Last December 23rd, two of our local bodies opened their mail.

One got some good news, the other bad.

Let’s end on an upbeat note, so starting with the bad news.

On December 23rd officials at the Hawke’s Bay DHB were informed by the Chief Medical Officer at MidCentral DHB that patients in the HB region who suffered from fourteen specific kinds of cancer could no longer be referred to specialist oncologists at Palmerston North Hospital, which had been the usual practice. The reason: a shortage of oncologists at PN Hospital. The reasoning: no point in using the scarce available time of oncologists to see patients who were statistically unlikely to be treatable.

Here’s the December 23rd MidCentral memo. And here’s the HBDHB media statement released on January 5th in response to media reporting of the cutback in referrals. It said: “Chief executive Kevin Snee said the letter had prompted the DHB to review the full range of options regarding the future development of medical oncology services for Hawke’s Bay people.”

I’m sure many cancer patients in Hawke’s Bay and their families are eager to hear more.

There’s been some indication that the oncology vacancies at Palmerston North Hospital might be filled reasonably soon. That in itself, however, should not distract anyone from the large underlying issue. The real issue that surfaces here is the reality that more and more health care services are likely to be curtailed in NZ, through one form or another of triage, as demand outpaces resources (including key health specialists) in the face of a growing elderly population seeking more and more expensive care.

In the case of fourteen types of cancer, if the triage policy made sense because certain patients were not expected to benefit from referrals (and treatment), why would MidCentral, assuming oncologists are eventually recruited, revert to the old practice and see them anyway? Shouldn’t the resources be used where they might be expected to be most efficacious?

A tough question … indeed, a cruel one if you happen to suffer from one of the fourteen unresponsive cancers.

The lesson … this type of question will arise more and more. And our DHBs will need to handle them with greater sensitivity and forthrightness — and more pro-actively — than seems to be the case with this episode. Our community needs much education in such matters.

***

The same December 23rd, at the Hastings District Council, good news arrived in the mail. Specifically, a cheque for nearly $300,000!

Andy ‘Santa’ Lowe finally paid the nearly $300,000 his Lowe Corporation owed the Council (i.e., ratepayers) for the costs incurred in evaluating his proposed private plan change for developing Ocean Beach. Payment arrived two years and two months after Lowe withdrew his plan change in the face of tremendous public opposition … and only after several failed legal appeals by Lowe Corp challenging the charges.

The lesson in this story … justice prevails.

However, a small fly in the ointment. Perhaps opening a new chapter, Lowe has recently hauled in over the dunes a re-located ‘cottage’ at the north end of Ocean Beach, possibly on culturally sensitive land. HDC, upon receiving a public complaint, ordered work to stop and insisted on receiving a building consent application. Lowe has now applied for one, after the fact.

The further lesson … some things never change!

Tom Belford

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