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National fiddles – while Cancer Kills

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say-no-to-cancer

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Fun Fact 1: New Zealand has one of the highest bowel cancer rates in the world. Bowel cancer is the second highest cause of cancer death in New Zealand. More than 2800 people are diagnosed with bowel cancer every year and more than 1200 die from the disease. By 2016 the number of new cases of bowel cancer diagnosed each year is projected to increase by 15% for men and 19% for women to 3302 (for all ages). Ministry of Health

Fun Fact 2: Bowel cancer is more common as you get older, particularly from the age of 50. Bowel cancer affects more men than women. IBID

Fun Fact 3: People who are diagnosed with bowel cancer, and receive treatment when it is at an early stage, have a 90% chance of long term survival. If there is a delay in diagnosis and treatment, and the cancer is more advanced, it is harder to cure. Bowel screening can detect cancer early, when it can be more successfully treated.  IBID

It is a sobering statistic that we try to ignore and put out of our minds; more than 2,800 people are diagnosed with bowel cancer every year and more than 1,200 die from the disease. If that were a death toll from a communicable disease, the media would be carrying front page newspaper stories  and lead bulletins on 6PM news. The government would impose a State of Emergency, and strict travel conditions imposed on everyone.

But we don’t.

Bowel cancer is hidden away. Victims are not acknowledged.   People go about their every day lives. Media focuses on sensationalism or trivia (with few exceptions).  Government does nothing. The death toll continues to rise.

And it is wholly preventable.

In October 2011, the Ministry of Health began a four-year-long bowel screening pilot in the Waitemata District Health Board area. The screening was offered to  everyone aged between  50 to 74, living within  the Waitemata DHB zone, and who was eligible for publicly funded healthcare. Those lucky to be eligible were sent an invitation letter, a consent form along with detailed instructions, and the necessary free bowel-screening test kit.

By July 2013,  data from the screening pilot detected cancers  in seventyfive people within the first fifteen months of the pilot. Around 60% had been picked up at an early stage when they could be more successfully treated.

Between  1 January 2012 to 31 December 2013,  six thousand people had a colonoscopy or a CT colonography through the Bowel Screening Pilot.  By 1 April 2015, two hundred and fiftyfive people had been identified with a cancer.

Those are 255 people who might not have approached their medical clinic for a test screening kit, or followed up with a colonoscopy. Those are 255 people whose cancer was detected early, and who had necessary treatment.

The pilot screening have also picked up non-cancerous polyps (adenomas) and those  participants will still be at an  increased risk of developing more adenomas or bowel cancer. These participants will require on-going regular bowel checks  in the future.

The initial four year pilot project, initially costing $24 million, was extended to the end of 2017, with a further $12.4 million invested in the programme. But only in the Waitemata District Health Board area. Those living outside the WDHB are not eligible to participate.

That result is from just one DHB “catchement” area. There are twenty DHBs  throughout the country. If similar results were obtained from the nineteen other DHBs, that could mean approximately 5,100 people detected with cancer.

The government’s response can best be described as slow – at worst, reluctant to invest in a nationwide programme. On 6 July, Health Minister Jonathan Coleman announced a graduated roll-out of a nationwide screening programme.

First, Minister Coleman began with the usual meaningless platitudes;

Delivering better cancer services is a top priority for the Government. Bowel cancer is the second most common cause of cancer death in New Zealand.”

Minister Coleman then explained in a little more detail;

I expect to take a business case to Cabinet by the end of the year which will consider a potential staged roll out of a national bowel screening programme from early 2017.”

However, note the caveats;

I expect to take a business case to Cabinet by the end of the year which will consider a potential staged roll out….”

To inform the next steps towards a possible roll out of a national bowel screening programme, the Ministry of Health will be consulting with the health sector and other agencies on how the service could be provided across the DHBs.”

So not only will any nationwide extension of the life-saving screening programme not begin until “early” 2017 – which happens to be an election year (no connection of course)  – but at this stage it is still only  a   “possible” or “potential staged roll out”. At this point, Coleman will be only be taking “a business case to Cabinet by the end of the year”.

Unsurprisingly, health advocates and professionals are not impressed

Bowel Cancer NZ’s, Dr Sarah Derrett, did not hold back when she condemned National’s lethargic response to the sucessful screeing programme;

Currently this Government is more interested in holding a referendum for a flag as a legacy to our Prime Minister at a cost of $26.5 million than it is at saving lives… it was scandalous there had been no action on a national programme, given 1200 people a year die from bowel cancer in New Zealand.

Bowel Cancer NZ’s chairwoman, Mary Bradley, was also scathing;

We are really pleased that this is happening and that they are talking about a staged roll-out, but we would like to see potential moved to definite roll-out in 2017.

We would like to see a staged roll out now or a start next year would be fantastic. We’ve always known it [screening] is proven, so why wasn’t it done sooner. It could have happened a couple of years ago. This is great, but it’s taken a long time to get here. In the meantime, people are dying.

There is no feasible reason why Coleman is delaying a national extension of this screening programme that has already saved 255 people.  Delaying the roll out condemns hundreds of New Zealanders to a horrible illness and unnecessary death.

Coleman claims that that the delay is caused by a shortage of skilled staff;

The largest constraint to a national bowel screening programme is having the workforce to do the colonoscopies. There are a number of initiatives underway to address this.

[…]

Initiatives to strengthen the endoscopy workforce include increasing the number of gastroenterology trainees. The sector is also considering increasing the use of CT colonography where appropriate.

Yet, the pilot programme has been in operation since October 2011 – giving this government a lead time of five years to begin training required staff. Where was the planning for staffing a nationwide screening programme that was being considered after the  Waitemata DHB pilot?

Did no one at the Ministry of Health or the Health Minister’s office pause to think; “Ok, what happens after the pilot?!

The only possible explanation for this tardiness is purely financial. As Bill English attempts to balance the books and deliver a budget surplus, cuts to health services become more invasive;

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Health fund loses $18 million

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National’s reluctance to spend on much-needed, critical services is no secret. Successive National governments have cut services, whilst giving away billions in tax cuts.

But it is also not averse to spending taxpayers’ money on projects it deems “necessary”;

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NZ government shells out $11m on New York apartment for UN representative

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Flag referendum to cost $26M

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Government accused of wasting $11.5 million on wealthy Saudi farmer

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Govt pays $30 million to Tiwai Pt

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Those four examples alone come to $78.5 million that could have been invested in rolling out a nationwide bowel screening programme plus pay for training of required specialist staff. Instead, the money has been spent on a luxury apartment; bribing a Saudi businessman; John Key’s vanity-project to change the flag; and acceding to a multi-national corporation’s demands for a cash subsidy.

This is worse than wasting tax-payer’s hard-earned money.

New Zealanders are dying whilst National fiddles and wastes time.

It is not the first time this has happened;

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Public hospital ills blamed on fund - Otago Daily Times - 20 august 1999

‘Public hospital ills blamed on fund’ – “Otago Daily Times” – 20 August 1999

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'Four forced off waiting list die',

‘Four forced off waiting list die’, “The Press”, 15 March 1999

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On 21 July, I wrote to Minister Coleman on the issue;

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Kia ora Dr Coleman,

I understand that you plan to “take a business case to Cabinet by the end of the year which will consider a potential staged roll out of a national bowel screening programme from early 2017”.

Considering that a Ministry of Health  pilot programme carried out by the Waitemata District Health Board since October 2011 has saved the lives of approximately two hundred and fiftyfive people who had been identified with a cancer, it seems unbelievable that New Zealanders will have to wait at least another year and a half before a screening programme is rolled out nationally.

You stated on 6 July this year that;

“The largest constraint to a national bowel screening programme is having the workforce to do the colonoscopies. There are a number of initiatives underway to address this.” (https://www.national.org.nz/news/news/media-releases/detail/2015/07/06/Consultation-on-next-steps-for-bowel-screening-programme)

Surely the training of skilled staff should have been started in 2011, when the pilot programme at Waitemata was initiated?

Waiting until the beginning of 2017 means that thousands of people around the country may be stricken by bowel cancer.

How many will contract the illness during the time it takes to extend the screening programme?

The Ministry of Health states;

More than 2800 people are diagnosed with bowel cancer every year and more than 1200 die from the disease. By 2016 the number of new cases of bowel cancer diagnosed each year is projected to increase by 15% for men and 19% for women to 3302 (for all ages) (http://www.health.govt.nz/our-work/diseases-and-conditions/cancer-programme/bowel-cancer-programme/about-bowel-cancer)

I urge you to re-visit this problem and to begin an immediate, strategic  roll-out throughout the country, so that screening can begin to take place.

It is simply unacceptable that 1,200 New Zealanders will perish this year; next year; and the year after, when an effective screening programme is available to save their lives.

If this government can spend $78.5 million on a Saudi farm; a Manhattan apartment; an aluminium smelter; and a flag referendum – then spending at least half that amount to save lives should not be beyond us.

2017 may be an election year – but we should not have to wait until then. Not when thousands of lives are at risk.

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One of Minister Coleman’s staff replied the following day;

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The Minister has asked Ministry of Health officials to advise him on the matters you have raised.  Please be aware that due to the large volume of correspondence we receive, a personal reply to your email may take some weeks.

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Time, evidently, is not of the essence here.

What is truly shameful is not that a National government Minister is prevaricating on this critical medical problem – but that the Minister in question is a qualified medical clinician.

He, more than any other politician, should know better.

Somewhere in this country, another person has just developed bowel cancer. And doesn’t know it.

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References

Ministry of Health: About bowel cancer

Ministry of Health: Bowel screening pilot

Comprehensive Care: Bowel Screening programme successes

Radio NZ:  Govt told to act now on bowel screening programme

Ministry of Health: Bowel Screening Pilot results – January 2012 to September 2014 – How many colonoscopies have been performed?

Ministry of Health: Bowel Screening Pilot results – Round 2 – January to December 2014 – Footnotes

Ministry of Health: DHB Location boundaries (map)

National Party: Consultation on next steps for bowel screening programme

Radio NZ: Govt told to act now on bowel screening programme

Radio NZ: Health fund loses $18 million

Fairfax media: NZ government shells out $11m on New York apartment for UN representative

TV3 News: Flag referendum to cost $26M

TVNZ News: Government accused of wasting $11.5 million on wealthy Saudi farmer

Fairfax media: Govt pays $30 million to Tiwai Pt

National Party: Hon Dr Jonathan Coleman

Previous related blogposts

Unhealthy Health Cuts

Priorities?

Terminal disease sufferer appeals to John Key

Health Minister circumvents law to fulfill 2008 election bribe?

Johnny’s Report Card – National Standards Assessment – Compassion

Children’s Health: not a high priority for Health Minister Tony Ryall

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HeraldCartoon3413

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This blogpost was first published on The Daily Blog on 22 July 2015.

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Jobs for the bro’s?

20 November 2011 1 comment

10 September 2011

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Is it me – or does this sound plain wrong

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Full Story

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Why was the position not advertised, as is common practice?

Is this an example of nepotism? (Silly question. Of course it is.)

And at a time when this government has thrown thousands of government workers out of their jobs, and onto the unemployment scrap-heap – how much is this “advisor” job costing the tax-payer?

As an indication, this case might give us an idea,

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Full Story

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And once again, the highly-paid “advisor” involves the English family.

Another case,

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Full Story

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So much for this government “cutting expenditure”. They are sacking ordinary workers – and rehiring “advisors” aid exorbitant amounts of tax-payers’ money?

What on Earth is going on here?

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+++ Update +++

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It appears that the ‘heat’ has gone on Tony Ryall in this matter.  He and his colleagures may have been hoping that Mervyn English’s appointment slipped in “under the radar” – but New Zealand is too small a country for that to happen.

Appointments of family and friends to jobs that are not publicly advertised is never a good look, and it is surprising that the government was silly enough to think they could get away with it. It reeks of corrupt practice.

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19 November 2011

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And yet more of the same…

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Full Story

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Katherine Rich has been appointed to the Health Promotion Agency Establishment Board, which replaces the Alcohol Advisory Council.

The move has outraged advocacy group Alcohol Action. Spokesperson Doug Sellman says Ms Rich has been one of the most vociferous defenders of the alcohol industry.

Professor Sellman says supermarkets normalise alcohol as an ordinary commodity and sell it by the tonne at ultra-cheap prices up to 24 hours a day.Ibid

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The Labour Party agrees the appointment of Katherine Rich is too much a conflict of interest.

Health spokesperson Grant Robertson told Radio New Zealand while he holds Ms Rich personally in high regard, he believes her role with the Food and Grocery Council does clash with being part of such an agency.

“I think the linkage with her role supporting and advocating for the supermarkets is unfortunate and doesn’t sit well with the health promotion role that the future agency will have.”

However, in a written statement on Saturday, Health Minister Tony Ryall says Ms Rich, a former National MP, was appointed for her experience, balance and integrity.” Ibid

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(L-R) National MPs Simon Powell, Katherine Rich, former National leader Don Brash, National MPs Nathan Guy and Gerry Brownlee applaud John Key as he delivers his speech as the New Zealand National Party launch their election campaign at Sky City on October 12, 2008 in Auckland, New Zealand.

Source

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Stacking government and quango roles with party hacks (even if they are talented party hacks) seems to be a time-honoured tradition that National is loathe to depart from.

However, the Radio NZ report does raise an important question regarding her appointment to  the Health Promotion Agency Establishment Board, which replaces the Alcohol Advisory Council.

ALAC was an organisation dedicated to raising awareness of New Zealand’s considerable alcohol related (some say fueled) problems.

2009 BERL report estimated that “$4.437 million of diverted resources and lost welfare” could be directly attributed to alcohol abuse. That $4.4 billion  is reflected in  ACC, hospital admissions, crime, family violence, lost productivity, etc, and places a firm dollar cost on the harm that alcohol abuse is causing NZ society. These are costs we all pay for through ACC levies and taxes spent on medical intervention; policing; and the justice system.

Whilst working for the Food and Grocery Council, Ms Rich was a firm advocate of liberal laws surrounding marketting and retailing of alcohol.,

The New Zealand Medical Association (NZMA) and Alcohol Advisory Council (Alac) strongly backed the recommendations.

Alac chief executive Gerard Vaughan said it set out a clear objective of reducing alcohol-related harm which stretched to structure and role changes for the district licensing agencies responsible for managing liquor licensing in their own communities.

Communities up and down the country were sick of the violence and vandalism that came with drinking and that proposed changes to licencing regimes would help address the problem, Mr Vaughan said.

Nearly 3000 submissions were received by the commission, many of which supported the tightening of laws around alcohol sales, purchasing and consumption.

But NZ Food and Grocery Council chief executive Katherine Rich said the report reflected “classic nanny state thinking.”

It failed to target those causing the problems and punished everyone, she said. The industry was already one of the most regulated, and more sensible ways to approach existing problems included better enforcement of current rules and better use of legal powers, along with industry-led initiatives.”   Source

New Zealand has a $4 billion-plus problem with alcohol abuse (BERL report) and Katherine Rich dismissed attempts to address this crisis as “classic nanny state thinking“.

Thank you, Ms Rich. It’s nice to know where you stand on social problems that affect us all.

It is worthwhile reflecting that since liquor laws were de-regulated in the mid 1980s (as part of the wave of Rogernomics “reforms”), that 25 years later things have gotten steadily worse. In those 25 years, the free market system has reigned practically unchallenged and unchanged.

Somehow I think “Nanny State” has little to do with it.

Nanny is still nursing a hang-over from the last 25 years.

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Related

A kronically inept government

Community Needs vs Business Demands

New Zealand 2011AD: Drunken Mayhem and a nice Family Day Out

Our ‘inalienable right’ to destroy communities through alcohol abuse

Govt’s consultants’ bill $375m and rising

 

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