Monday, December 31, 2007

Child cancer under-funded, say DHBs

Ministry money has fallen behind costs

RUTH HILL - The Dominion Post | Wednesday, 31 October 2007

Child cancer units in Wellington, Auckland and Christchurch - the only three offering advanced treatment for life-threatening cases - are chronically underfunded, say health boards.
Editorial: Facing failure in cancer wards

Last year Wellington Hospital's paediatric oncology unit spent $1.3 million more to treat child cancer patients than it received in government funding.

Capital and Coast District Health Board's chief operating officer, Martin Hefford, told the board Health Ministry funding had not kept pace with costs. "It's got to be priced in a way that gives us full cost of the service."

The unit, which serves the lower North Island, was forced to close its doors to new patients in July when one of its two specialists left for Australia. So far at least eight child patients have been sent to Auckland or Christchurch for treatment.

The board has been negotiating with Canterbury DHB to set up a joint service, but the plans have been jeopardised by the resignation last week of Wellington's remaining paediatric oncologist, Anne Mitchell, who leaves in January.

A report prepared for the board showed the unit was $322,000 in the red last year in direct costs and also overspent $857,000 on support services (including radiology, pharmacy and laboratory tests) and corporate overheads.

Christchurch Hospital's unit blew its budget by $70,000 in the first three months of the 2007-08 financial year. A board spokeswoman said it cost about $3.7million a year in direct operating expenditure to run Canterbury's paediatric oncology.

The price paid for child cancer services by the Health Ministry mainly reflected "secondary" procedures and did not adequately compensate tertiary care, she said.

The charges for child cancer treatments are set by the National Pricing Committee, a combined DHB and ministry group, which is not due to meet again till mid-2008.

It could be February 2010 before there is some relief for cash-strapped child cancer units.

Mr Hefford said the Wellington unit, which has the lowest patient numbers, was the "lowest-cost provider" of child cancer services.

Wellington cancer patients had the least money spent on them of all three tertiary units: an average of $4471.22 per treatment, or 85.3 per cent of the national average of $5240.69 - partly because some more advanced treatments are not available in Wellington.

Auckland spent an average of $6178.33 per treatment while Canterbury patients had $5144.88 spent on them. "A variety of factors, including lower capital costs, contribute to lower overall costs," Mr Hefford said.

The Health Ministry's sector accountability and funding manager, John Hazeldine, said boards were funded on the population-based funding formula - not for specific services such as child cancer.

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