Where do Political Parties stand on cancer issues this election?

Parliament Shoot 851Political Party responses to four cancer-related questions from the Cancer Society of New Zealand

All parties are making ‘health’ an election promise, and the Cancer Society wanted to understand some of the details around these claims. So prior to the 2017 general election, the Cancer Society asked each party standing for government four questions about national cancer issues and opportunities.

Below are the responses the Cancer Society have received. They address:

  1. Bowel cancer screening
  2. Access to medicines
  3. National Travel Assistance scheme
  4. Smokefree 2025.

The Cancer Society is bipartisan, and will work with any party in government to create policies that help prevent, and minimise the impact of cancer. After the election, we look forward to working with them to create better cancer services in New Zealand.

  


 

 

Question one

Bowel Cancer Screening – a national rollout is currently underway, but there is limited clarity on time-frames, milestones and support for DHBs to implement bowel screening. There are no extra resources allocated for those who are diagnosed. What will your party do to develop the workforce and resources required for a full national roll out of the programme to all affected age groups?

 

National Party

The National Government has begun the roll out of the National Bowel Screening Programme. The programme funds DHBs for the delivery of the screening programme, including colonoscopies.

National has invested $78 million into the screening programme’s progressive roll-out to date, with a further $19 million invested into delivering more colonoscopies quicker. Additional funding for colonoscopy services (to reduce waiting times and ensure that the progress made on delivering colonoscopies is sustained) has been provided to DHBs since 2013/14. DHBs are also provided with project establishment funding to help with their set up phase of the National Bowel Screening Programme.

The numbers of outpatient diagnostic colonoscopies performed have increased each year from 29,030 performed in 2013 to almost 40,000 performed in 2016, an increase of 37%.

Information from the Waitemata DHB Bowel Screening Pilot and discussions with the sector confirm there is the capability and clinical workforce in New Zealand to deliver the additional colonoscopies required for a progressive roll-out of a national bowel screening programme for people aged 60 to 74 years. Initiatives are underway to further strengthen the endoscopy workforce, including increasing the number of trainees for specialities that are involved in delivering colonoscopy,

 

Labour Party

We think there needs to be more transparency around the Bowel Screening Programme. We have no idea how much it is actually going to cost district health boards to roll out the programme, let alone the additional treatment costs that DHBs will incur which they are not funded for. The ad hoc approach to rolling out the programme by the Government will only increase inequity of outcomes for cancer patients depending on where they live. Labour will establish a National Cancer Agency and this will be charged with streamlining cancer care in New Zealand including overseeing the Bowel Screening Programme. The Agency will be in charge of assessing any shortfalls in workforce capacity, treatment and equipment and will be able to allocate resource to scale up those district health boards that need additional support. This work programme will be laid out transparently in a National Cancer Plan with targets to reduce death rates.

 

New Zealand First Party

New Zealand First acknowledges that the National Bowel Cancer Screening rollout has been seriously underfunded and under resourced. New Zealand First have a number of policies to ensure that there is a full health workforce and resources to adequately support a full national roll out of the programme, we would;

 

Green Party

A national bowel cancer screening program is an essential element for preventative health. The Green Party supports increasing funding to our health system overall. Our health system has been run down by the underfunding of billions of dollars by the National Government.

It is increasingly clear that the bowel screening program was implemented without accurate planning for the workforce implications. There is large unmet need in the health system already, and that is the because of a lack of specialists in areas like cancer screening. The Greens in government will be proactive about fixing those gaps via funding and robust support for organisations like Workforce NZ. We need a government that listens to the sector especially when it says there are specialist shortages. National have dropped the ball. The Greens will fix it.

 

ACT Party

ACT understands the importance of the Bowel Cancer Screening programme and is open to additional funding.  ACT is also a pro-immigration party and recognizes the role immigrant healthcare workers play in the New Zealand Health sector.

 

Māori Party

The Māori Party supports the Bowel Cancer Screening programme and the national rollout currently underway. We would however review the rollout to ensure that resources are allocated appropriately to fully support workforce requirements.

As part of their response to the four questions, the Maori Party noted they would also:

Establish a Māori/Pasifika Health Commissioning Unit to identify health needs, identify evidence based interventions and approaches, and then prioritise funding to any organisation that can deliver the best contribution to outcomes. This Unit will measure, monitor and report on the funding and the outcomes

Establish a new Maori/Pacific Social Investment Fund managed by the Māori Pasifika Health Commissioning Unit

 

Question two

Access to medicines – Our access to cancer medicines is now falling behind other countries including Australia, the UK and Canada. Last year we saw a funding injection to increase access to melanoma medicines, but the fundamental structural issues remain. It would be great to see clearer processes and more engagement from PHARMAC with our community, and a wider view beyond just the cost of drugs. What is your party’s position on access to cancer treatments, and what improvements would you make if you were in the next government?

 

National Party

Pharmac recently released a comparative study of cancer drugs between Australia and New Zealand. The study shows that not all cancer medicines deliver benefits that can be considered clinically meaningful, or an improvement on what we already have. Out of the 35 funded in Australia and not funded in New Zealand, only three provide real, meaningful benefit. Pharmac has already funded one of these, pertuzumab for breast cancer, and is considering funding applications for the two others.

 

Since April 2016 PHARMAC has funded six new cancer medicines and widened treatment access for four cancer indications.  The total gross expenditure in New Zealand on cancer drugs in 2016/17 was $197 million (16.6 percent of the total gross CPB $1.26 billion) and the total prescription items for cancer was 250,000 (0.6 percent of the total CPB 44.5 million funded items).

National has increased Pharmac’s Budget by $220 million since 2008. Pharmac’s Budget for 2017/18 is a record $870 million.

 

Labour Party

We believe there should be greater access to cancer treatments, including the ones PHARMAC says are a high priority but don’t fund due to a lack of funding. We need to increase funding to PHARMAC and look at ways we can make its recommendations more transparent in terms of factoring in the wider benefits of a treatment e.g. productivity. But it’s not just treatment, it’s also technology that New Zealanders are missing out on. Under Labour, a National Cancer Agency will have the ability to prioritise investment in the most effective technology such as the latest radiation treatments. This is part of Labour’s plan for health which includes an additional $8 billion over the next four years as laid out in our fiscal plan.

 

New Zealand First Party

New Zealand First would conduct a review of the efficiency and efficacy of Pharmac's operations and of the adequacy of pharmaceutical funding. New Zealand First would review the processes and funding for the public purchase of essential new technology, such as new medicines, to ensure that the New Zealand public have access to the best possible health services.

Further to this New Zealand First would enable Pharmac to be more responsive to funding treatment for life-limiting and rare conditions affecting no more than 1:10000 people.

 

Green Party

A national bowel cancer screening program is an essential element for preventative health. The Green Party supports increasing funding to our health system overall. Our health system has been run down by the underfunding of billions of dollars by the National Government.

It is increasingly clear that the bowel screening program was implemented without accurate planning for the workforce implications. There is large unmet need in the health system already, and that is the because of a lack of specialists in areas like cancer screening. The Greens in government will be proactive about fixing those gaps via funding and robust support for organisations like Workforce NZ. We need a government that listens to the sector especially when it says there are specialist shortages. National have dropped the ball. The Greens will fix it.

 

ACT Party

ACT supports the independent Pharmac model where experts rather than politicians make evidenced-based decisions around the funding of medicines. However, ACT is open to a discussion about further increasing Pharmac’s budget.

 

Māori Party

Direct Pharmac to explicitly seek to address the disparity in health outcomes for Maori and Pasifika when funding decisions are made

 

Question 3

National Travel Assistance scheme – the Ministry of Health currently have an outdated scheme that may not be fit for purpose. This is increasingly a barrier to equitable treatment access and makes it tougher for vulnerable people to get to their treatment. What is your party’s position on the National Travel Assistance scheme, and if elected, when do you propose to review and fix it?

 

National Party

A National Government will review the National Travel Assistance Policy. Timing of this review is yet to be decided, but it is likely to begin later in 2017.

It will review that those with the highest needs are consistently accessing the scheme, administration (including access, availability of information and ease of use) of the policy, payment levels, and the guidance available to support decision making. While the scheme is well used, it is appropriate to review it to ensure that it is achieving good outcomes for the people who need it.

The total amount paid under the National Travel Assistance Policy for the year ending June 30, 2016 was $32,925,749 and the total number of registrations by people using the service was 23,254.

 

Labour Party

Labour will review the National Travel Assistance scheme with a view to increase subsidies and make the criteria to access subsidies easier. One of the options will be to look at bringing the scheme back into the Ministry of Health to make sure that it is consistently being applied. We haven’t seen a substantial increase in subsidies since 2009. Mileage and accommodation subsidies do not cover the actual costs of travel and the costs to stay at a motel/hotel. Rural GP referrals that have been accepted by a DHB with specialist consultation should be considered eligible for the subsidy. As well as this, there should be a needs assessment for those who don’t meet the criteria for a subsidy and allow some flexibility in the scheme because not every patient’s situation neatly fits into the criteria.

 

New Zealand First Party

New Zealand First would increase rural health services and ensure good access to basic healthcare equitably throughout the country. We need to provide all New Zealanders with certainty about their healthcare and ensure timely access to quality services. 

 

Green Party

We don’t think the National Travel Assistance scheme is fit for purpose. Criteria are too strict and funding is definitely too short to meet the needs of those without easy access to a main centre. We would urgently review this and other funding choices.

 

ACT Party

ACT is open to reviewing the National Travel Assistance scheme.

 

Māori Party

Review the Health Act, ensuring that schemes such as the National Travel Assistance scheme is urgently reviewed and funding allocated appropriately to what is fit for purpose.

 

Question four

Smokefree 2025 – Smoking is the single most preventable cause of cancer and it disproportionately affects Māori and Pacific peoples as well as the poorest members of our communities. We have a national target of NZ being Smokefree by 2025 but lack a strategy and initiatives to achieve this. What is your party’s view on achieving Smokefree 2025 and what affordable, accessible and appealing initiatives do you propose to help us achieve it?

 

National Party

National is committed to making New Zealand smokefree by 2025 through a wide range of evidence-based interventions, including implementing standardised packaging, legalising e-cigarettes and broadening smokefree policies at the local and regional level.

New Zealand’s Tobacco Control Programme is comprehensive, evidence-based, and aligns with international frameworks. The programme has achieved good progress, including:

We’re starting to see the effectiveness of blanket policies diminish, which is why the Government has realigned stop smoking services to target the most difficult to reach cohorts, particularly Maori and pregnant women.

The results show targeted programmes work — the number of people quitting after accessing these services has grown from 34 per cent in 2014/15 to 44 per cent for the year to date. Counties Manukau has one of the most successful programmes, with quit rates of 57 and 55 per cent for its Maori and pregnant clients respectively.

 

Labour Party

We want to bring back the action plan for Smokefree 2025 after it was ditched by National. We need a coherent pathway and an action plan if we truly want to aim for being smokefree in Aotearoa. We also want to review the Government’s recent decision to establish pre-market approval for smokeless tobacco as we have serious concerns about allowing chewing tobacco in New Zealand. We will continue using excise taxes to discourage consumption and re-examine the new Stop Smoking Services contracts to ensure there is face to face delivery of services by providers for New Zealanders who need this type of intervention

 

New Zealand First Party

New Zealand First believes Smokefree by 2025 is an unrealistic target. The government is pocketing millions of dollars in excise tax money they get out of tobacco but very little of the money goes towards education for a Smokefree New Zealand.

We support every effort to make the risks of smoking known.

 

Green Party

The Greens are strongly committed to the Smokefree Aotearoa goal. However, the government has a history of embracing targets without backing them with the measures to achieve the goal. Efforts so far have put us behind the goal of smoking prevalence at below five per cent. Māori and Pasifika are miles off getting there.

We will:

 

ACT Party

ACT is against further increases in tobacco taxes as they have been ineffective at reducing smoking rates and are highly regressive taxes. Increased cigarette taxes have taken $28 a week from the poorest New Zealanders.  That is more than the Government's $25 increase in benefits, and almost as much as the increase in the minimum wage for the past five years. Tax increases on tobacco have also made cigarettes a target for thieves, with dairy and service station robberies at epidemic proportions. ACT supported the recent legalisation of nicotine e-cigarettes, which together with the current government funding of nicotine patches and the drug Champix, and other smoking cessation policies will see smoking rates reduce.

 

Māori Party