Professor Diana Safarti at the Miramar Golf Course hui on February 20

The biggest inequities in cancer treatment in this country are between Maori and Pacific people and all others. The causes are complex, it’s unacceptable and it won’t sort itself out by itself, said Professor Diana Sarfati of the new Cancer Control Agency.She spoke to a group of cancer “consumers” (we hate that name) at a hui in Wellington on 20 February. She admitted that there is a gap between rich and poor in New Zealand, showing us the Listener cover with the banner “Survival of the Richest”. She insisted, however, that the poor outcomes for Maori and Pacific people need the most urgent analysis. The stats are terrible. (My words.)

Diana Sarfati is the chief executive of the agency set up in 1 December 2019 partly as a response to the Blair Vining petition for an end to post code health care in New Zealand. Her role is within the Ministry of Health but autonomous and almost on the same level as the Director General of Health.

Cancer is the leading cause of death in NZ and numbers will double in the next 20 years with our growing and aging population. We are struggling now and since the 1980s we have had the most rapid increase in health costs ever seen in the history of health care. Our cancer outcomes have improved but not as much as those of similar countries. We need a new structure that enables us to utilise our resources better.

An agency such as this should have national leadership, give sound policy advice to government and be accountable. She discounts criticism that the agency is weaker because it is in the Ministry of Health. Inside, they can have more influence, she said – outside they could just end up being an advocacy organisation. In her role she can talk to the PM for example. The agency is not constrained in any way by the Ministry.

Countries with agencies do better.

 

She said she stepped out of a comfortable university job into this “uncomfortable job” to make a difference and needs everyone working together.

Would a new government at the end of this year shut it down? She is adamant that it won’t, that her role is to support any government and that both government and opposition support having an agency.

There are already many cancer groups in operation, too many to mention here and I think she said that these will all work with or under the agency in future. The agency is so young, it “hasn’t really been born yet”. (The consumer group discussed future naming and branding of the agency.)

Set up takes time she said. She is developing a 100 Day Plan and hopes to have branding and a website established ASAP.

Below is what my notes tell me will be the divisions in the agency:

  • · Equity group
  • · Treatment quality and standardisation group
  • · Data monitoring and reporting group
  • · Person-centred care group
  • · Prioritisation, innovation and research group
  • · Screening programmes (?). I’m not sure if this is a separate group.

There will be a website where we can check how our DHB is doing.

There was discussion of DNAs. Did Not Arrive. Why don’t patients turn up? She made the interesting point that it is cheaper to provide transport than to cover the cost of late cancer care.

She mentioned the role of primary care and how cancer patients can get cut off from primary care and their GPs. I didn’t mention that the GP is not free for most of us!

They will work to improve the Pharmac model and offer better access to clinical trials.

There was a lot of emphasis on person-centred/whanau-centred care.

What about the less frequent cancers like head and neck? She said that they must start somewhere and will drill down on some of the more common cancers to find out where the weaknesses are in the NZ system.

I’ll summarise the work of the consumers at the hui later, but I can say that Diana Sarfati impressed me with her passion for improvement for us all and her clarity of thought. This is a live process and we “consumers” will have plenty of chances to give the agency feedback in the coming years. “Our concerns go direct to her.”