Take cancer role off Govt says specialist

By FRANCESCA MOLD

A new agency with statutory responsibility for controlling cancer rates in New Zealand must be set up independent of Government health funders and policy makers, says a leading public health medicine specialist.

Dr Brian Cox, an expert epidemiologist, yesterday told the Gisborne ministerial inquiry into cervical cancer that New Zealand had the world's sixth-highest cancer mortality rate for women and 33rd-highest for men.

To combat these rates, which are expected to climb over the next few decades, Dr Cox said it was vital that a Cancer Control Agency was set up with its own policies and budget, separate from the Ministry of Health.

Dr Cox, director of the Hugh Adam cancer epidemiology unit at Otago University's Medical School, told the inquiry that the agency could be made responsible for the national cervical and breast screening programmes, their databases and monitoring and evaluation.

It could also house the Cancer Registry, coordinate the activities of agencies and develop guidelines for improving primary prevention, treatment, rehabilitation and palliative care.

Dr Cox's call for a national agency follows a unanimous recommendation from 110 participants in a workshop last year that a taskforce be set up to develop a national cancer-control strategy within two years.

Since the workshop, several agencies have come forward with funding offers, including the Cancer Society, the Child Cancer Foundation and the Health Funding Authority, which promised $50,000 last year.

However, Dr Cox said yesterday that the Government was now looking at incorporating a national cancer strategy, "driven" by the ministry in its New Zealand Health Strategy, but this was contrary to the recommendations of the workshop.

Dr Cox's recommendation yesterday received strong support from the Cancer Society, which said there must be a national agency, adequately resourced in funding and staffing.

The society's senior health promotion policy adviser, Betsy Marshall, said that such an agency, and the programme for which it was responsible, had to be free of political instability to function effectively.

"From now on there must be no ambivalence or compromise of its integrity."

In its evidence, the Cancer Society has been highly critical of health officials and politicians who, they say, have continually ignored recommendations from experts proposing improvements to the programme.

The society said that in the case of Gisborne, Cancer Society officers had reported concerns about misreporting of smears two years before any action was taken.

Ms Marshall said all obstacles to appropriate monitoring and evaluation of the screening programme must be overcome, which might require changes to legislation.

Nothing less than that would achieve the full potential of screening while ameliorating potential risks, "risks that we in New Zealand have carried at the potential cost of human lives."

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