David Downs: Government's cancer action plan is good, bad and ugly

Prime Minister Jacinda Ardern, Health Minister David Clark and cancer epidemiologist Diana Sarfati announcing a new national cancer agency. Photo / Sylvie Whinray

COMMENT

This weekend, the Government released its Cancer Action Plan for the next 10 years. This much anticipated plan aims to pull together a consolidated approach for reducing New Zealand's shocking cancer statistics and have impact for real Kiwis.

There is a lot to like about the plan, and there is some that doesn't seem to resonate for me. I recently wrote up what I thought should be in the cancer plan, and the document released covers some – but not all – of that.

As someone with direct personal experience of cancer treatment, both in New Zealand and internationally, I thought I'd document what I see as the good, the bad and the ugly of the new cancer plan.

Firstly the good. The fact that there is a plan is clearly the first good thing – and that it is aimed to be action oriented. The plan itself has a good framework with four key outcomes sought (a consistent and modern cancer care system; equitable outcomes; fewer cancers; better survival). I am also really impressed that a new director has already been put in place, and that extra funds have been committed to Pharmac.

Blair Vining and his wife Melissa, pictured at a celebration of his life, campaigned for a national cancer agency. He says he can now put his feet up. Photo / Supplied

Within the plan, it's good to see a focus on prevention, and early detection – both things we know will have a great long-term impact. I also applaud the efforts to focus on the inequities in Māori and Pacific peoples' health outcomes, and to look at the regional variations in delivery and approach.

What's not so good – the bad – is that the plan is lacking measurable targets and has no specific timeframes or action owners. A plan without a timeframe and a target is a wish. In places, it reads more like the plan for the plan, rather that a measurable and concrete approach. I understand the agency will take a few months to establish and would encourage those responsible to prioritise setting targets for elements of the plan – what gets measured gets done.

I think the plan missed the opportunity to look at how the wider cancer support community can operate more effectively – it seems to me that we have a lot of cancer support organisations all working well to support patients and their whanau, but also struggling for scale and funding.

Similarly, in the research space, we have a number of organisations working independently and competing for funding, be that public or private. The national cancer plan and agency would have the opportunity to streamline these two systems to maximise the impact for New Zealand and for Kiwis.

And the ugly? There are a couple of potentially ugly things here. Firstly, I get worried that cancer care is becoming a political issue, where I think the incidence rate is so high that this needs a nonpartisan and joined up commitment. In the same way we don't debate actions related to the road toll, or our commitment to sensible savings for retirement, we should see the cancer care area as one where political differences are set aside and serious long-term action is committed to.

We also have to be careful that this doesn't become a bureaucratic exercise and loses its urgency in the machinery of the ministry. I would have preferred an independent body, but I can also understand some of the reasoning behind having this in the Ministry of Health. Now that this decision is made, however, we have to guard against it becoming just a series of feedback workshops and in-active plans and reports – already some of the wording in the document worries me in this regard. The plan must remain focused on individuals, measurable outcomes and urgency.

David Downs. File photo / Supplied

On balance, reading through the plan in detail, I come away with the thought that this is a decentstart, but perhaps a bit underwhelming. However, I know that it's the beginning of something, and if agencies, support groups and individuals give feedback and "lean in", then this could be the beginning of real change in the prevention and treatment of cancer in New Zealand.

I for one will be giving my feedback, and I hope that what will emerge from this will be a detailed, measurable, fully scoped and comprehensive plan, executed with the urgency our shocking cancer statistics demand.

• David Downs documented his own personal battle with terminal lymphoma in his book "A Mild Touch of the Cancer", and now works raising funds for cancer research, and helping other patients with their own battles