Call for Māori staff to curb cancer rates

6:54 am on 23 May 2016
Polly Marsters, Cancer Coordinator at Te Runanga O Raukawa

Polly Marsters, Cancer Coordinator at Te Runanga O Raukawa Photo: SUPPLIED

They said there was a breakdown in care and communication with Māori with cancer, and services were fragmented.

Māori are also 50 percent more likely to get cancer than non-Māori.

Public health specialists at Massey University recently published findings in the New Zealand Medical Journal showing the mainstream health system did not respond well to the needs of tāngata whenua.

They also found a lack of appropriate information was a barrier to cancer services for communities served by Māori Health Providers.

The research showed quality of life differed between Māori and non-Māori from diagnosis through treatment, as well as whether the cancer returned and survival rates, the authors said.

A cancer coordinator with Te Rūnanga o Raukawa, Polly Marsters, said if there was more sharing of information between mainstream health services and with Māori Health Providers, outcomes for Māori would be improved.

"Anybody would benefit from more information, better care, but moreso Māori," she said.

"I know we go through the system and our system here is trying, but unfortunately it's just not enough. If it was working our statistics wouldn't be so bad."

Ms Marsters was critical of what she said was a lack of formalised follow-up treatment and support for Māori.

There were gaps in care, with doctors not always knowing the outcome of hospital stays and Māori health providers being left out of the loop as well, she said.

"With communication breakdowns somebody could miss out on vital treatment that could either determine whether or not he's here in five years."

Ms Marsters said even when patients had signed off giving Māori health providers access to their information in hospitals they had to work hard to convince staff to share it.

She said they were viewed as being less legitimate than other care services.

"We always have to try harder than if we were with a PHO (Primary Health Organisation) or with the Cancer Society, we have to justify why we're there over and over again."

Tira Albert, manager at Mana Wahine, Kokiri Marae, Lower Hutt.

Tira Albert, manager at Mana Wahine, Kokiri Marae, Lower Hutt. Photo: SUPPLIED

Tira Albert is the manager at Mana Wahine, Kokiri Marae in Lower Hutt.

Ms Albert said providers' advice to hospital staff was ignored.

She said there were few Māori staff in palliative care and there was an urgent need for more.

"They should be appropriately trained, just because they're Māori that doesn't mean they're going to have all the knowledge, but it basically comes down to respect.

"Yes, there should be more Māori staff in hospices - and not just the cleaners I have to say!"

"With the whānau that we work with, and even my own self, I would feel immediate warmth to somebody that I'm akin to.

"That would also give me the courage to speak freely and know that I'm going to get a real response."

Ms Albert and Ms Marsters said care services should ensure information was shared electronically to ensure they were joined up.

That way they and the patient and whānau knew what treatments were occuring and when and could be followed up.

Chrissy Paul from the Te Wakahuia Manawatu Trust agreed there were inequities.

She, along with other Māori health providers urged the Ministry of Health to install full-time dedicated Māori cancer 'navigators' in hospitals to guide tāngata whenua through the process from diagnosis to recovery or palliative care.

"I'm a cancer navigator 20 hours a week and then the rest of the time I'm working on community development and other projects so most of us can be spread quite thinly."

Ms Paul said patients and their whānau were left isolated with no clear handover and transition into community services.

Ministry of Health acting chief medical officer Andrew Simpson said in a statement the ministry was aware of, and had acknowledged the need for, dedicated cancer navigators.

"We are currently implementing the faster cancer treatment programme, which aims to reduce waiting times for appointments, tests and treatment, and to standardise care pathways for all patients," he said.

The programme had an explicit aim of reducing inequalities in Māori cancer experiences and outcomes, he said, and had already taken some steps towards that.

"The cancer nurse co-ordinator programme is a dedicated fund for nurses to co-ordinate the care and support for patients through the course of their cancer treatment.

"The ministry has appointed nurses in cancer nurse co-ordinator roles which will improve the experience for patients with cancer or suspected cancer, as well as their family and whānau, and also improving overall access and timeliness.

"Another enabler of the FCT programme is the Service Improvement Fund, where funding has focused on supporting DHBs to make sustainable service improvements in the cancer-patient pathway.

"The Bay of Plenty and Nelson Marlborough DHBs are among those working towards the achievement of the FCT goals by exploring health equity issues for Māori with cancer."

The chair of Hospice New Zealand's Maori advisory group, Ria Earp, said hospices were trying to address how they related to Māori communities and include appropriate ways in their standards for them to work with Maori patients and whānau.

While the number of Māori training to be doctors has risen, Ria Earp said they tend to be attracted to working in early development and preventative areas of health.

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