One core area Gurney is interested in is the impact that centralisation of services could have on Māori patients. He says evidence already suggests Māori who live rurally are less likely to access centralised services based in the main centres.
“The kicker to that is that Māori are also much much more likely to live in deprivation, so more likely to live further away and less likely to be actually able to afford to access that treatment. That’s a really acute problem that we need to solve now, if not last week.”
While he acknowledges centralisation of cancer services allows a larger population of patients to access a larger pool of clinicians and specialists, it also creates a bigger barrier to whānau who live further afield.
Access to care issues
“And then following on from that, what are the ramifications of Māori whānau having to borrow money just to get to Auckland? Those sorts of things that aren’t thought about in the context of cancer care enough, they’re kind of siloed off. We need to think about it much more comprehensively and broadly.”
Gurney says the findings of the study will be crucial in forming policy and strategies to turn the Māori survival rate around, with an eye toward the bicentenary of New Zealand in 2040.
“Because if we’re not doing extremely well now, in terms of survival for Māori from cancer, odds are that’s not going to get better on its own and the burden is only likely to get worse as time goes on.
“So the idea is to bring together a lot of information around access to surgery, radiation therapy, systemic therapy now, and then project out what we’re going to need in the future, so we can start planning for that need.”
Cancer burden
The programme will also evaluate the likely future cancer burden for Māori, providing vital context for the cancer control sector to plan the size and scope of future services.
“We aim to meaningfully contribute to eradicating inequities in cancer survival for Māori, by learning from what we have done previously and considering how this needs to change. Kia whakatōmuri te haere whakamua - walking backwards into the future with our eyes fixed on the past.”