Hard News by Russell Brown

Tricky issues

With the latest allegations against Taito Philip Field, Helen Clark had little choice but to invite the police to decide who is telling the truth: her former minister - and currently suspended MP - or the Thai tiler who now says he was promised a visa in return for doing unpaid work on Field's house in Samoa.

Frankly, Field has been dog tucker in one way or another for months, and the latest round of allegations seem the clearest and most serious yet. But for Labour there's a world of difference in electorate politics between the police bringing a prosecution and the party precipitately giving him the chop. It seems fair to say that the only people who value Field's presence are in the National Party.

Meanwhile, our guest commentator, "Rex", gets the Kiwiblog treatment.

Last night's 60 Minutes programme on Pharmac's refusal to extend funding of the breast cancer drug Herceptin (it is presently only funded to extend the lives of women with advanced breast cancer) was a Rod Vaughan special: emotive and uninformative.

The decision seems harsh, but perhaps if Vaughan hadn't spent so much of his report chanting the same phrase about how many New Zealand women were going to die he could have asked a New Zealand representative to explain it. He could have talked a New Zealand doctor. He could have spoken to Women's Health Action director Jo Fitzpatrick who this week endorsed Pharmac's decision:

"They're right to be cautious about it. From media reports, you would think if you got Herceptin, that was going to be your saviour; you were going to live," she said. "But it's not the difference between life and death for most women."

The New Zealand Federation of Women's Health Councils has expressed a similar view. Not that you would have picked that up from Vaughan's report: the New Zealand patient was going to die and the Australian patient (who, it slipped out, had a lower risk of reoccurrence before treatment) was going to live. Simple as that.

Vaughan could have looked at identical controversies overseas, including in Britain, where it went all the way to the Court of Appeal, and Australia, where Fran Boyle, the Australian oncologist who was so critical of New Zealand policy in the report was until recently equally critical of the Australian funding stance. He could have asked the company marketing it, Roche, why it's so expensive (the Scoop report linked to there also notes a typically wild statistical misstatement on risk rate reduction by Susan Wood on Close Up).

He might have looked at the Guardian story from earlier this year, The selling of a wonder drug, which looked at the way Roche, the company marketing Herceptin, funds advocacy groups. Or this story from April in Cancer World, which began thus:

Herceptin may turn out to be the biggest advance in treating breast cancer since tamoxifen. But if we are to prevent soaring drugs bills eating up our health budgets or barring Europe’s poorer patients from the latest therapies, cancer professionals will have to wrest back the debate from the unfettered hype of the mass media.

The story, which is really worth reading, notes the research on the short-term Herceptin treatment Pharmac says it is investigating, suggests that the widely-aired claim that 22 OECD countries are funding it already is not quite what it seems, and observes that Herceptin isn't the last word, but the first of a new generation of cancer treatments (including others for breast cancer) that cannot all be funded without bringing down public health systems.

Vaughan might also have pondered who would miss out if full treatment - amounting to around half the annual hospital drug budget - had been approved. In the Canadian province of Ontario, among the first to fast-track approval and funding last year, multiple myeloma patients asked why their expensive wonder-drug wasn't being funded too. The neighbouring province of British Columbia funded Herceptin by cutting off funding for the treatment of other cancer sufferers.

Vaughan might also have asked National's campaigning MP Jackie Blue how such funding would have been accommodated under National's own health budget (clue: it wouldn't).

But I guess that would have been a bit more work. Women with breast cancer have every right to advocate for a better treatment, and to feel desperately angry that it's not available. None of us would probably feel any different. But I think our current affairs professionals owe it to us to look at such issues properly, and not dash off one-sided, disease-of-the-week efforts like that.