National health reform
and cancer care in New South Wales
2010 is potentially a watershed year in health service delivery in Australia. I say potentially because although there are many details available, many of the people that we serve through the Cancer Institute NSW are still not described in the new health system.
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The proposal has a strong base around hospital networks, and a clear strengthening of primary care including general practice, practice nurses, allied health and community health centres. The unknown areas include many marginalised people within our community — mental health, palliative care and areas which require a close interface between the hospital and the community such as the move to new models of care for acute haematological malignancies. Under new and emerging models of care, is a person admitted to hospital but being treated at home, or living at home with occasional emergency presentations to hospital with each presentation regarded as a new admission? Such issues have enormous implications for the delivery of cancer services and for the patient-centred care that we all strive to deliver.
At a state level, we all await with interest the way that the new hospital networks will be implemented. The role for the Cancer Institute NSW is crucial in ensuring that each hospital network is working collaboratively with other hospital networks to ensure that the current excellent outcomes in cancer across NSW can be further improved. There is a risk that if hospital networks are too small and don’t work collaboratively with each other, some of the reductions in mortality seen over the last 20 years in cancer could potentially be compromised. This is going to take real leadership across the state in order to ensure that those relationships between networks are effective and responsive to the needs of patients now and into the future.
Within this context, the Cancer Institute NSW is undertaking strategic planning. I would like to thank everyone who has participated in this. Divisional directors and their managers have done a fantastic job in putting together the workshops. I am delighted with the focus that has been brought to our work program for the next 5 years. This period of consolidation of the Cancer Institute NSW after such rapid growth over the last 7 years is really where we establish our street credentials. There is still a great deal we can do to improve cancer control at every level — prevention, screening, early detection, treatment, survival and palliation. At the same time, we need to focus on the areas where we can make the most impact and where we can do a couple of key things:
- Decrease the disparity in outcomes for identifiable groups within our community such as Aboriginal and Torres Strait Islander communities, culturally and linguistically diverse communities, people from lower socio-economic status and people from rural and remote areas.
- Decrease variations in practices that are leading to variations in outcomes.
If over the next 5 years we can achieve outcomes in those areas with our research programs, prevention, screening and service & education programs, we will have achieved something incredibly significant not only for the people of NSW but in demonstrating what can be done in Australia and the region for people with cancer.
I look forward to the conversations over the next few months as the strategic plan for cancer in NSW is finalised. It is great to be collaborating with such a dynamic team of professionals.