In Australia we are very lucky to have a public health system. Treatments and medications are covered to a certain extent for all sorts of things.
Prior to diagnosis, and due to growing up in a major city, I’d assumed that the quality of care across Australia was much the same. While I knew through work that health outcomes for people in regional areas were worse than in metropolitan areas, I gave greater weight to issues like lifestyle than to the quality of care, or even the options for care, as to why this was the case. Looking back, I’m embarrassed by my naivety and my city centric approach.
I’m now under no such illusion. The difference in quality across hospitals and health systems is enormous. For the best outcome, you need to go to a centre where your issue is their core business.
I’ve recently returned to Peter Mac as a clinical trial patient. In part this is because there are almost no trials offered in Canberra and absolutely zero that I’m eligible for. However, in a large part, it is because I am getting towards the pointier end of my treatment options, and the capacity of the small ACT Health system to manage this proactively was not great.
While a cure is not on the table, it seems from my Peter Mac oncologists that there are a few more treatments we can try in an attempt to buy more time. That’s all I’m after – time.
I’m extremely grateful that I had a pre-existing relationship with both my primary Peter Mac oncologist and the trial oncologist as otherwise the already difficult process of finding and getting accepted on a trial would have been near impossible. Finding and getting onto a trial has been the hardest stage since diagnosis and in all honesty we were essentially dropped by Canberra. Not due to any maliciousness, but rather I think due to a lack of resources and possibly a lack of broad knowledge on what trials were out there.
Which brings me back to my point. Go to where your disease is their bread and butter. If travelling for treatment is too hard due to the state of your health or for other reasons, go at least to a place like Peter Mac for a second opinion and to test the treatment plan of your primary oncologist. I’ve always sought second opinions and I’m really glad I have. It’s been reassuring most of the time, and on the odd occasion has opened up new treatment options.
The other issue I wanted to touch on is public versus private healthcare. There can be a tendency to think that private health care is better. With regards to serious disease like cancer this is a fallacy. The best and brightest in cancer in Australia by and large work in the public system. Treating serious illness is where the public system is at its best.
Despite this, I would encourage people to keep their private health insurance for the sole reason that it gives you choice. When the Peter Mac surgeon turned me down for a liver resection I was able to find a private surgeon who would. He has since operated on me again and is my first choice for surgery going forward. Having (horrendously expensive) private health insurance has meant this is an option.
It’s not fair that all treatment centres are not created equal, but it is reality.