Saturday, April 4, 2009

Numbers 'too low' for child cancer unit

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By REBECCA PALMER - The Dominion Post
Last updated 05:00 04/04/2009

Low patient numbers and a need for highly specialised support services put the future of Wellington Hospital's specialist child cancer services in doubt, its managers say.

Ken Whelan, Capital and Coast District Health Board's chief executive, said yesterday that the paediatric oncology service had only eight new patients in the past six months.

The service had a chequered history, he said. "We can't have the service off-again, on-again."

The hospital's two paediatric oncologists husband and wife Christian Kratz and Mwe Mwe Chao resigned last month, less than six months after arriving from Germany. They leave in August.

Their arrival in Wellington last October ended nine months of the most vulnerable child-cancer patients being sent to Auckland or Christchurch for treatment. Mr Whelan said the hospital would continue providing tertiary child-cancer services till August, but would work with the Health Ministry and other district health boards to find a long-term solution.

"The reality is that providing paediatric oncology services is a highly specialised area and there are a lot of work force issues, especially in an area where the patient volumes are very small."

Money was not the issue. The hospital had put an extra $1.4million into the service. Capital and Coast child health services clinical director Graeme Lear said seven children were in the initial stages of treatment and another 30 were receiving chemotherapy.

The paediatric oncologists had done a "fantastic job".

Providing a high-quality, tertiary level child-cancer service required specialised support. That included staff in pharmacy, nursing, pathology and radiology and a paediatric intensive care unit. There was only one such unit in New Zealand in Auckland.

"We [Wellington] are not going to have a paediatric ICU because we don't have enough volumes coming through."

Dr Lear said if Wellington offered a secondary but not tertiary service, it would mean children would go to other centres for the intensive start of chemotherapy, "which is what makes the kids really sick". Follow-up care would be provided in Wellington.

A third paediatric oncologist, from Chicago, is due to start work in Wellingtonnext month, initially as a locum. She has been appointed for a three-month period but the board could extend the contract.

Paediatric oncology steering group chairman Scott McFarlane, of Auckland's Starship children's hospital, said Waikato and Dunedin hospitals had already been through a similar transition, moving from tertiary to secondary child-cancer services.

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