Speaker 1: I'm Chelsea Daniels and this is the Front Page, a
Speaker 1: daily podcast presented by the New Zealand Herald. The parties
Speaker 1: of the coalition government were staunch critics of the state
Speaker 1: of our healthcare system while on the opposite side of
Speaker 1: the aisle. Now that they're in charge, though, the heat
Speaker 1: is being put on them to sort out everything from
Speaker 1: months long waiting times to see specialists to gaps in
Speaker 1: the mental health system and most recently, Budget twenty twenty
Speaker 1: four did not deliver the much promised funding of thirteen
Speaker 1: new cancer drugs that are shocked advocates. Today on the
Speaker 1: Front Page, Patient Voice Altied, our chairperson Malcolm mulholland joins
Speaker 1: us to discuss the issues facing patients across the country
Speaker 1: and what the government needs to do to improve our healthcare. Malcolm,
Speaker 1: could you start by telling us what Patient Voice alter
Speaker 1: It does.
Speaker 2: Patient Voice alter Or has had a focus now on
Speaker 2: improving medicine access for New Zealand patients since its inception back.
Speaker 3: In twenty nineteen.
Speaker 2: We came about as a result of a number of
Speaker 2: petitions being presented to Parliament advocating for certain medicines to
Speaker 2: be funded, and at the time we thought, well, rather
Speaker 2: than just focusing on say those in cancer medicines or
Speaker 2: those with a red disorder or chronic illness, why don't
Speaker 2: we set up PVA so we can all fight under
Speaker 2: the one umbrella. And that's what PVA is and what
Speaker 2: we do.
Speaker 1: The Coalition government is still a bit fresh at six
Speaker 1: months in the job. Hey, but how would you describe
Speaker 1: their efforts in the health sector so far?
Speaker 3: I think it's probably fairly slow going.
Speaker 2: I think people would probably freely admit that the health
Speaker 2: sector by and large is in a crisis, whether they
Speaker 2: be are waiting times at ED or the struggles in
Speaker 2: order to see a GP, or if you're talking about
Speaker 2: medicine access. I think there are some urgent actions needed,
Speaker 2: especially in.
Speaker 3: Terms of health workforce.
Speaker 2: I think there's probably more we could do on that front,
Speaker 2: and certainly in the field that we've been advocating for
Speaker 2: around medicine access.
Speaker 1: Most recently, Health Minister Shane Ready announced thirty million dollars
Speaker 1: for faster access to radiology services. He said, at the moment,
Speaker 1: some New Zealanders are having to wait weeks or months
Speaker 1: to see a hospital specialist, who then refer them to radiologies.
Speaker 4: In some places, New Zealanders are waiting longer, making additional
Speaker 4: payments for scans, for traveling long distances to radiology appointments
Speaker 4: at their own cost. I'm pleased to announce that we
Speaker 4: are investing thirty million dollars through Health New Zealand to
Speaker 4: level up access to X rays, CT scans and diagnostic
Speaker 4: ultrasound are cost New Zealand and to ensure that primary
Speaker 4: health providers can refer patients directly we're clinically approached rather
Speaker 4: than waiting for a specialist assessment.
Speaker 1: Is cutting out that middleman and allowing GPS to refer
Speaker 1: patients the way to go? Do you think?
Speaker 5: Yeah?
Speaker 2: I think it is a better system, and I think
Speaker 2: it will see patients not having to wait longer, which
Speaker 2: can only be a good thing. I think though, you're
Speaker 2: also going to have some problems in terms of the
Speaker 2: treating of the patients. It's one to get a diagnosis,
Speaker 2: and sure, the more we can speed that up, the better.
Speaker 2: But then there's another problem, and that is actually having
Speaker 2: the patient in front of a specialist, whether that be
Speaker 2: under the knife or doing whatever to fix the problem.
Speaker 2: And I think that there's more that needs to be
Speaker 2: addressed again in terms of workforce development.
Speaker 1: At the same time, near research out of Otaga Uni
Speaker 1: actually shows more kiwis are unable to access specialist care
Speaker 1: in a timely way. We know this, but it leaves
Speaker 1: GPS to manage complex cases without those extra resources. I guess,
Speaker 1: is allowing them to refer to radiology only adding to
Speaker 1: their workload.
Speaker 2: Well, it will mean and again I think we run
Speaker 2: into that same problem. We just don't have the health
Speaker 2: workforce in order to deal with the tsunami of patients
Speaker 2: that are currently backed up within the system. And so
Speaker 2: you know, it's one to get a faster diagnosis and
Speaker 2: that is a good outcome, But the second part of
Speaker 2: the equation is having enough specialists on the ground who
Speaker 2: can deal with a number of patients who require the attention.
Speaker 3: That they do recently.
Speaker 1: As well, the funding needed to supply thirteen new cancer
Speaker 1: drugs that National promise before the election won't actually become
Speaker 1: available for another year at least.
Speaker 5: Is this disappointing to you without a doubt, because it
Speaker 5: was very clear in the election and as a part
Speaker 5: of their election manifesto that the intention was to fund
Speaker 5: those drugs from one July this year, not to have
Speaker 5: to wait another year and I sincerely hope that that
Speaker 5: is not the case moving forward.
Speaker 2: I would hope that you know the amount of protest
Speaker 2: that the government has received on the back of their
Speaker 2: announcement not to fund thirteen drugs or not to announce
Speaker 2: them within the budget. You know, they work at pace
Speaker 2: and put patients' minds at ease by saying this is
Speaker 2: the time frame and this is the process by which
Speaker 2: we're going to fund these standing medicines moving forward.
Speaker 5: Osie murdered.
Speaker 6: It was the first medication on their list that they
Speaker 6: promised to fund if they were elected into government, and
Speaker 6: that's the medication that I desperately need. To promise something
Speaker 6: like that for so many desperate and vulnerable people, and
Speaker 6: to just not keep their promise as shameful.
Speaker 1: Why is it so difficult to get cancer drugs funded
Speaker 1: in Altiadora.
Speaker 2: I think the primary problem is that politicians can't be
Speaker 2: seen to be instructing farmatic as to what drugs they
Speaker 2: can and cannot fund.
Speaker 3: They're being said.
Speaker 2: This has certainly happened in the past with both sides
Speaker 2: of the political spectrum, whether you be talking about a
Speaker 2: labor leir government or a national led government. So Beckon
Speaker 2: twenty seventeen, for example, Labor campaigned on prep being funded.
Speaker 2: What happened, They got elected, the drug got funded. And
Speaker 2: certainly you can see a pattern of behavior under the
Speaker 2: previous government whereby there were high profile protests happening for
Speaker 2: certain drugs to be funded, and then within a relatively
Speaker 2: short space of time that drug would come to be funded.
Speaker 3: And if we go back even.
Speaker 2: Further in time, we can look at the her septum
Speaker 2: example under the John Key guvernment.
Speaker 3: So both sides are guilty of it. But what I
Speaker 3: would say is that this is.
Speaker 2: Just simply an outcome, if you like, of a broken system,
Speaker 2: of the mere fact that far Mek has been underfunded
Speaker 2: now for some time, and so politicians are put in
Speaker 2: the position of having to pick winners and losers.
Speaker 1: And it seems like it takes a while to go
Speaker 1: through that approval process, so much so that when the
Speaker 1: drug is funded, we generally hear about another better drug
Speaker 1: being funded in say America or Europe or search.
Speaker 3: Right, Yeah, that's right.
Speaker 2: Look, on average, it takes somewhere in the vicinity of
Speaker 2: seven years for a drug to be funded in New Zealand.
Speaker 2: I mean, that's just ridiculously long. We're still the only
Speaker 2: country in the world that has a waiting list of
Speaker 2: medicines that farmic would like to fund. So these are
Speaker 2: drugs that have been through farmas process and systems. I've said, yes,
Speaker 2: we believe they're efficacious, Yes we would like to fund
Speaker 2: them if the funding permits us to do so.
Speaker 3: What's also missing from that equation, though, that people.
Speaker 2: Don't realize is that whilst these drugs are around the
Speaker 2: ninety marks, it is ninety or so drugs that are
Speaker 2: on this waiting list that they would like to fund.
Speaker 2: For over one hundred indications, there's another two hundred and
Speaker 2: eighty drugs grinding their way through farmac system right now.
Speaker 3: So you know that gives you an idea of the
Speaker 3: size of the whole that New Zealand patients are in.
Speaker 7: There is some complexity to both how those medicines are approved,
Speaker 7: how they are procured, and the order in which that happens.
Speaker 7: But I've spoken to a former health minister and they
Speaker 7: say National should never have promised this in the first place,
Speaker 7: because essentially, when you name thirteen drugs, it shows your
Speaker 7: hand and allows drug companies to milk it.
Speaker 1: And Malcolm, I hope you don't mind me bringing this up,
Speaker 1: but I guess, in a cruel twist of fate, you
Speaker 1: yourself were actually diagnosed with cancer a couple of years ago. Hey,
Speaker 1: first off, how are you going? And secondly, how was
Speaker 1: it going from an advocate to patient? And what did
Speaker 1: you learn from having that first hand experience?
Speaker 2: I guess what I would say is that my journey
Speaker 2: in this battle started with my late wife's diagnosis back
Speaker 2: in twenty eighteen, So Wiki, my wife was diagnosed with
Speaker 2: advanced breast cancer and we were put in the position
Speaker 2: of having to find a lot of money for a
Speaker 2: drug that we ended up campaigned for and it was funded,
Speaker 2: that drug.
Speaker 3: Being Ibrant, And then shortly.
Speaker 2: After we lost Wiki, I myself was diagnosed completely out
Speaker 2: of the blue, with no symptoms whatsoever, of an aggressive
Speaker 2: form of prostate cancer. What that meant for me was
Speaker 2: that we had to find about fifty thousand dollars so
Speaker 2: I could be seen privately with urgency in order to
Speaker 2: have my prostate removed, which is what happened. Nothing can
Speaker 2: prepare you for a diagnosis of cancer, and at the
Speaker 2: time it was unknown whether or not I had stage
Speaker 2: three or stage four, and I knew what each stage
Speaker 2: meant because I'd been through our cancer journey with Wiki,
Speaker 2: your mind is basically smashed into a million pieces and
Speaker 2: you're not sure what to do. You can't even put
Speaker 2: your left foot in front of your right foot. So
Speaker 2: to have that diagnosis, and then if you're put in
Speaker 2: the position of needing an unfunded medicine, to have to
Speaker 2: think that part of a journey through, I mean, it's
Speaker 2: just just so cruel.
Speaker 1: I guess we hear cancer and we just immediately think death.
Speaker 1: So but there are drugs out there, aren't there, Malcolm.
Speaker 1: We're constantly hearing stories about New Zealanders resorting to crowdfunding
Speaker 1: and seeking health treatment overseas and moving to Australia. I
Speaker 1: mean you would have heard them all.
Speaker 3: Yeah, I have, and they don't get any easier to hear.
Speaker 2: And one thing I would say is that the number
Speaker 2: of stories that I hear about is certainly on the increase.
Speaker 2: They're not going away anytime soon. And so I have
Speaker 2: met patients. For example, there was a lady he diagnosed
Speaker 2: at the same time as my late wife. She managed
Speaker 2: to get the drug that we needed, ibrance as their
Speaker 2: first line treatment, So that meant that that was the
Speaker 2: first drug she was put on. That's the only drug
Speaker 2: she's received to date, and she's still.
Speaker 3: Living really well up there and flung it a.
Speaker 2: I met a person who had self funded a prostate
Speaker 2: tenser drug. He lives in Tolonger. He's been on that
Speaker 2: drug now for over a decade. So what we are
Speaker 2: seeing is a transition for some people from stage four being,
Speaker 2: if you like, a death center, towards living with a
Speaker 2: disease almost under the banner of being chronic. And so
Speaker 2: there is a shift, and that's something that the public
Speaker 2: really should understand and appreciate.
Speaker 1: And when you and your dear wife went through the system,
Speaker 1: what was it like for you, guys, I guess seeing
Speaker 1: it from the inside, or was it just a completely
Speaker 1: different world because you did go through that private route?
Speaker 2: So wiki didn't go through private, she went through public.
Speaker 2: And I've got to say that the world of Kncer,
Speaker 2: of your life was extremely foreign to us. We had
Speaker 2: probably been one of the more fortunate faro in New
Speaker 2: Zealand where Kncer I had lost, for example, a cousin
Speaker 2: quite some years ago, and I'd lost the odd uncle
Speaker 2: and what have you. But you know, it wasn't something
Speaker 2: that's fresh in the memory. We had no concept of cancer.
Speaker 2: So I can distinctly recall when WICKI was given the
Speaker 2: diagnosis of metastatic breast cancer. I didn't know what the
Speaker 2: hell that meant, and so they had to bring in a.
Speaker 3: Special listners to explain it to us, because of course
Speaker 3: you've got the shock.
Speaker 2: Of the diagnosis and then having to talk through what
Speaker 2: that meant.
Speaker 3: What I would say is that with.
Speaker 2: My own experience having gone through private, the contrast is
Speaker 2: night and day, especially in terms of the urgency under
Speaker 2: which you are treated. So you know, time was a
Speaker 2: ticking for me. If I had to left it there
Speaker 2: a little bit longer, chances that it would have metestasized
Speaker 2: and you'd now be talking to me as a terminally
Speaker 2: ill cancer patient. Because I was able to go private,
Speaker 2: I was able to go out to Grace Hospital and
Speaker 2: total on there. I had robotic surgery, state of the art,
Speaker 2: and they removed it with very good margins, which means
Speaker 2: hopefully touch wood I won't see the cancer return.
Speaker 1: Ever, how do we make that kind of treatment available
Speaker 1: to everyone?
Speaker 8: Though?
Speaker 3: We need to increase funding, that's the bottom line. You know.
Speaker 2: We pride ourselves and being part of the developed world,
Speaker 2: but when it comes to healthcare, and especially when it
Speaker 2: comes to cancer care, we are worlds behind.
Speaker 3: And really grapes me when I hear stories of some
Speaker 3: of our best and.
Speaker 2: Brightest oncologists saying, you know, if I'm a senior oncologist
Speaker 2: practicing here in New Zealand and if I'm a starting
Speaker 2: oncologist in Australia, a starting oncologist is on the same
Speaker 2: wage as a very experienced oncologist here at home.
Speaker 3: And so there are so many gaps in the system.
Speaker 3: And also the fact that oncologists overseas have access to
Speaker 3: modern medicines, whereas here we're playing catch up. We're probably
Speaker 3: a decade behind where we should be.
Speaker 2: And so because doctors are unable to prescribe those medicines,
Speaker 2: they're going offshore. So we also have a brain drain
Speaker 2: in that space. And I think these are some of
Speaker 2: the obstacles that we have to overcome. We have to
Speaker 2: look at this seriously, we have to get a plan
Speaker 2: in place, and we have to put the funding where
Speaker 2: it matters.
Speaker 8: It's an expensive drug, but it does have far better outcome,
Speaker 8: both in survival level and in the quality of life.
Speaker 3: That you get.
Speaker 8: I believe that in Australia a pension that only needs
Speaker 8: to pay six dollars fifty a month for this drug.
Speaker 8: I'm really disappointed.
Speaker 1: What would you like Shane Ready and the other ministers
Speaker 1: to know about the pressures on the health system at
Speaker 1: the moment and what would you like to see them change.
Speaker 2: Well, I think they have to have an appreciation of
Speaker 2: the relief that medicines or better access to medicines can
Speaker 2: bring on the health system. There are numerous studies out
Speaker 2: there that will show you if you fund a medicine,
Speaker 2: that will relief pressure elsewhere in the health system. So
Speaker 2: a really good example, it springs to mind, is the
Speaker 2: funding of tri cafta those websisted fibrosis. Now, if that
Speaker 2: hadn't have been funded, those patients would have required more
Speaker 2: hospital care. They certainly would have had to have had
Speaker 2: more lung transplants, and that in itself would have cost
Speaker 2: a lot more than funding the medicine. Thankfully, for that community,
Speaker 2: the medicine was funded and so that's overall savings on
Speaker 2: the health system. I think my plea to Shane into
Speaker 2: others is please make good on your promise to fund
Speaker 2: those thirty medicines. Patients knew that their medicines were on
Speaker 2: that list, and they voted accordingly, and I think to
Speaker 2: take that away from them at this point in time,
Speaker 2: it's just simply cruel and I would say to them also,
Speaker 2: please have a view of mine. So New Zealand is
Speaker 2: no longer the only country in the developed world that
Speaker 2: has a waiting list for modern medicines and fun farmac seriously,
Speaker 2: so that we can see other places in the health
Speaker 2: system having that pressure alleviated.
Speaker 1: And given how many issues there are across the health system,
Speaker 1: and of course these thirteen cancer drugs that we're talking
Speaker 1: about as well. When Budget twenty twenty four announced eight
Speaker 1: billion dollars for health over the next four years, but
Speaker 1: then fourteen billion in tax cuts, did that annoy you
Speaker 1: at all?
Speaker 3: Yeah. Look, I'll be honest with you.
Speaker 2: I don't know how many times I've been approached in
Speaker 2: the street where as they've said, we're okay paying our
Speaker 2: taxes so long we agree with where our taxes are
Speaker 2: being spent. So you know, I'd much rather give you
Speaker 2: back my tax break if I know that in my
Speaker 2: time of need, I'm.
Speaker 3: Going to be catered for by the health system.
Speaker 2: And some of them did actually touch on the education
Speaker 2: system as well. I guess from their point of view,
Speaker 2: they see that as the essentials that government should be providing,
Speaker 2: and so many a person's come out and said, Hey,
Speaker 2: I don't need the extra twenty bucks or whatever it
Speaker 2: is in terms of tax breaks. What I need to
Speaker 2: know is that that money is going to go towards
Speaker 2: medicines or towards a health system, so that we have
Speaker 2: a fully functioning health system and so that in my
Speaker 2: time of need, I know I.
Speaker 3: Can access the medicine that I will need.
Speaker 1: Yeah, and getting a tax cut won't mean much to
Speaker 1: you if you then have to go and give a
Speaker 1: little when you get sick, K, that means nothing.
Speaker 2: I mean you're looking at the thousands and thousands of
Speaker 2: dollars we're in other OECD countries.
Speaker 3: You know they're able to access it VERA prescriptions. It's insane.
Speaker 1: Thanks for joining us, Malcolm. That's it for this episode
Speaker 1: of the Front Page. You can read more about today's
Speaker 1: stories and extensive news coverage at enzed Herald dot co
Speaker 1: dot z. The Front Page is produced by Ethan Siles
Speaker 1: with sound engineer Patty Fox. I'm Chelsea Daniels. Subscribe to
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Speaker 1: and tune in tomorrow for another look behind the headlines.