Will there be enough trained staff to operate the new radiotherapy machines?

The AM Show 05/08/2019

Medical professionals are welcoming the Government's investment in new radiotherapy machines, but warn they'll be useless without investment in staff that can use them.

Health Minister David Clark on Sunday said 12 new linear accelerators would be purchased over the next three years, with a focus on increasing access in the regions.

"People who have to travel long distances will often forego that therapy, because it's just too long to be away from their families," Cancer Society medical director Chris Jackson told The AM Show on Monday.

"If you have to be away from your work or family for four, five or six weeks, you can see why some people wouldn't be able to survive that long without an income, so therefore they would forego that treatment - that would mean their lives would be shorter, or they would have more symptoms from their cancer as a result of not being able to get that treatment, and that's just not good enough."

That would mean their lives would be shorter.

Dr Jackson said it's the first public sector investment in radiotherapy capacity in New Zealand in the last 30 years - existing machines are replaced every decade, but the only increase in capacity over the last three decades has been in the private sector.

"This is one of the reasons why the gap between New Zealand and our comparative countries is getting bigger and bigger. 

"Internationally, radiotherapy is used in one in two people with cancer, in New Zealand we're hitting about one in three, so we're clearly below the benchmark for using radiotherapy. We also know the further you live from a major centre, the less likely you are to get access to radiotherapy."

Dr Clark said the new machines will treat patients more quickly than the old, and with fewer side-effects. But specialised staff are needed to operate them, Royal College of Radiologists spokesperson Dr Carol Johnson told Newshub.

It's very much a niche job.

Dr Johnson says they already have a staff shortage, particularly in the regions.

"It won't be as much the doctors as the staff to actually operate the machine and to look after the quality of the machine - so that's the physicists and the radiation therapists... We believe that we actually will need a further step of increasing investment to meet the increased capacity."

Dr Clark declined to give more details on the Government's cancer action plan, which it has been working on since earlier this year. National released its plans for a dedicated cancer agency in July.

"We're working to get this right," he told The AM Show. "I have spoken to cancer sufferers who have told me they don't want us to rush this - they want us to get this right. It is important to absolutely get this right, and we are working as quickly as we can."

An announcement is expected later in August. In the meantime, patients will have to make do with what's currently on offer - the new machines will take three years to get online. Dr Clark said the delay was unavoidable.

"I'm not a technical expert... they require bunkers, they require decommissioning of old machines."

There is quite a significant logistical [challenge]. That is what it takes.

Dr Jackson said it was good to see the Government start to take control of the nation's cancer treatment.

"We do need to make sure we have a centrally planned approach. If you do things from the top, you can work out where the stuff should go... if you leave it to each individual DHB, they will just do business as usual. We also know that the DHBs, when left to their own devices, these devices cost an awful lot of money so they delay implementing them in order to trim a little bit off their budget deficits."

A report published at the weekend in medical journal The Lancet also blamed the decentralised health system for compounding inequalities, including neglecting to maintain and upgrade infrastructure. 

Dr Jackson says with cancer now our number-one killer and an ageing population, demand for radiotherapy will only increase over the next decade.

The AM Show / Newshub reporters Dan Satherley & Ella Prendegast