OPINION: Investing in early detection will help more people than expensive late-stage drugs, writes Kushlan Sugathapala.
I was diagnosed with cancer early last year.
Early detection, flagged by my GP, meant that only surgery was needed, not the prolonged, more invasive and more expensive radiation or chemotherapy.
A visit to your GP can prevent an illness from escalating to hospital stays that cost taxpayers thousands of dollars or acute, long-term conditions that cost tens of thousands in health dollars.
Yet, because adults must pay for GP visits, nearly 13% of New Zealand adults missed GP visits last year because they didn't have the money. This was especially the case if they were female, Māori or lived in a highly deprived area.
This shortsighted policy costs our health system billions of dollars every year.
The World Health Organization (WHO) says 95% of cancers (the largest cause of death in New Zealand) are detected following GP referrals.
WHO advises investing in primary healthcare first.
"[We] need to invest first and foremost in strong primary health care, emphasising health promotion and disease prevention ... no country can afford to rely on curative care," it says.
"By promoting health and preventing disease, countries can prevent or delay the need for more expensive services."
An ounce of prevention is worth a pound of cure
The NHS in the UK and Canada's highly regarded health system provide free GP visits, medicines and dental care for all residents.
In New Zealand, we spend almost nothing on prevention.
The Health Promotion Agency of the Health Ministry, which promotes activities like quitting smoking, spent only $38 million last year — a tiny fraction of our $30 billion annual health budget.
Both major political parties have been reluctant to tackle commercial determinants of health — that is private sector activities harmful to health, which can be curbed at almost no cost.
Restrictions on fast food advertising and sugar taxes have been implemented in the UK, but advocacy by academics and activists has fallen on deaf ears here. Politicians must do what is squarely in their wheelhouse, like restricting unhealthy commercial activities and reducing poverty.
Increasing obesity, heart disease, diabetes, workforce needs, and an ageing population mean we need to be smarter about healthcare.
The NHS in the UK wants to transform "from a national sickness to a national health service". It is setting up shop outside supermarkets to get physical and genetic data from five million Britons and track their health to look at possibilities for early intervention, using artificial intelligence to crunch data.
The NHS is focusing on middle- and low-income earners to close the life expectancy gap of 10 years between the richest and poorest areas in the UK.
New Zealand's life expectancy gap between the richest and poorest areas is more than nine years. We live longer but spend more years in ill health than we did 30 years ago, increasing health costs.
Budget priorities
I welcome this week's increase in the Pharmac budget.
However, investing in early detection will help more people than expensive late-stage drugs, some of which extend life for only a few months.
Successive governments have invested in free GP visits for children. This is no doubt why just 1% of children missed a GP visit last year.
It's time to extend these free GP appointments to adults.
Minister of Health Dr Shane Reti, highly qualified and himself a GP for almost two decades, says he wants to "get community and primary healthcare right".
So will Reti get the funding needed to significantly improve primary healthcare in the upcoming budget? Or will coalition politics triumph over science and expertise?
Kushlan Sugathapala is a researcher and writer on social justice issues.
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