Prof. Chris Jackson
@drkiwicj
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Professor of Oncology @Otago . Drug and cancer policy research, and clinical practice. Arguments fine; abuse=block. Spouse of @BrookingRachel , often disagree.
Dunedin NZ
Joined October 2014
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National/Act/NZF coalition agreement scraps smokefree environments amendment act.
That legislation has the potential to be the single most important step against cancer in our lifetime.
Huge blow for cancer prevention.
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I've never seen the health sector so unified as they are opposing the
#Smokefree
changes.
And universally, every health professional and academic I have spoken to thinks scrapping the smokefree changes will cost lives.
Every. Single. One.
The health advice is clear.
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Māori are 20% more likely to get cancer and twice as likely to die from it.
Inequities by ethnicity are real, pervasive, and unfair.
Doing nothing about that means you're fine with that.
Not this doctor.
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So we've lost Te Aka Whai Ora, Smoke free laws, free prescriptions for the sick and needy, and haven't got the free cancer drugs that we were promised.
Not the kind of transformational change our health system is needing.
#budget2024
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Would like to see the Herald run a story about people who decide to stay put in NZ because they like it and it has a lot to offer.
Would be a nice change, and there seem to be a lot.
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So far,
@drayeshaverrall
has -
- overhauled contact tracing
- made fluoridation centrally decided (read: compulsory)
- moved to self testing HPV screening
- fortified bread
And today,
- outlawed cigarettes for a generation
Reminder: this is *year one*.
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The Venn diagram of people getting outraged at "Meri Kirihimete", who also post anti-Ardern and anti-Vax sentiment is quite the circle.
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The thing about telling hospitals to "live within their means" is that it's govt who decides what those means are.
A hiring freeze on doctors and nurses is a political choice.
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My colleagues who treat lung cancer say rolling back smoke free would cause more smoking deaths.
Mark Patterson MP
@markpfarmer
says they're catastrophising.
Do you know what's really catastrophic?
Being diagnosed with lung cancer.
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Wait, what? Govt talking points on
#Smokefree
weren't evidence based, or supported by official advice?
What then were the reasons for repealling smokefree? Couldn't have been
#BigTobacco
influence, could it??
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So we're going to have legislation introduced to reverse
#smokefree
laws that will be passed under urgency, without select committee review, without public consultation, based on false assertions, that experts and officials reject.
This is not how serious govt shd work.
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"Backroom staff" in health are people like our schedulers who make the appointments, and people who type letters that allows communication between hospitals and primary care.
I can't run my practice without them, and patient care suffers.
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Vaccines, hand hygiene and surgical masks slow the spread of the virus, keep cancer services working, and protect the immune compromised.
People who have their operations or chemo cancelled because of staff sickness or a full ICU will suffer. THAT'S why we do this. Together.
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The grade you get in first year health sci doesn't predict what kind of doctor you will be. No one has a right to med school entry and we need a workforce that reflects our community. That means more Māori and Pasific doctors.
#mirroronsociety
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I agree with Seymour and think PHARMAC's focus on Te Tiriti *has* been performative.
Just in the opposite direction to what he thinks.
There has *not* been enough engagement with Mana Whenua or any major pro-Māori decisions on cancer I can remember.
1/2
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2.47pm. Receive email from PHARMAC w proposal to fund drugs for breast cancer, lymphoma, acute myeloid leukemia, and myelodysplastic syndrome.
#thatwasquick
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Listen at 1min50.
The changes in Smokefree legislation *are part of a plan* to fund tax cuts.
Let that sink in for a bit.
Where is National going to find the money for tax cuts without a foreign buyers tax, and what does Nicola Willis mean by 'trimming the package'?
#NationNZ
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Wishing
@MaramaDavidson
the very best as she embarks on treatment for breast cancer.
No one is immune - as Marama said
#getscreened
Very humble of her to acknowledge the support she has that others may not.
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By abolishing Te Aka Whai Ora and sacking Te Whatu Ora / HNZ board, the Minister of Health now really is personally responsible for the functioning of our health system.
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@Rachel_Smalley
@NZStuff
@NewstalkZB
Hi Rachel. Interested to talk with you about conflicts of interest when I have *literally* written the report in cancer drugs.
While we're here, who's funding you?
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Have a patient on oncology ward in Dunedin who is v sick and who would love to meet any of the
@EnglandRugby
team who are in Dunedin.
Twitter can you help grant a dying guy a bucket list wish?
@NZRugby
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Oncologists know our drug access is poorer than Aus. Heck, I wrote the report.
Also, no one I've spoken to thinks PHARMAC should be bypassed, as has been proposed.
Lift the funding, let them do their job.
(and more Drs and Nurses please)
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Nationals Cancer Drug List of 13 is 3 years out of date.
How have they got this so wrong?
#updatethelist
#fundcancerdrugs
My piece in Newsroom
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Twitter can be a cess-pool sometimes so here's a picture of my new dog Alfie. Hope he brightens your day a little
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This isn't the right take on screening. If you diagnose bowel cancer at an earlier stage you need fewer drugs to treat it.
Screening catches cancers earlier with more cured and fewer needing drugs.
Win win win win win.
If you bring forward the screening age for bowel cancer and diagnose it, you need to fund the medicines to treat it. Pharmac doesn’t fund a SINGLE immunotherapy to treat bowel cancer. Those meds are sitting on Pharmac’s waiting list. National have said they’ll fund one drug -
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What this headline doesn't reveal is that the excellent Middlemore staff suspected, identified, tested and isolated this person all while in full PPE. Outstanding work by all
#healthcareworkers
involved
@CMDHB
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Anyone seen costings for proposed third NZ medical school, or number of new docs, or how long to set it up?
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Show me you know nothing about social determinants of health
@drkiwicj
@MaramaDavidson
Shame that Davidson has chosen to politicise her cancer by taking a dig at the health system about inequities Maori and Pacific allegedly face, despite acknowledging she has had great care. Shows inequities are more to do with being proactive about one's health not ethnicity
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@Rachel_Smalley
Except that's not true. Bowel screening reduces the number of people who need cancer drugs, because fewer people are diagnosed at stage 4.
Don't disagree with your point that more bowel cancer drugs would be great, but opposing screening isn't the way there.
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I think it's important that politicians are connected to the realities facing our healthcare workers.
However I am troubled by politician being with first responders, seeing vulnerable patients who may not be in a position to consent.
Questions need answering.
For nearly every weekend over 3 months to Easter, I joined an ambulance crew across the country, usually on a night shift, to see for myself how NZers and our health system is coping after dark. This was quite a body of work. The map below shows the areas and EDs that I visited.
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A peaceful protest does not bring nooses.
On. Day. One.
People who pretend otherwise are sanitizing, white washing apologists, that give oxygen to the behaviour we saw.
We cannot accept, tolerate, or normalize this.
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Sure, ending $5 prescription fees helps some people whom might not need it.
So do tax cuts for the richest, or indexing the top tax rate.
It's about who you're trying to help the most that tells us who you are.
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Big pharma licking their lips. Why would they offer PHARMAC any discounts when they've been guaranteed funding?
Would be smarter to lift PHARMAC's budget then let them do their job.
(Also, we need the funding for doctors and nurses to deliver this)
Today,
@chrisluxonmp
announced that a National Government will pay for 13 cancer treatments that are helping extend survival rates in Australia, by making them available to patients in New Zealand.
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I have no interest into anything a tobacco spokesperson has to say
@NZMorningReport
However listening to Kim Hill eviscerate one, I have a keen interest in that.
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Quite the coup for
@otago
- congrats to Grant Robertson on appointment to Vice Chancellor.
Otago will have Robertson as VC, David Clark as academic registrar, and
@BrookingRachel
as the local MP.
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2/2
Māori die 7 years earlier than non-Māori and have more advanced cancers.
Is this not need?
Why NOT prioritise investment that would address this?
#needsfirst
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@marklewismd
Mark we don't lose them, they walk with us forever, and help us become better doctors and better people. We are their companions, guides, confidants, and that is a blessing, although their company is often too transient. I hope you don't feel their deaths as your own failing.
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Some people more concerned about imperfect targeting of the cost of living payment than they were about the wage subsidies effectively going to shareholders as profits.
Orders of magnitude of difference.
Lots for me but not for thee.
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After repealling our world-leading
#Smokefree
laws, Minister for Big Tobacco goes against evidence and advice to reduce excise tax on unproven nicotine alternatives.
Why could this all be?
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Big news re Dr Bloomfield's resignatn. Having worked closely with him on cancer matters, I have always found him to be an exemplary professional, thoughtful, affable, considered, and dedicated. He has been immense thru the pandemic. A genuine servant.
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@Rachel_Smalley
@NZStuff
@NewstalkZB
Oh, and am chairing the committee on capacity in cancer related to cancer drugs.
And chair the national cancer agency's clinical committee. And sit on their council.
And your "medicines gap" website doesn't list your funding.
But sure, sure. *I'm* "biased".
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When I was at school there was a lot of bullying. I got a bag dropped on me from a mezzanine, chewing gum put in my hair, shoved into a rubbish bin, dead arms and legs etc, and frequent threats of violence. I regularly feared for my safety.
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I was diagnosed w COVID this week, 2 years after the first case hit our shores.
In that time my kids have been double vaxxed and I've had the triple, so thankfully it's mild for me and everyone else is ok so far.
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A lot of aroha following Kiri Allen's diagnosis, and people wondering what to do.
1. Vaccinate your kids against HPV (not avail when Kiri younger)
2.
#smearyourmea
(as Kiri said)
3. is a great resource for coordinating support
4. hug someone you love
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Officially first day in new role
@otago
@DSMOtago
Grateful for all the collabs that made this possible esp. with
@DiSarfati
& Jason Gurney,
@profevasegelov
, Ben Lawrence, Mike Findlay and Tak & Noelyn Hung.
Excited for the new projects and opportunities ahead
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This cancer target will achieve 100% of not much in terms of improving outcomes for NZers with cancer.
Earlier diagnosis, better access to specialists a bigger bottle neck
Our Government has today committed to five key health targets to drive better outcomes for all New Zealanders:
1️⃣ Faster cancer treatment - 90 per cent of patients to receive cancer management within 31 days of the decision to treat.
2️⃣ Improved immunisation for kids - 95 per
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This Wednesday at the Hutton Theatre, Otago Museum.
As an oncologist interested in reducing rates of cancer I am particularly interested in this topic.
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If you are against the repeal of smokefree legislation, you can sign this petition to show your support.
Please share!
'Put our People over Profit - Stop the Repeal of the Smokefree Legislation!'
We urgently call on the Government to stop the repeal of the Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act.
Sign and share the petition!!
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Not one of the bullies has ever apologised, but I hope many have grown up, and have regrets.
If one did apologize out of the blue, just prior to entering parliament, I too would question the sincerity.
I feel sick.
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#CovidVaccine
available for teenagers at #Ōtepoti
#Dunedin
Ice Stadium - drove in and thru <2 mins. Amazing job by
#TeK
āika. Next stop ice cream!
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The oustanding
@AshBloomfield
hands the reins to the brilliant
@DiSarfati
.
We are so lucky to have absolutely world class individuals dedicate their lives to public service.
These are hard jobs with big consequences and need top people.
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Clinical note bug bears:
"Patient refused chemotherapy".
Really?
Did they?
Or did they make an informed choice about options, that just so happened not to include chemo as one of the MANY options for their future care?
How we summarize events in notes really matters.
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Quick note to all political parties offering more funding for drugs -
Cancer drugs without workforce is like more buses without drivers.
People want more money for medicines, sure.
But without workforce, waitlists go up.
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26 new cancer meds is the biggest investment we've seen in NZ.
@PHARMACnz
also going to be used to negotiate and deliver.
Huge.
*Exactly* what I suggested they do when they first announced the prev policy.
Need the funding for staff and facilities or wait lists will blow.
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The most powerful of all tools in an oncologist's armamentarium is an honest and empathic conversation.
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"New" 31day
#target
for cancer a disappointing one that won't drive meaningful systems change.
It's a watered down version of Ryall's old targets that took us nowhere.
Early diagnosis, earlier stage at presentation, and wait time to see specialist currently the bottlenecks.
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Congrats
@BrookingRachel
on being selected as
#Dunedin
candidate for
@nzlabour
at the 2023 election.
An outstanding lawyer, environmentalist, governor, climate expert, and proud Dunedinite.
You have my total support.
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I believe in seeocnd chances and am certain that some who were horrible as teenagers have become good men.
Also I imagine the person who received the apology has been retraumatised as they began to see the apology as potentially insincere. I genuinely feel for them.
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UPDATE: Meds now scheduled to arrive 1630 today.
Thank you beautiful people.
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I spoke to
@NZStuff
about National's Cancer drugs promise, and all the problems with it, as well as some options to move forward.
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@RobinBGrieve
@MaramaDavidson
You're just completely wrong on nearly every aspect of this. Strongly encourage you to read "unequal impact" and other useful reports on this
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Huge congrats to the immensely talented
@BrookingRachel
being appointed a Minister outside cabinet.
A self-confessed law and public policy geek, with an impressive track record on environmental issues.
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I have never seen a university publically call for the retraction of a paper from one of its staff.
From the Head of UOA School of Population Health calling for one of its own staff, Simon Thornley, to retract a paper.
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@publicaddress
All the comments on here - "it's so awful Māori got different treatment".
Yes, yes it is awful that Māori and pasifika get such different treatment (and outcomes).
Just maaaaaybe not in the direction these reply guys think.
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I'd tell you a joke about medical oncology, but first, tell me what you understand about jokes about medical oncology.
I have a joke about General Practice but it takes 15 minutes and doesn't even get to the punchline.
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Dreaming of school hols w kids: making a lifetime of wonderful family memories.
Actual school hols w kids: UN peace keeping force.
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People diagnosed with cancer often ask me if the stresses in their life caused cancer.
This study just published not a full answer but shows no meaningful relationship between mood (anxiety and depression) and cancer risk.
Cancer is not your fault.
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@DrJinRussell
Yeah, it's a whole pipeline, eh, and fixing the workforce issue is multi-step from med school to specialist (incl GP)
Also got to think expanding existing schools more efficient than starting a new one from scratch
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In today's Guardian - changes to NZ's resource consenting laws "getting bad things done in a potentially dangerous way".
Lack of checks and balances on executive powers, and ministers making decisions on projects that benefit their donors?? Not how serious govt shd work.
As told by Prof Nicola Wheen, with small editorial assist from Prof Andrew Geddis ...
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NZF "Health" Minister Costello looking to reduce excise on tobacco products and effectively cut excise on smokes, as well as scrapping our world-leading smokefree legislation.
Not serious on smokefree, can't be serious about cancer.
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LA? Sydney? No, only true Dunedinites would post pictures of their car thermostat on social media
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@vincristine
Wondering about the economics of a third med school compared to expanding the existing ones.
The infrastructure of setting up a new school - wowsers. Huuuuge undertaking.
Might not be -- efficient?
Bureaucracy rather than outcomes? Might just be me tho.
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Surely we can celebrate and acknowledge incredible service and achievement without having to denigrate people for the sins of being not completely perfect?!?!
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@MaxRashbrooke
@antihobbes
It's $5 per item - many people with chronic health conditions are on multiple. It makes an immediate, real and practical difference to those w long term health conditions.
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vaccine dose one done. Thank you all the incredible health professionals, planners, researchers, and team of 5 million that got us to this point safely.
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@john_grono
@markpfarmer
80% of smokers want to quit. Nicotine is one of the most addictive substances there is. This law would take the nicotine out of tobacco. Why do you oppose that?
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This is why we need better science journalism: -
Headline - 79% increase in cancers in people under 50
Content - death rates down, a lot driven by screening, early diagnostics, and POPULATION GROWTH!!!
Sheesh. Relative vs absolute increases please!!
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For people interested in factors influencing cancer survival disparities, we wrote about this here
Here's a picture from that paper
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Randomised trial of CBD oil in advanced cancer showed a high proportion feeling better after treatment.
Here's the catch - patients on placebo did as well or better.
Scientific assessment beats confirmation bias yet again.
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Dunedin residents showing what a
#realresistance
looks like - crowds and queues at
#TeKaika
drive thru vax centre
A case in Dunedin today - don't be next - get
#boosted
!
#inthistogether
#Otepoti
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🧵 1/2 Being an oncologist in a community means you often get to treat people you know, sometimes even friends and colleagues. When you treat someone close it reminds you even more of the significance of our work, but it brings unique stresses and challenges for staff.
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@Gregoryp8888
Yeah nah.
We've got plenty of data. It's action that's needed.
It's just what we need to do is unpalatable to many of the people who squal "equality" without understanding the disparities that actually exist.
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Lancet Oncology praises NZ COVID and cancer services response. A lot of uncertainty and fear for people w cancer who were affected, as it was an uncertain time. But ultimately we are better off than than many other countries *at present*.
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@docdanz007
Having worked w Bloomfield closely on cancer matters can confirm he is a thoughtful, intelligent, principled man who I sometimes disagree with on matters of content. He is no one-trickster.
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Interesting to see net gain of +2000 migrants from Aus in last 12 months. You'd think the opposite was true by reading features
(%C2%B1%201%2C800,of%2019%2C300%20(%C2%B1%20100).
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Officials and experts say that the "black market" argument against the
#smokefree
legislation is wrong. Where is Costello getting her advice to the contrary?
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Enjoying the company of the two biggest brains in cancer control in NZ - with Diana Sarfati and our new Cancer Chief Rami Rahal
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@KeithQuinn88
Hi Keith. Love your rugby commentary. Anyway, my job involves a lot of emotion, and esp. grieving. I reckon crying helps heal. I'm pleased sports stars cry as it gives permission for others when they might need to. Would love it if you'd acknowledge the strength of that.
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Pandemic oncology in full swing - >50% virtual consults, and >50% of nurses absent w COVID.
Patients v understanding of the rescheduling and altho some treatments delayed by days, all patients still getting all treatments this week.
My nursing team are outstanding.
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Someone holding a different opinion is not the same as someone being "divisive".
Governments do stuff lots of us don't agree with since forever.
That's politics, not division.
We need a higher threshold for that word please.
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Headlines like this don't aid clear conversations in cancer.
You'd think that this drug helped people live longer.
The study didn't show that.
It slowed tumour growth on scans
Patients want to live longer and live better. We need to be honest. This ain't it.
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This is amongst the world's most radical smokefree legislation.
Dying of lung cancer, or from emphysema, is awful beyond description.
This is what game changing action on cancer looks like.
The Cancer Society has urged the Government to be bold and brave and they did not disappoint. This legislation is world-leading and will save thousands of lives in our country. We hope to see a fast implementation to set a precedent for other countries to follow soon.
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Continuous glucose monitors are life changing for people who use them. Great to see funding for these announced by
@PHARMACnz
today.
(Who knew that investing in PHARMAC could deliver so many good things???!!!)
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The problems with politicians picking which drugs to fund - and some solutions that may be a way to deliver even better
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