Saturday, April 4, 2009

Parents dread outcome of doctors' departure

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By STACEY WOOD - The Dominion Post
Last updated 05:00 04/04/2009

Mothers of child cancer patients at Wellington Hospital dread the prospect of travelling to Christchurch or Auckland to get treatment for their children.

Palmerston North mother Nikki Christian already travels to Wellington with son Brayden, 7, once a week for chemotherapy treatments.

They have no friends or family in Christchurch and, while Mrs Christian's mother-in-law lives in Auckland, the inconvenience of travelling would be huge. "It raises so many questions.

"Where are we going to go? Do we have a choice? Do we drive or fly?"

Brayden has suffered from car-sickness since starting his chemotherapy and the added travel would cause him more discomfort.

Olivia Utting, whose son Elijah Utting-Parker, 4, has leukaemia, said she was "really scared" that the departure of the two paediatric oncologists would leave an unacceptable gap in expertise at the hospital. "These two doctors are incredibly qualified and the fact we got them here was so fortunate.

"[The DHB] said they've gone out of their way to keep them but I simply do not believe it."

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.

Laws blasts child cancer care

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4:00AM Sunday Apr 05, 2009
By Jane Phare
Michael Laws with daughter Lucy, who has leukemia. Photo / Wanganui Chronicle

Michael Laws with daughter Lucy, who has leukemia. Photo / Wanganui Chronicle

Talkback host Michael Laws launched an angry and frustrated assault on health authorities last night over the care available for child cancer patients - including his daughter Lucy.

"The inadequacy of New Zealand's child cancer facilities has been pretty much brought home to me," said Laws, who is Wanganui Mayor and a member of the Whanganui District Health Board.

Laws said in the past week Lucy had deteriorated and needed a platelet transfusion. His daughter had no immunity and was at high risk of infection.

A range of options for Lucy's care had been canvassed with doctors but a room in Starship Hospital in Auckland was not considered an option because the hospital was too busy.

It came 18 days after Lucy went into isolation at Wanganui Hospital, and as child cancer services across the country face fresh pressure with the loss of two Wellington-based specialists. The pair - hired from Germany - quit six months after taking the job.

The resignations mean the centres for child cancer treatment might be again cut back to Auckland and Christchurch. It leaves families with long trips to those main centres or greater reliance on provincial hospitals where doctors use "tele-medicine" to communicate with specialists.

The Herald on Sunday has learned of some families with children needing regular care who have moved away from Wellington because of the inconsistent staffing and care.

Labour is calling for new Health Minister Tony Ryall to fix the problem.

Ryall acknowledged that the loss of the paediatric oncologists could be "upsetting" for families. He said a temporary paediatric oncologist had been hired and work was under way to fix the problem.

Laws highlighted the Wellington problem as placing greater pressure on the system, and said he had been told that ill children were unable to get into Starship Hospital's oncology wards.

He praised Wanganui hospital staff for their work. Not only had Lucy received excellent treatment there, but they had kept a room to the side of her room empty to help keep infection at bay, and turned away other child patients with infectious illness.

Dr Lochie Teague, clinical director of paediatric oncology at Starship, denied there was a waiting list for child cancer patients. He said if any child in a regional hospital got sick enough they would be transferred to Starship. "Space will always be made available."