention and screening”.

There have been other criticisms of how the current government is dealing with cancer treatment. For example, Emma Russell reports: “Public reporting of DHBs’ performance of cancer treatment wait times was axed by the Labour Government in June last year. Health Minister David Clark said at last year’s announcement the targets created ‘perverse incentive’ but cancer experts say people are dying because of it” – see: Dying father speaks out about failing health system.

According to this, Bowel Cancer NZ spokesperson Mary Bradley complained that the failure of the Government to set targets for the DHBs was “simply not good enough”. She pointed out that “A delayed diagnosis can be the difference between having a fighting chance to facing a terminal outcome”.

Another criticism being made of the Government comes from the Cancer Society’s Chris Jackson. According to Kate Nicol-Williams’ report, “Jackson disagreed that cancer treatment was a priority for the Government, saying more investment and action is needed.” And Jackson is quoted, elaborating: “In the Minister’s letter of expectations to DHB’s last year, which is one of the instruments they use, cancer wasn’t mentioned so it’s clearly not a major priority for this Government and we think that needs to change”.

Labour’s promises on cancer

The Government is already under fire over its funding decisions and mechanism for cancer medicines – see my column on this from earlier in the week: Are Kiwis dying because the government won’t fund. Now, the focus is shifting to the bigger questions about the overall management of cancer treatment.

At last week’s “Cancer Care at a Crossroads” conference in Wellington, which was one of the largest international conferences of its type in recent years, David Clark responded to criticisms by promising to do more. Clark said: “We need stronger central leadership, I think it’s well acknowledged that the Ministry [of Health] hasn’t always achieved that” – see Ruby Macandrew’s Health Minister David Clark commits to improving cancer treatment for all Kiwis.

This article reports that “Clark has vowed to get the ball rolling on a national cancer plan”, and in terms of the “postcode lottery” problems he said “I am personally concerned about the growing inequalities [to access health care] and that is the main reason I chose to get involved in politics.”

It is not clear, however, if the Minister of Health is committing to carrying out his party’s pre-election promise to establish a National Cancer Agency. This was a commitment made in election year by then-leader Andrew Little. But answering questions about this last week, the Minister suggested that such promises no longer held because Little had been replaced as leader by Jacinda Ardern.

This week has also seen the publication on the Noted website of an important article on the politics of cancer treatment by Donna Chisholm – see: Why cancer treatment runs the risk of becoming unaffordable. This is an in-depth look at the way the public health system deals with cancer. And, as with other investigations, the article emphasises disparities of treatment and the lack of measurement of how well the system is working: “But to hold anyone or anything to account, it’s necessary to measure results and gather data, and that’s not happening here as often as it should. When it does, it can reveal concerning regional disparities in practice, because services are run by each district health board (DHB) without a coherent national model.”

Donna Chisholm has another article about ethnic inequality in cancer treatment: “Overall, Māori are diagnosed late, referred late, seen late and offered and receive treatment late and receive lower-quality treatment” – see: How we can overcome cancer inequality in New Zealand.

How can this discrimination be fixed? According to one “Māori cancer survivor” and health professional, “the health sector is inherently racist towards Māori patients and is calling for a change in workforce cultural competency to save more lives” – see Moana Makapelu Lee’s Health sector ‘inherently racist’ to Māori says cancer survivor.

Finally, last week’s “Cancer Care at a Crossroads” conference featured an important talk from the University of Otago’s Professor David Skegg on what has been happening in the politics of cancer treatment, and where things might be going – see the 18-minute video of his speech: #Cancerandme.