Child Cancer

I can imagine few things worse than coping with a child with cancer, except losing a child through cancer, of course. It is easy for me to empathise with Michael Laws as he expresses his frustration with the paediatric oncology system in this country. As a doctor, I have some appreciation for what he and his daughter are going through.

Unfortunately, the state of the paediatric oncology system in New Zealand is inevitable, and has little to do with government underfunding and DHB ineptitude. It is because (happily) cancer in childhood is rare. We are a small population in a fairly large geographical area. inevitably, very specialised services like these tend to gravitate towards a very few centers. This is not due to cost-savings in any meaningful way, this is due to the sheer pressure of numbers, or, rather, the lack of numbers.

Specialists need to see a certain number of patients a year in order to keep their skills honed. Wellington have just lost their paediatric oncologists. Though they were careful not to state their reasons for leaving, the primary reason would be lack of work. At the time there were only eight paediatric oncology patients being treated by the unit. By concentrating oncology services to two venues, the number of patients becomes viable.

Some specialist disciplines get over the lack of numbers by moving from hospital to hospital, servicing a much wider area but only one day a week or a fortnight. Unfortunately, this model does not work for paediatric oncology, where the patient needs daily attention, sometimes for long periods. There is no real alternative to centralisation of services.

So I understand where Michael Laws is coming from, but the reality is that Wellington should be putting its money and efforts elsewhere, as a paediatric oncology service in Wellington is unlikely to be viable anytime soon.

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