Sad ironies as patient’s advocacy lives on

Melissa and Blair Vining attend a 2019 celebration of his petition for a national cancer agency...
Melissa and Blair Vining attend a 2019 celebration of his petition for a national cancer agency reaching 140,000 signatures. PHOTO: LUISA GIRAO
Parliament does not usually set out to be deliberately ironic, but often the way its processes work mean that it inadvertently gives one cause to shake one’s head.

Take last Wednesday for example, when the health select committee reported back to Parliament on the combined petitions of Blair Vining and 142,791 others.

Mr Vining, a humble Southland farmer with no thirst for public attention, became one of the country’s most recognisable people in 2018 after an egregious chain of scandalous events left him and his family facing a diagnosis of terminal bowel cancer.

Triggering an almighty sense of injustice was Mr Vining receiving a letter which said that an oncologist could possibly see him in about 12 weeks, just after he had been told that he had between six to eight weeks to live.

As it turned out, the medical profession — in oh so many ways — underestimated the stamina and stubbornness of Mr Vining.

Through sheer grit and determination, Mr Vining lived on much longer than expected. He was driven not only by a desire to see several family milestones passed, but also by a heart-felt need to help others in the same predicament as himself.

Mr Vining sensed that there would be thousands of others whose longevity was threatened by what has come to be called the post-code lottery, and he was right.

Among his demands was the establishment of a centralised cancer control agency to co-ordinate treatment of the deadly disease on a national level, a wish the government acceded to three years ago.

Despite knowing all that, Parliament still has a legal process to go through, so last week the health select committee released its report on Mr Vining’s petitions, even though their plea, like his letter promising an appointment with an oncologist, had already passed beyond the deadline of being personally relevant — Mr Vining died in October 2019.

If Parliament can dish out the irony, what about the universe in general?

A week after the select committee had asked the House to take note of its report, Health and Disability Commissioner Morag McDowell released an own-initiative investigation into cancer services in Otago and Southland from 2016-22 and found them sorely lacking.

Parliament might have turned the page on Blair Vining but the Vinings do not go away that easily.

Blair’s widow, Melissa, is twice as determined and then some when it comes to fighting for the rights of cancer patients, and it was her pleas to Ms McDowell which not only inspired the commissioner to take the rare step of initiating a sector-wide examination under her own steam, but also to broaden its initial scope so that it encompassed Blair Vining’s case.

While the tale of Mr Vining — thinly veiled in the anonymised report as the husband of "Ms A, a patient advocate" — is well known, the stories of hundreds of others, who are represented in the HDC report by some alarming facts and figures, are not.

The report paints a picture of increasingly desperate clinicians trying to warn administrators of a looming cancer care crisis, only to find their colleagues so petrified of antagonising the Ministry of Health by blowing out an already crippling deficit still further that they neglected the foundation upon which the health system is built — to help the sick and to abstain from all intentional wrongdoing and harm.

Management questioned the methodology by which the cancer statistics were compiled, while the doctors compiled a small snapshot of data which showed that dozens of people each month were being harmed by having to wait for treatment which for all too many of them — including Ms A’s husband — would come too late.

Health and Disability Commissioner Morag McDowell was scathing of cancer services in Otago and...
Health and Disability Commissioner Morag McDowell was scathing of cancer services in Otago and Southland. PHOTO: SUPPLIED
Those patient-harm registers were crucial to Ms McDowell’s findings and strongly suggest that the situation faced by cancer patients in Otago and Southland is one endured by people throughout the country.

Many important political questions arise out of this report.

What price health?

For a start, has the dilemma faced by all governments — of wanting the best health system possible but not having the money to pay for it — been tilted too far on to the "paying for it" side?

Yes, health is expensive and yes, it is incredibly hard to find the specialist clinicians needed to provide cancer treatment — but one of the few things which wage and salary earners will unbegrudgingly hand over their tax dollars for is a properly functioning health system.

The quandary of the southern cancer system is mirrored on the much larger stage of the new Dunedin hospital.

In this case clinicians of every department have been desperately trying to secure enough space in the dwindling inpatient building to care for their patients, but inflation is eating away at the contingency the Government has set aside to pay for what until yesterday was a $1.5 billion project.

To borrow the phrase this newspaper is using for its campaign for the Government to build the hospital as signed off by the Cabinet in the project’s detailed business case, most people would say "our health is priceless".

This Government has spent a record amount on health care and has chewed through four health ministers in the process.

For all its multimillion-dollar investment in Dunedin, the Government was about to be confronted by a major election issue in two seats which should be safe but in which, nevertheless, many voters are righteously angry with it.

How ironic would that have been?

Too ironic it turns out, and yesterday the Government upped its funding for the new Hospital — which now has a 1.68 billion budget — and called a halt on any substantial redesigns.

The whole episode shows, just like the story of the Vinings, that if ordinary people raise their voices sometimes Parliament just has to listen.

mike.houlahan@odt.co.nz