Faster, More Accurate Brain Tumour Diagnoses For Kiwis
More than 100 New Zealanders have already benefited from a groundbreaking diagnostic tool that is delivering faster, more accurate brain tumour diagnoses, Health Minister Simeon Brown says.
DNA methylation profiling, the international gold standard for diagnosing brain tumours, has been rolled out at Auckland City Hospital over the past year.
'This technology is a game-changer for brain tumour diagnosis in New Zealand. It enables doctors to pinpoint the exact tumour type with greater precision and in less time, meaning patients can start the right treatment sooner,' Mr Brown says.
'Until now, diagnosis was typically made by microscopic examination. In some complex cases, samples were sent overseas for methylation profiling, but that could take up to six weeks.
'Having this cutting-edge capability in New Zealand means more Kiwi patients can access this advanced diagnostic technology locally. Turnaround times are faster, around four weeks, and quicker for urgent cases.
'It also means we can prioritise urgent cases, deliver answers sooner, and give patients and their families greater certainty.'
In some recent cases done locally, methylation profiling has significantly altered the initial diagnosis. In others, it has identified rare or unexpected tumour types that may have been missed using traditional methods.
The Auckland-based service is one of only three in Australasia, with samples from hospitals around the country also being sent to Auckland for analysis. Along with improving access and outcomes for patients, it is also significantly cheaper than sending samples offshore.
'Delivering faster access to cancer treatment is a key focus for the Government, which is why it is one of our five national health targets. Faster, more accurate diagnosis for brain tumours that may be cancerous is a vital part of that.
'By providing local access to the world's best diagnostic tools, we are improving outcomes for New Zealanders,' Mr Brown says.
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The original Pae Ora Act had come into effect three years earlier in July 2022. The amendment bill is now with Parliament's health committee. Brown's speech included the following: 'This Government is firmly focused on delivery. That's why we're legislating health targets – not just talking about outcomes but making them law – because what gets measured gets managed. 'Let's be clear about what those targets are: shorter wait-times in emergency departments; faster access to elective surgeries like hips, knees, and cataracts; on-time immunisations for our children; faster access to cancer treatment; shorter delays for first specialist appointments.' Later in his speech he added: 'Mandating the health targets in legislation provides clarity and certainty for the entire health sector going forward.' There are two defining pieces in his speech. First, 'what gets measured gets managed' and second, the legislative mandating of this 'provides clarity and certainty' for the entire health sector into the future. Potted history of health targets There are two essential ingredients to health targets if they are to be effective. First, they need to make good clinical sense. Second, they need to lead to systems improvement in some way. Health targets were first introduced in 2007 by Labour health minister Pete Hodgson. After the 2008 general election National health minister Tony Ryall kept half of Labour's targets – elective surgery, cancer treatment, immunisation, smoking, and heart and diabetes checks. He also added a sixth new target of cutting emergency department waiting times. Some targets contributed to better outcomes but not necessarily to systems improvement because it was difficult to distinguish between them and other measures (particularly heart and diabetes checks and smoking). Increased immunisations was successful as an illness prevention measure although it is now struggling due to the small but strident anti-vaccination movement that arose out of the Covid-19 response. It was the other three targets, however, that attracted the most prominence and controversy. One was improved access to planned (elective) treatment, mainly surgery. This involved timeframes between general practitioner referrals for first hospital specialist assessments and, following this assessment, for patients to be treated. The second was the time for diagnosing and treating (where necessary) patients graded with a high suspicion of cancer. The third and most significant target in terms of systems improvement was shorter stays in emergency departments; specifically, 95 percent of patients should be either discharged or admitted into the main hospital within six hours. There was a high level of emergency medicine clinical leadership in its design. Further, it was not just about what happened in emergency departments; they are a barometer of how well hospitals performs. The target required a hospital-wide response because the key challenge was not patients who could be discharged from the department without being admitted into a hospital ward as an inpatient requiring further investigation or treatment. Instead the key challenge was those patients who required hospital admission. This meant that there had to be available inpatient beds for them to be admitted. When hospital bed occupancy is 100 percent (or close to it) it is called 'bed-blocking'. Unfortunately, the then-National-led government erred in hyping up the targets by incorrectly asserting that they were a measure of productivity improvement. This monitoring narrative was judgemental and punitive. Consequently it incentivised various forms of 'gaming' within district health boards (managerially rather than clinically driven) in order to appear to meet the target. 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Although less comprehensive and more prone to 'gaming' than Labour's health indicators, there were two useful specified target enablers – workforce and infrastructure. From policy to legislation Under successive governments from health ministers Pete Hodgson to Shane Reti, health targets (and indicators) were policy-based. Now, under Minister Simeon Brown they are to become legislatively-based. As part of a wider amending bill specified health targets would be included in the Government Policy Statement. These specified targets are: cancer management care; immunisation of children; admission to, and discharge and transfer of patients from, emergency departments; specialist assessments; elective treatment; and access to primary care. The upside of these legislative targets is that although narrow in scope (at least in respect of hospitals) they are not prescriptive. 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