Achieving national cancer governance reform: Lessons from a successful academic, clinical, and community advocacy approach in New Zealand.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14131-e14131
Author(s):  
Christopher G. C. A. Jackson ◽  
Diana Sarfati
Keyword(s):  
New Zealand ◽  
Cancer Survival ◽  
Cancer Control ◽  
Direct Result ◽  
Governance Reform ◽  
National Cancer Plan ◽  
Cancer Plan ◽  
The Government ◽  
Cancer Networks ◽  
National Director

e14131 Background: Cancer survival in New Zealand (NZ) is high in global terms but gains in outcome are less than in comparable countries over recent time cohorts. Outcomes of indigenous Māori New Zealanders are significantly worse for most major cancers. This is potentially due to decentralisation of cancer provision and lack of emphasis on national governance. Methods: In 2017, academics, clinicians and patient advocates embarked on a planned and sustained programme of advocacy with the goal of establishing a national cancer plan, centralised cancer governance, and publicly reportable cancer outcomes and quality indicators by region and ethnicity. Elements central to success were partnerships with politicians and opposition parties, building credible media voices, establishing international academic collaborations, clear problem identification, positive evidence-based policy solutions, sustained and consistent yet varied media messaging, and strong relatable patient stories with direct citizen engagement. Results: As a direct result, in 2019 the Government established a National Cancer Agency, updated the national cancer plan for the first time in 16 years, moved to dissolve regional cancer networks, and appointed a national director of cancer control. New funding specifically for cancer investment was also announced and commitments to additional funding have been made. We review the strategies that were most successful, challenges encountered, and outcomes achieved. Conclusions: Advocacy and collaboration between patients, academics and clinicians remains a powerful stimulus for meaningful policy change. Our approach can be instructive for other countries where national cancer control and governmental leadership are faltering.

scholarly journals 039 Regional disparities in cancer survival following the NHS National Cancer Plan for England: an analysis by cancer network

2010 ◽  
Vol 64 (Suppl 1) ◽  
pp. A16-A16
Author(s):  
S. Walters ◽  
M. Quaresma ◽  
B. Rachet ◽  
D. Forman ◽  
E. Gordon ◽  
...  
Keyword(s):  
Cancer Survival ◽  
Regional Disparities ◽  
National Cancer Plan ◽  
Cancer Plan ◽  
Cancer Network

Ethnic differences in breast cancer survival in New Zealand: contributions of differences in screening, treatment, tumor biology, demographics and comorbidities

2015 ◽  
Vol 26 (12) ◽  
pp. 1813-1824 ◽  
Author(s):  
Sanjeewa Seneviratne ◽  
Ian Campbell ◽  
Nina Scott ◽  
Rachel Shirley ◽  
Tamati Peni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
New Zealand ◽  
Ethnic Differences ◽  
Cancer Survival ◽  
Tumor Biology ◽  
Breast Cancer Survival

scholarly journals Lung cancer survival trend in Umbria, Italy, 1994-2016: preliminary results

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Ostorero ◽  
A Gili ◽  
S Violi ◽  
F Stracci
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Tobacco Smoking ◽  
Cancer Survival ◽  
Cancer Control ◽  
Mortality Trends ◽  
Incidence And Mortality ◽  
New Treatments ◽  
Lung Cancer Survival

Abstract Background Lung cancer is the second most common cancer worldwide and the leading cause of death for cancer (18.4%). During the last 30 years, lung cancer incidence and mortality increased in women and decreased in men, because of tobacco smoking exposure. Population survival trend reflects both the influence of disease severity at diagnosis and treatment effectiveness. Some studies reported an increase in global lung cancer survival and linked it to new treatment options. However, change in the overall survival may also reflect a shift towards morphologies with more favorable prognosis. We analyzed overall and morphology specific survival trends for lung cancer to gain insight on the role of new treatments and changing exposures. Methods We analyzed lung cancer 1 y-survival and 3 y-survival after diagnosis in Umbria (890'000 inhabitants) in the period 1994-2016. Population-based data were obtained from the Umbrian Cancer Registry (RTUP), Italy. We estimated relative net survival (Pohar-Perme approach) stratified both for sex and histotype (NSCLC, SCLC, NOS), considering six diagnostic periods from 1994 to 2016 (4 years for period, except 3 in the last one) for 5'268 lung cancer cases (26% women). Results Overall survival by gender resulted 40,5% (1y) and 16.5% (3y) in men, 47,3% (1y) and 23,2% (3y) in women. NSCLC survival increased in women during the period 1994-2016 from 41% to 53% (1y) and from 23% to 33% (3y), and remained unchanged in men. SCLC 3 year-survival did not change significantly neither in women nor in men. Conclusions We did not observe a significant increase in lung cancer survival over a 25 years period. We observed a significant increase in survival probabilities for NSCLC among women only. Thus, our data don't confirm a major role of new treatments in improving lung cancer control. We will provide further analyses for adenocarcinoma and a comparison of incidence and mortality trends to understand the influence of exposures and treatments on survival. Key messages A general increase in lung cancer survival, as could be expected after the introduction of new highly effective treatments is not present in western countries. Reducing exposure to tobacco smoking and environmental pollution remain the main intervention to improve lung cancer control.

Medical Device Regulation and the Proposed Therapeutic Products Bill: Devising a New Regime

2021 ◽  
Vol 52 (2) ◽  
pp. 319-342
Author(s):  
Laura Hardcastle
Keyword(s):  
Patient Safety ◽  
New Zealand ◽  
Medical Devices ◽  
Cosmetic Products ◽  
Regulatory Oversight ◽  
Speed To Market ◽  
The Government ◽  
The Right ◽  
Promote Patient Safety ◽  
Medical Device Regulation

Despite medical devices being integral to modern healthcare, New Zealand's regulation of them is decidedly limited, with repeated attempts at reform having been unsuccessful. With the Government now indicating that new therapeutic products legislation may be introduced before the end of the year, the article considers the case for change, including to promote patient safety, before analysing the draft Therapeutic Products Bill previously proposed by the Ministry of Health, and on which any new legislation is expected to be based. It concludes that, while the proposed Bill is a step in the right direction, introducing regulatory oversight where there is currently next to none, there is still significant work to be done. In particular, it identifies a need to clarify whether the regime is indeed to be principles-based and identifies further principles which might be considered for inclusion. It further proposes regulation of cosmetic products which operate similarly to medical devices to promote safety objectives, while finding a need for further analysis around the extent to which New Zealand approval processes should rely on overseas regulators. Finally, it argues that, in an area with such major repercussions for people's health, difficult decisions around how to develop a framework which balances safety with speed to market should not be left almost entirely to an as yet unknown regulator but, rather, more guidance from Parliament is needed.

Design Challenges of the Horotiu Paa Bridge - Maximising Structural Efficiency and Economy

2016 ◽  
Author(s):  
Liam Edwards
Keyword(s):  
New Zealand ◽  
Weathering Steel ◽  
Steel Bridge ◽  
Design Development ◽  
Economic Prosperity ◽  
Total Length ◽  
The Government ◽  
National Significance ◽  
Bridge Spans ◽  
Design Challenges

The Horotiu Paa Bridge, also known as the Karapiro Gully Bridge is the largest weathering steel bridge in New Zealand. Construction of the bridge was recently completed in November 2015. The bridge is part of the Cambridge section of the Waikato Expressway in New Zealand. The Waikato Expressway is one of the seven state highways, named the Roads of National Significance, identified by the government as essential to New Zealand's economic prosperity. The bridge spans over the Karapiro Gully with a total length of 200m, consisting of four 50m long equal spans and is 24m wide, servicing 4 lanes of traffic.<p> This paper discusses the design development, key design aspects, innovations and technical challenges for the design of the Horotiu Paa Bridge.

scholarly journals Coping with a New Curriculum: The Evolving Schools Program at the Carter Observatory, New Zealand

1998 ◽  
Vol 162 ◽  
pp. 267-272
Author(s):  
K. Leather ◽  
F. Andrews ◽  
R. Hall ◽  
W. Orchiston
Keyword(s):  
New Zealand ◽  
Education Program ◽  
Science Curriculum ◽  
National Observatory ◽  
Education Programs ◽  
The Public ◽  
New Science ◽  
Making Sense ◽  
Astronomical Research ◽  
The Government

Carter Observatory is the National Observatory of New Zealand and was opened in 1941. For more than ten years the Observatory has maintained an active education program for visiting school groups (see Andrews, 1991), and education now forms one of its four functions. The others relate to astronomical research; public astronomy; and the preservation of New Zealands astronomical heritage (see Orchiston and Dodd, 1995).Since the acquisition of a small Zeiss planetarium and associated visitor centre in 1992, the public astronomy and education programs at the Carter Observatory have witnessed a major expansion (see Orchiston, 1995; Orchiston and Dodd, 1996). A significant contributing factor was the introduction by the government of a new science curriculum into New Zealand schools in 1995 (Science in the New Zealand Curriculum, 1995). “Making Sense of Planet Earth and Beyond” comprises one quarter of this curriculum, and the “Beyond” component is astronomy.

scholarly journals Free and Frank Advice and the Official Information Act

2018 ◽  
Vol 14 (2) ◽  
Author(s):  
Andrew Kibblewhite ◽  
Peter Boshier
Keyword(s):  
Decision Making ◽  
New Zealand ◽  
Government Agency ◽  
Government Officials ◽  
The Public ◽  
Good Government ◽  
Work Programme ◽  
The Government ◽  
The Right ◽  
Official Information

Concern exists that New Zealand hasn’t struck the right balance between two potentially competing principles of good government: officials should provide free and frank advice to ministers, and the public should have opportunities to participate in decision making and hold the government to account. Steps we have taken to address this include: strengthening constitutional underpinnings for free and frank advice (Cabinet Manual changes and issuing expectations for officials); a work programme to improve government agency practice in relation to the Official Information Act; and the Office of the Ombudsman reducing uncertainty about when advice can be withheld by issuing new principles-based guidance and providing more advisory services.

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