In April 2019, Minister for Health and Aged Care, Greg Hunt and Senator the Hon. Bridget McKenzie, Minister for Regional Services committed $63.4 million towards a federally funded initiative that will provide greater access, help and support for people fighting cancer. This commitment included funding for new centres to deliver high quality, comprehensive radiation oncology services to thirteen regional areas including the Eurobodalla.
This initiative was endorsed by the Radiation Therapy Advisory Group & Radiation Therapy for Regional Australia.
A similar pre-election commitment was made by the Leader of the Opposition, the Hon Bill Shorten MP and Shadow Minister for Health and Medicare, the Hon Catherine King MP, to boost cancer services for people in the Eurobodalla by investing in a local radiation therapy facility.
Due to this bipartisan policy, the Eurobodalla community understandably interpreted these statements as " a done deal" for local radiotherapy services regardless of the electoral outcome.
In August 2020, under Greg Hunt's Ministry the public and private service providers were invited to apply for grants totalling $45.5 million, to develop regional radiation treatment centres for local cancer patients in ten regions across four states, including South Coast (Bega/Eurobodalla).
Tenders closed on Wednesday 7 October 2020. SNSWLHD did not submit an application.
"Following the release of the Commonwealth grant opportunity, SNSWLHD underwent a process to determine the potential viability of establishing radiation therapy services at the South Coast (Bega/Moruya). In the end, SNSWLHD did not submit an application.
Unfortunately we have no visibility of applications from private providers. The only private application we are aware of is the application by Cancer Care Associates for Griffith. The three successful applications that we know about were made by Northern NSW LHD, Mid North Coast LHD and Cancer Care Associates."
SNSWLHD
The following note to NSW Health was also provided to the December 2020 meeting of the SNSWLHD Board:
Response to NSW Health on exploration of options for radiation therapy services
Cancer patients in SNSWLHD access radiation therapy (RT) services via Canberra and Nowra, making use of existing accommodation facilities at both centres. Canberra Health Services is improving patient accommodation facilities as part of the Canberra Hospital Expansion Program. This process has involved consultation with SNSWLHD residents to ensure that patients accessing RT services in particular can be accommodated.
In August 2020, the Australian Government Department of Health announced a grant opportunity for funding to assist with building regional radiation treatment facilities on the NSW South Coast (Eurobodalla or Bega Valley). SNSWLHD has been approached by private organisations expressing partnership interest in the grants.
Commonwealth capital grant funding of $5 million (non-recurrent) to build and install RT infrastructure in the Bega Valley or Eurobodalla could be used to purchase a proportion only of the building and equipment required for a public RT service. SNSWLHD took advice, including from the Cancer Institute NSW, that public-only RT services are not viable in regions with populations under 400,000. With approximately 70,000 people, the South Coast population is unlikely to have the capacity to supply the required team of specialist staff or patient caseload. Establishing a public radiation therapy service lacks evidence of viability.
Two private organisations – Icon and Genesis - have proposed partnerships to deliver RT services, subject to annual co-payments from SNSWLHD. The proposals estimate projected service demand, document high-level building and equipment requirements, and outline strategies for staff recruitment. Both organisations offer RT services with no out-of-pocket costs for patients and clinical support from their existing networks. Statements of service sustainability and quality are included but not sufficiently detailed. Potential partnerships with private providers lack evidence of affordability, sustainability and quality.
SNSWLHD has declined the Icon and Genesis partnership proposals and has not submitted an RT grant application."
Above: SNSWLHD took advice, including from the Cancer Institute NSW, that public-only RT services are not viable in regions with populations under 400,000. With approximately 70,000 people, the South Coast population is unlikely to have the capacity to supply the required team of specialist staff or patient caseload. Establishing a public radiation therapy service lacks evidence of viability. Therefore, due to the population of the South Coast of NSW, an application was not submitted for any portion of the proposed grants. No consideration was made of any alternative or innovative models of care to improve the cancer services to the population of the South Coast of NSW.
One half of cancer patients would benefit from radiotherapy but only 1/3 actually receive treatment.
It is estimated that approximately 30 women per year die in NSW from underutilisation of radiotherapy for breast cancer. Many of these women would be geographically isolated.
There is no radiotherapy service on the 350km of the NSW coast south of Nowra.
Patients in the Eurobodalla are 2.5 - 3.5 hours from the nearest radiation oncology services in the ACT or Nowra.
There has not been a single radiotherapy consultation in the Eurobodalla or Bega since at least 2018.
25% of cancer services services in the ACT are provided to SNSWLHD residents.
The Eurobodalla has the highest aged population in Southern NSW and has the highest rate of:
- lung cancer
- colorectal cancer
- prostate cancer
- breast cancer
- pancreatic cancer
- cancer of unknown origin
The incidence of cancer in Southern NSW by 2024 is estimated to be 1710. (4)
There is estimated to be a 64% increase in cancer cases in the region by 2031 and an extra 100 cancer deaths per year.
The decision of the SNSWLHD to not apply for a potential $5 million from the Fighting Cancer - Regional Cancer Treatment Centres for Radiation Therapy (GO3613) on the basis of population is in contradiction to the Federal Government policy to provide these services in rural and regional areas of equivalent populations (Mt Gambier/Limestone Coast, Geraldton, Gladstone, East Gippsland, South Gippsland and Clarence Valley)
The Minister for Health and Aging, Greg Hunt, has been asked to intercede on this matter to the SNSWLHD and NSW Minister for Health and Medical Research to review their decision and progress with application for the funding offered by his Ministry and the expected provision of radiation oncology services on the South Coast of NSW.
