Big differences in cancer care are "embarrassing" for the worst-performing District Health Boards and must be closed, Health Minister David Clark says.

In an exclusive interview with the Weekend Herald, Clark said having those regional disparities out on show for the public may be difficult for some DHBs but it was essential to put an end to healthcare's postcode lottery.

"Perhaps it might even be a little bit embarrassing for some DHBs to see they aren't performing as well as others but it enables us to put supports around those areas that aren't performing as well and make sure we raise the standard."

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Clark spoke to the Weekend Herald as part of a special investigation examining New Zealand's cancer care, which has been spotlighted by patients-turned-advocates like the late Blair Vining, and is set to be overhauled through a new national agency.

The minister hinted the DHB system could be in for a major overhaul saying Heather Simpson's Government-commissioned review into the whole health and disability sector asked all the right questions.

"[We should be thinking] about what value are Primary Health Organisations adding in their current form?

"Is a reduced number of DHBs a way to get through greater efficiency in the system or is it through more shared services or some other mechanisms?"

Clark said he hadn't come across anyone who violently disagreed with the findings from the interim report and was eager to see the recommendations that would come in the March report.

"Our system is good at addressing local demands and pressures but it's not as good as it could be, in my view, at sharing learning across the system.

"There's stuff that needs to be done on workforce, there needs to be a greater focus on primary care, there's a whole lot of things."

He said he had heard far too many stories of people choosing not to travel because they couldn't afford it or because they couldn't leave their family responsibilities.


"That's not acceptable and I do think we can do better."

The minister said the cancer agency was working to create the standards that would make sure all New Zealanders have better equality of outcomes and access.

When asked about whether specialised centres were being considered, Clark said those leading the cancer space would make that judgement.

"Whether cancer outcomes would be improved by concentrating down to a few specialist areas or focusing on the access question that's what they are working hard to address.

"[Gathering] best practice seems to be where the easy wins are, that's where the opportunity lies to make sure that all surgeons, and others providing cancer care, are performing at best practice levels and are supported to do that."

Our reporting in the series will explore how New Zealand's cancer treatment can catch up to countries like Australia and Canada - something that would save about 800 lives a year; what will be done to end postcode lottery care; concerns the ambitious new national cancer agency could be held back by funding shortfalls; and what our treatment will look like by the end of next year and in 10 years' time.

We speak to one terminally ill Auckland mum, Kim Girbin, who reveals her chance to fight the deadly disease was taken away from her after she was let down by the health system nine times.

"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.

"Literally, they couldn't even get the camera into my bowel, the tumour was that big," the 42-year-old said.

Her story was labelled horrendous and "absolutely tragic" by Diana Sarfati, the woman chosen by Clark to lead the new national cancer agency.

She said it showed some of the systematic weaknesses that must be overcome.

"By in large we have a good health system, we have good health professionals who are working to the best of their patients but that doesn't stop people from missing out on the care that they need," Sarfati said.

"I am personally absolutely committed to improving the way that New Zealand manages cancer."