Health system in crisis: What needs to be fixed to improve patient care

I'm Chelsea Daniels and this is the Front Page, a daily podcast presented by the New Zealand Herald. The parties of the coalition government were staunch critics of the state of our healthcare system while on the opposite side of

Patient Voice alter Or has had a focus now on improving medicine access for New Zealand patients since its inception back.

In twenty nineteen.

We came about as a result of a number of petitions being presented to Parliament advocating for certain medicines to be funded, and at the time we thought, well, rather than just focusing on say those in cancer medicines or those with a red disorder or chronic illness, why don't we set up PVA so we can all fight under the one umbrella. And that's what PVA is and what we do.

The Coalition government is still a bit fresh at six months in the job. Hey, but how would you describe their efforts in the health sector so far?

I think it's probably fairly slow going.

I think people would probably freely admit that the health sector by and large is in a crisis, whether they be are waiting times at ED or the struggles in order to see a GP, or if you're talking about medicine access. I think there are some urgent actions needed, especially in.

Terms of health workforce.

I think there's probably more we could do on that front, and certainly in the field that we've been advocating for around medicine access.

Most recently, Health Minister Shane Ready announced thirty million dollars for faster access to radiology services. He said, at the moment, some New Zealanders are having to wait weeks or months to see a hospital specialist, who then refer them to radiologies.

In some places, New Zealanders are waiting longer, making additional payments for scans, for traveling long distances to radiology appointments at their own cost. I'm pleased to announce that we are investing thirty million dollars through Health New Zealand to level up access to X rays, CT scans and diagnostic ultrasound are cost New Zealand and to ensure that primary health providers can refer patients directly we're clinically approached rather than waiting for a specialist assessment.

Is cutting out that middleman and allowing GPS to refer patients the way to go? Do you think?

Yeah?

I think it is a better system, and I think it will see patients not having to wait longer, which can only be a good thing. I think though, you're also going to have some problems in terms of the treating of the patients. It's one to get a diagnosis, and sure, the more we can speed that up, the better. But then there's another problem, and that is actually having the patient in front of a specialist, whether that be under the knife or doing whatever to fix the problem.

At the same time, near research out of Otaga Uni actually shows more kiwis are unable to access specialist care in a timely way. We know this, but it leaves GPS to manage complex cases without those extra resources. I guess, is allowing them to refer to radiology only adding to their workload.

Well, it will mean and again I think we run into that same problem. We just don't have the health workforce in order to deal with the tsunami of patients that are currently backed up within the system. And so you know, it's one to get a faster diagnosis and that is a good outcome, But the second part of the equation is having enough specialists on the ground who can deal with a number of patients who require the attention.

That they do recently.

As well, the funding needed to supply thirteen new cancer drugs that National promise before the election won't actually become available for another year at least.

Is this disappointing to you without a doubt, because it was very clear in the election and as a part of their election manifesto that the intention was to fund those drugs from one July this year, not to have to wait another year and I sincerely hope that that is not the case moving forward.

I would hope that you know the amount of protest that the government has received on the back of their announcement not to fund thirteen drugs or not to announce them within the budget. You know, they work at pace and put patients' minds at ease by saying this is the time frame and this is the process by which we're going to fund these standing medicines moving forward.

Osie murdered.

It was the first medication on their list that they promised to fund if they were elected into government, and that's the medication that I desperately need. To promise something like that for so many desperate and vulnerable people, and to just not keep their promise as shameful.

Why is it so difficult to get cancer drugs funded in Altiadora.

I think the primary problem is that politicians can't be seen to be instructing farmatic as to what drugs they can and cannot fund.

They're being said.

This has certainly happened in the past with both sides of the political spectrum, whether you be talking about a labor leir government or a national led government. So Beckon twenty seventeen, for example, Labor campaigned on prep being funded.

And if we go back even.

Further in time, we can look at the her septum example under the John Key guvernment.

So both sides are guilty of it. But what I would say is that this is.

Just simply an outcome, if you like, of a broken system, of the mere fact that far Mek has been underfunded now for some time, and so politicians are put in the position of having to pick winners and losers.

And it seems like it takes a while to go through that approval process, so much so that when the drug is funded, we generally hear about another better drug being funded in say America or Europe or search.

Right, Yeah, that's right.

Look, on average, it takes somewhere in the vicinity of seven years for a drug to be funded in New Zealand. I mean, that's just ridiculously long. We're still the only country in the world that has a waiting list of medicines that farmic would like to fund. So these are drugs that have been through farmas process and systems. I've said, yes, we believe they're efficacious, Yes we would like to fund them if the funding permits us to do so.

What's also missing from that equation, though, that people.

Don't realize is that whilst these drugs are around the ninety marks, it is ninety or so drugs that are on this waiting list that they would like to fund. For over one hundred indications, there's another two hundred and eighty drugs grinding their way through farmac system right now.

So you know that gives you an idea of the size of the whole that New Zealand patients are in.

There is some complexity to both how those medicines are approved, how they are procured, and the order in which that happens. But I've spoken to a former health minister and they say National should never have promised this in the first place, because essentially, when you name thirteen drugs, it shows your hand and allows drug companies to milk it.

And Malcolm, I hope you don't mind me bringing this up, but I guess, in a cruel twist of fate, you yourself were actually diagnosed with cancer a couple of years ago. Hey, first off, how are you going? And secondly, how was it going from an advocate to patient? And what did you learn from having that first hand experience?

I guess what I would say is that my journey in this battle started with my late wife's diagnosis back in twenty eighteen, So Wiki, my wife was diagnosed with advanced breast cancer and we were put in the position of having to find a lot of money for a drug that we ended up campaigned for and it was funded, that drug.

Being Ibrant, And then shortly.

After we lost Wiki, I myself was diagnosed completely out of the blue, with no symptoms whatsoever, of an aggressive form of prostate cancer. What that meant for me was that we had to find about fifty thousand dollars so I could be seen privately with urgency in order to

I guess we hear cancer and we just immediately think death. So but there are drugs out there, aren't there, Malcolm. We're constantly hearing stories about New Zealanders resorting to crowdfunding and seeking health treatment overseas and moving to Australia. I mean you would have heard them all.

Yeah, I have, and they don't get any easier to hear.

And one thing I would say is that the number of stories that I hear about is certainly on the increase. They're not going away anytime soon. And so I have met patients. For example, there was a lady he diagnosed at the same time as my late wife. She managed to get the drug that we needed, ibrance as their first line treatment, So that meant that that was the first drug she was put on. That's the only drug she's received to date, and she's still.

Living really well up there and flung it a.

I met a person who had self funded a prostate tenser drug. He lives in Tolonger. He's been on that drug now for over a decade. So what we are seeing is a transition for some people from stage four being, if you like, a death center, towards living with a disease almost under the banner of being chronic. And so there is a shift, and that's something that the public really should understand and appreciate.

And when you and your dear wife went through the system, what was it like for you, guys, I guess seeing it from the inside, or was it just a completely different world because you did go through that private route?

So wiki didn't go through private, she went through public. And I've got to say that the world of Kncer, of your life was extremely foreign to us. We had probably been one of the more fortunate faro in New Zealand where Kncer I had lost, for example, a cousin quite some years ago, and I'd lost the odd uncle and what have you. But you know, it wasn't something that's fresh in the memory. We had no concept of cancer. So I can distinctly recall when WICKI was given the

Special listners to explain it to us, because of course you've got the shock.

Of the diagnosis and then having to talk through what that meant.

What I would say is that with.

My own experience having gone through private, the contrast is night and day, especially in terms of the urgency under which you are treated. So you know, time was a ticking for me. If I had to left it there a little bit longer, chances that it would have metestasized and you'd now be talking to me as a terminally ill cancer patient. Because I was able to go private, I was able to go out to Grace Hospital and

Ever, how do we make that kind of treatment available to everyone?

Though?

We need to increase funding, that's the bottom line. You know.

We pride ourselves and being part of the developed world, but when it comes to healthcare, and especially when it comes to cancer care, we are worlds behind.

And really grapes me when I hear stories of some of our best and.

Brightest oncologists saying, you know, if I'm a senior oncologist practicing here in New Zealand and if I'm a starting oncologist in Australia, a starting oncologist is on the same wage as a very experienced oncologist here at home.

And so there are so many gaps in the system. And also the fact that oncologists overseas have access to modern medicines, whereas here we're playing catch up. We're probably a decade behind where we should be.

And so because doctors are unable to prescribe those medicines, they're going offshore. So we also have a brain drain in that space. And I think these are some of the obstacles that we have to overcome. We have to look at this seriously, we have to get a plan in place, and we have to put the funding where it matters.

It's an expensive drug, but it does have far better outcome, both in survival level and in the quality of life.

That you get.

I believe that in Australia a pension that only needs to pay six dollars fifty a month for this drug. I'm really disappointed.

What would you like Shane Ready and the other ministers to know about the pressures on the health system at the moment and what would you like to see them change.

Well, I think they have to have an appreciation of the relief that medicines or better access to medicines can bring on the health system. There are numerous studies out there that will show you if you fund a medicine, that will relief pressure elsewhere in the health system. So a really good example, it springs to mind, is the funding of tri cafta those websisted fibrosis. Now, if that hadn't have been funded, those patients would have required more

And given how many issues there are across the health system, and of course these thirteen cancer drugs that we're talking about as well. When Budget twenty twenty four announced eight billion dollars for health over the next four years, but then fourteen billion in tax cuts, did that annoy you at all?

Yeah. Look, I'll be honest with you.

I don't know how many times I've been approached in the street where as they've said, we're okay paying our taxes so long we agree with where our taxes are being spent. So you know, I'd much rather give you back my tax break if I know that in my time of need, I'm.

Going to be catered for by the health system.

And some of them did actually touch on the education system as well. I guess from their point of view, they see that as the essentials that government should be providing, and so many a person's come out and said, Hey, I don't need the extra twenty bucks or whatever it is in terms of tax breaks. What I need to know is that that money is going to go towards medicines or towards a health system, so that we have a fully functioning health system and so that in my time of need, I know I.

Can access the medicine that I will need.

Yeah, and getting a tax cut won't mean much to you if you then have to go and give a little when you get sick, K, that means nothing.

I mean you're looking at the thousands and thousands of dollars we're in other OECD countries.

You know they're able to access it VERA prescriptions. It's insane.

Thanks for joining us, Malcolm. That's it for this episode of the Front Page. You can read more about today's stories and extensive news coverage at enzed Herald dot co dot z. The Front Page is produced by Ethan Siles with sound engineer Patty Fox. I'm Chelsea Daniels. Subscribe to the front page on iHeartRadio or wherever you get your podcasts, and tune in tomorrow for another look behind the headlines.