Page 2446 - Week 08 - Wednesday, 18 August 1993
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We can also use information to follow trends in cancer incidence. Funding options need always to be considered. Listening to the Opposition would lead you to a state of confusion. Making accusations about the high cost of health while calling for massive amounts of new spending requires careful scrutiny. If the Government had Mrs Carnell's money tree there would be no service we could not provide. We could provide them all. But of course there is more to it than that.
Mr Berry: We would be able to get free dancing with the fairies under it too.
MRS GRASSBY: Lots of fairies, Mr Berry. There are lots of fairies under the Liberals' tree, and at the bottom of their garden too. In times of tight budgets all proposals for spending need to be weighed against other priorities. The question is whether we need a cancer register now or whether the expense can be justified against, for example, increasing the level of direct cancer services. I would think that these were the most important issues.
The Government is well aware of the benefits and costs of a register. Cancer registers provide valuable data on the occurrence of cancer and are the source of a considerable body of both clinical and epidemiological cancer research. This information obtained from the register showing trends and patterns is essential when planning services. The Minister for Health is looking into this. This ensures that appropriate, efficient and effective services are provided. It is important that we have the best, not just anything. The Leader of the Opposition would be happy to say, "Just get anything. It does not matter whether it works or it does not. Just get anything".
A well-organised cancer register has some advantages over death certificates and, to a lesser extent, over hospital morbidity data. For instance, a cancer register provides information that better allows us to study relativity to common cancers and low fatality rates. Additionally, the accuracy of the information is less questionable than for cause of death information. There are, however - and I would like to make this point very strongly - disadvantages associated with cancer registers. For instance, they tend to have incomplete coverage of cases within the population. The Government is well aware of the challenges of ensuring economies of scale, of preserving client confidentiality when a number of particular cancers may be so small as to allow easy identification of the individual, of gaining the support and cooperation of the medical profession.
Let me say here that this is the part that is very important. Somebody may apply for a very high-powered job, and it is found out that they have had an operation for cancer. It may have been a small operation, but immediately this information comes out the employer thinks, "If I employ this person, will they be able to do the job and, if so, for how long?". I find this very distressing. I know of some people who not only do not want their friends to know that they have cancer but do not even tell their families.
The value of a cancer register should not be overstated, because of the small population base. This is part of the reason for the current practice of contributing to the New South Wales register. We already do that. The ACT Health Department provides substantial services to the region and hence will need to maintain links with the New South Wales registry for that part of its service anyway. Through the New South Wales registry we contribute to the national cancer statistics. Many years of data would be needed from the register in the
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