Funding shortfalls and lack of independence could prevent New Zealand's new cancer agency from lift off, experts warn - stalling the fight to save hundreds of lives each year.
Pre-election, Labour promised $10 million to establish a national cancer agency and a further $10m to get work under way.
Nearly two years later, in September, Prime Minister Jacinda Ardern and Health Minister David Clark announced plans to set up the national agency by December 1.
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However, instead of being independent from Government the agency will run within the Ministry of Health and instead of the $20 million pledged pre-election, only $2 million was put forward with the rest coming from within ministry baselines.
Speaking to the Herald, Health Minister David Clark said he could not specify how much funding would be allocated to the agency, but promised more would be earmarked in Budget 2020.
Cancer Society of New Zealand medical director Chris Jackson told the Herald he was concerned that without the funding and resources to pillar the agency and plan, improvement will continue to be stalled.
"We've tried several times to get this right with past health reforms - and now it's third time right for cancer control."
Real targets and timeframes were needed to ensure the Government and DHBs were accountable for delivering goals of the plan, Jackson said. Another condition: a whole lot more money.
"The plan has hit the mark with equity-led, knowledge-driven, and outcomes-focused principles," said Jackson, who's worked as an oncologist at Southern DHB for 15 years.
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"But we can't lift outcomes without spending in the key areas identified in the plan to reduce the number of kiwis affected by cancer and improve survival for those who get cancer."
Jackson said he hoped the funding announced in next year's Budget would be as much as, if not more than, orginially promised.
Cancer epidemiologist Professor Mark Elwood echoed Jackson's comments, saying significant funding was crucial to creating any change.
"I think it's a real issue this group is not going to have any independence and no new budget has been given."
In both Australia and Canada, national cancer agencies were given an independent budget to stimulate change such as improving workforce issues, Elwood said.
In 2016, the Canada federal budget included $47.5 million to go towards the Canadian Partnership Against Cancer annually.
For the last seven months the Herald has been examining cancer care in New Zealand, which has been spotlighted by patients-turned-advocates like the late Blair Vining, and is set to be overhauled through a new national agency.
On Saturday we told a story of young Auckland mum Kim Girbin who did everything right but was let down by the system at least seven times - including having her symptoms dismissed as "girl problems".
If she hadn't used her mortgage money to pay for a $3500 colonoscopy it's likely she'd already be dead.
"I was young, fit and healthy so I was put on an eight-month waiting list unless I paid, which I did and was seen the next day."
But even then it was too late.
"If they found my cancer when I first started to get symptoms I wouldn't have been left with no options, and I wouldn't be spending half my days in bed."
Funding shortfall: Cancer agency will stall without more money