Wednesday is a special day for the Border region.
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After many years of hard work, we will see the official opening of the Albury Wodonga Regional Cancer Centre.
It’s a day of celebration for the cancer workforce and the thousands of patients and families on the Border that have been affected by cancer. (When I stop to reflect on how many patients have been treated and how many are not here today it is quite overwhelming.)
I don’t think we should underestimate the hope and expectation this centre symbolises for many people.
There are many patients who have privately told me they were “hanging on” to see the cancer centre built.
Some have managed to do that, others have fallen along the way.
Wednesday’s official opening is a government and media event and many of those who brought the centre to fruition and did the unpaid work will not be able to attend.
I would like to thank all those who helped and point out the national significance of this and other regional centres that have been recently commissioned.
The opening of the AWRCC marks the end of a decade of rapid progress in the development of cancer services in regional Australia.
Only a decade ago there was emerging evidence of a growing gap between cancer survival and regional and metropolitan patients.
Regional patients were more likely to die of common cancers compared to their city cousins.
One of our national organisations, the Clinical Oncological Society of Australia (COSA) decided to look into reasons why.
It mapped existing cancer services in regional Australia and some of the results were stark.
Services simply didn’t exist in some areas.
There were only a handful of cancer specialists living outside the city.
Some areas had untrained practitioners delivering chemotherapy.
I saw my mother-in- law and my father, both living with cancer in regional Australia, having to drive long distances to access chemotherapy and radiotherapy treatment.
Every day I saw people refusing treatment, as it was sometimes just too difficult to travel for treatment.
People were unable to access treatment or choosing not to have treatment or being treated in basic facilities that would be considered unacceptable in the city.
Here was the link between lack of facilities and people dying.
The report called for governments of all jurisdictions to build a network of cancer centres in the largest cities in regional Australia.
These would provide a hub better cancer care, the introduction of new treatments and better models of care, for more research, and for training and support of smaller centres in the region.
COSA decided that the situation was unacceptable and it became a political story.
We spoke to the media and went on ABC’s Four Corners.
We lobbied health ministers and bureaucrats across the country.
They listened and in 2009 the treasurer at the time Wayne Swan announced a $550 million funding round to build a number of regional cancer centres across Australia.
Kevin Rudd called this one of the great achievements of his government.
Of course our local politicians, including Sussan Ley, Sophie Mirabella, Greg Aplin and Bill Tilley, all helped to lobby on our behalves but I believe that their influence was limited by us not living in marginal seats.
We were all very disappointed to miss out on funding in the first round.
Health minister Nicola Roxon came to announce funding for a PET centre (which has been a great success) but at the time felt like a consolation prize.
She toured our existing cancer facilities and looked and listened and announced that we indeed had a good case and she invited us to Canberra to talk to senior bureaucrats.
We had to become better politicians.
The medical staff and administrators lobbied hard and the community lobbied hard.
The Victorian government lukewarm in the first round become our strong advocates in the second round.
Organised by Eric Turner, Jenny Black, Marrianne Warren, Susan Stephens and many others, 1400 people representing the number of people diagnosed in the immediate region each year, turned up in yellow ponchos on the banks of the Murray.
I think we had an unstoppable case.
On Q&A, live on national TV, Simon Crean made the announcement we had been waiting to hear.
I would have to say it was, at times, an exhausting process.
Many people gave up many hours in unpaid work to get this project over the line.
Thanks to everyone who wrote letters, posted on social media and turned up.
Those deserving special thanks include, of course, my family, and colleagues Richard Fox, Kerrie Clarke, Richard Eek, Christopher Steer, Stuart Spring, Roger Snell, Doug McCrae, Aldo Rolfo, Stuart Baker, Glenn Davies, Catherine O’Connell, Sabe Sabesan, Margaret McJannett, Paul Grogan, Adam Chapman, Elise Davies, Bruce Mann, David Goldstein, Nicki Melville, Andrew Watson, Greg Pearl, Kerry Strauch, Leigh McJames, Helen Zorbas, Rosemary Knight, David Currow, Jim Bishop and Di Thomas and many others all made significant contributions to the Cancer Centre Program at a local, state or national level.
The biggest unsung hero to me, always contributing and always going the extra yards was Christine Packer.
We had a good cancer service before but now we are ready to fly.
It is just the start.
By bringing services under the one roof the centre will move us to another level.
It will catalyse research into new treatment and improved ways into delivering care more effectively, it will fast track new diagnostic methods and treatments, it will be a research and training hub.
It will help catalyse changes that we can’t even imagine now.
This centre can be part of a network of centres in regional Australia, linked to metropolitan centres and providing equal access to high quality care.
The buildings are commissioned but now how can we network them and use them to really drive rapid improvements in patient care?
The exciting thing is many of our governments and national groups are now discussing these very questions.
The buildings are open but we need ongoing funding commitments for the funding of services within these buildings.
To the political classes, it’d like to pose some questions.
Why did we need to go through this drawn out political process to get facilities comparable to the city?
At the same time that regional Australia was grateful for $550 million in funding, several billion was spent at metropolitan centres.
Recent evidence is that disparity in cancer outcomes between metropolitan and regional Australia continues to widen.
The excess in cancer deaths in regional Queensland in just breast cancer and bowel cancer alone over a 10-year period is estimated to be 3500 lives.
Why is this acceptable?
Please don’t make our cardiologists or the surgeons or the ED staff and critical care staff have to lobby and get the community to march in the streets to bring our regions services up to an acceptable standard.
There are many critical gaps in our current health services locally.
Albury-Wodonga Health deserves its masterplan to be funded.
Why do we not have equity of access to health facilities in regional Australia?
Why are our taxes and medicare levies spent more per capita in cities?
Why does this ongoing disparity seem entrenched?
It is time, I believe, that our health dollars are allocated on a more equitable basis based on population needs.
We need equity in access in regional Australia to all health services not just cancer.
Proper investment in health services in our region provides a critical basis for people to want to live in the region and will drive other investments across the economy.
Wednesday is a celebration but it’s also a time of reflection and a time to start again.
Craig Underhill is an oncologist and clinical director cancer services at Albury Wodonga Health