Cancer service 'always doomed'

20:20, May 31 2009

Staff from Wellington's embattled child cancer unit have accused management of making empty promises to appease worried families and say the service was "doomed from the start".

Correspondence given to The Dominion Post under the Official Information Act blames management's "hampering" attitude and lack of support for the resignations of husband-and-wife specialists Mwe Mwe Chao and Christian Kratz, who leave in August after less than a year in the job.

In a joint letter last month to Capital and Coast District Health Board chairman Sir John Anderson - copied to Health Minister Tony Ryall - non-clinical staff expressed "extreme disappointment" at the board's broken promises and accused other staff of being "obstructive and dismissive".

"Christian and Mwe Mwe have had to continuously ask for what was previously agreed ... the over-riding feeling of being unsupported and even hampered by management led to the final decision."

While there had been some progress - including extra spaces for day-stay patients, nurse training, the appointment of an additional nurse and a third specialist - they were disappointed plans for a new unit were scrapped, and requests for support staff and extra pharmacy time to ensure patients' safety had been ignored.

"We are left with the impression that this service was doomed from the start."


The resignations last year of the previous specialists, Liz Hesketh and Anne Mitchell, were provoked by similar problems and "should have alerted the board to a climate of malaise".

"It appears that the promise of the board last year [to restore the service] was a `words only' exercise to appease the vulnerable families who fought long and hard to maintain this service."

In an email response dated April 15, Capital and Coast chief executive Ken Whelan said there had been "some progress" but admitted the board could have "done better and moved faster".

He said he was committed to a service that "treats kids as close to their home as possible" and the board was working hard to retain services to do that.

Starship specialist Scott MacFarlane, who chairs the national paediatric oncology steering group, said it was "premature" to discuss future configuration of services.

"However, it is possible to say that, if patients have to move to Auckland or Christchurch, current resources are insufficient to provide an appropriate standard of care."

The 15 months before the new Wellington specialists started put a huge amount of stress on the other two hospitals.

"The thought that we may have to do it again is an appalling one."

Child health manager Kay Hudson said: "We are committed to providing child cancer services from Wellington Hospital. The only question which remains unanswered is what level those services can extend to."


February 1999: Review of Wellington child health shows current services neither clinically nor financially sustainable and "rationalisation" of child cancer services needed.

November 1999: Child cancer unit threatened with closure after sole specialist Wayne Nicholls resigns.

2000 to 2007: Succession of specialists and locums staff the unit.

July 2007: Paediatric oncologist Liz Hesketh leaves for Australia. The unit closes to new patients. Over the next 12 months, 45 children are sent to Auckland or Christchurch for treatment. Dr Hesketh later says she left because of "dwindling resources and a unit moving toward unsafe clinical practice".

October 2007: Capital and Coast votes to seek alliance with Canterbury to create joint service.

January 2008: The sole remaining paediatric oncologist, Anne Mitchell, quits. Clinical support from Christchurch keeps the ward afloat.

October 2008: Husband-and-wife team Christian Kratz and Mwe Mwe Chao hired to run the service.

April 2009: Drs Kratz and Chao quit.

The Dominion Post