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Te Aho o Te Kahu: The State of Cancer in New Zealand 2020 He Pūrongo Mate Pukupuku o Aotearoa 2020 The State of Cancer in New Zealand 2020
Te Aho o Te Kahu (Te Aho/Cancer Control Agency) has released its first report providing an overall picture of cancer in New Zealand. The State of Cancer in New Zealand 2020 highlights inequities and ways to improve cancer treatment for all New Zealanders affected by cancer. The report also highlights information about the vulnerable state of New Zealand’s cancer workforce. The College has, for several years, advocated for better workforce planning within radiation oncology and clinical radiology (encompassing diagnostic and interventional radiology) in New Zealand. We know that there are doctor shortages across the country and the problem will only worsen with our growing and ageing population. The College’s 2020 Election advocacy (www.ranzcr.com/our-work/advocacy) focused, in part, on workforce issues including training and retention. Addressing these issues will form the foundation of our advocacy efforts in New Zealand in the coming year. The State of Cancer in New Zealand 2020 highlights the significant workforce issues across all professions involved in cancer care. According to the Medical Council of New Zealand (www.mcnz.org.nz), there are currently 69 radiation oncologists with practising certificates and 615 diagnostic and interventional radiologists. The following graph demonstrates the need to increase training numbers due to the ageing of the overall workforce:
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Figure 3.1: Age breakdown of a range of specialist professions involved providing cancer in Aotearoa, 2019/20 Figure 3.1:in breakdown of a care range State ofAge cancer C.4 Workforce age of specialist professions involved in providing cancer care in Aotearoa, 2019/20 Radiation oncologists Medical oncologists Haematologists Cancer nurses Radiation therapists Diagnostic & interventional radiologists General surgeons General practitioners* 0
10
20
20–39 years
30
40
40–59 years
50 60 Percent
70
80
90
100
60 years and over
*General practitioners with vocational registration in general practice Source: Health Workforce directorate, Ministry of Health
The changing nature of cancer care also presents challenges to the sustainability of the cancer workforce. People are living longer and have greater expectations around the level of care they should receive, by default the demands on the professionals working in the area are increasing. Incidence ofand Cancer There are substantial in New Zealandtechnological changes, and the complexity of treatment is increasing. Each district health board (DHB) has responded to this increased pressure to different degrees and in Each year 25,000 are different ways, whichKiwis has led to diagnosed different models of care being developed around the country.
with cancer and 9,000 die—Māori Onetwice example sustainability are as of likely to die from cancerPsychosocial support needs to be available to all concerns is in theThe radiation as non-Māori. State of Cancer in people affected by cancer and therapy workforce. The New Zealand 2020 includes a detailedextended beyond treatment – especially for workforce is small, working section on the incidence of cancer in patients. Again and again, I see people across 10 public and private New Zealand. The most commonly returning, looking for some counselling as they cancer centres. There are a diagnosed cancers in New Zealand are experience adjustment difficulties post low number of graduates each treatment. … People tend to struggle with adjusting breast, prostate year andlung, high vacancy andand colorectal:
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to life post treatment and on treatment … The turnover rates, which place current psychosocial funding in DHBs needs to be the workforce in a vulnerable built on … to include the entire pathway, extended position. In a recent study to include people who do not have high and (Taylor and Oetzel 2020), only complex needs but who are struggling to adjust to 20 percent of workforce survey their situation. participants planned to stay Health practitioner in their current career until they retired, with 35 percent expecting to change careers at some stage. The reasons for change included seeking a new challenge, better work conditions, more flexibility and career progression. The remaining 45 percent of survey participants were unsure of their plans for the future. There are multiple initiatives currently underway to address sustainability concerns; one example is the Voluntary Bonding Scheme run by the Ministry of Health. The scheme aims to incentivise newly qualified health professionals to work in eligible specialty areas that are hard to staff and
