"What other DHBs might have done - we know they have done - is meet the targets but not respect the clinical need of patients," he said.
"It would be easy for us to meet the target by operating on slow-growing cancers such as prostate cancer - but what we want to do is make sure the patient gets the right treatment for the best outcome."
He said if the right changes were made the Ministry's target would result in better patient outcomes.
"Setting a six-hour target in the Emergency Department has resulted in fewer deaths - we have good evidence for that across the country. Setting targets for cancer treatment is a good idea and we think it will lead to better outcomes. That hasn't been evaluated yet in New Zealand although it has been evaluated in other countries."
He said clinicians respond "very badly" to imposed targets "so we have said it's about improving outcomes for people - that is the crucial thing."
The target would be achieved through sustained improvement for patient need and he was confident Hawke's Bay would climb the table.
"It is all little things that are going in tandem. We are building the platform to make it happen and when it all comes together we should have synergy."
Part of the improvement was co-ordinating expanded capabilities in areas such as radiology, surgery and the endoscopy unit under construction.
The cost of doctor visits, transport (travel assistance is income tested ) and personal choice were big barriers to timely treatment - some people went on holiday mid-treatment.
"Our big problem is people tend to arrive far too late and in an advanced state of disease. They quite often turn up at the Emergency Department or through primary care and in a late stage of cancer, by which time it is quite difficult to do anything. We are talking about forms of cancer which aren't painful and in late stages. You can have very late stage lung cancer and have no pain at all - a persistent cough doesn't go away or bleeding from places you shouldn't be bleeding from."
The biggest improvement of all would be from people simply visiting their doctor more often. Screening programmes lifted breast cancer survival rates to 90 per cent "so it is about catching things in the early stage".
While one out of every three people will get cancer at some stage in their life a healthy lifestyle, quitting smoking and weight loss reduce the odds dramatically.