This article is part of a Because It Matters Newshub series.
Described as New Zealand's "most prolific cancer survivor", Phil Kerslake says he's worried the country's falling behind in terms of cancer care, and is urging the Prime Minister and the Health Minister to pick up the pace.
Kerslake, who's survived eight new diagnoses or recurrences of cancer since 1974, says while he thinks New Zealand's "come a long way", the Government is acting too slow on new cancer treatments.
The 60-year-old UK-born author - diagnosed with incurable lymphoma - said Prime Minister Jacinda Ardern and Health Minister David Clark have been "very, very slow and considered" in their approach to cancer care for Kiwis.
- National promises $200 million cancer fund
- Cancer drug advocate holds back tears pleading for Pharmac funding
- Pharmac considers funding breast cancer drug Kadcyla advocates have been fighting for
"Being considered is fine, but if they're being slow at this point in time, it's an indication that they are not going to move far in the direction that they need to just to get anywhere near par with our counterparts around the world.
"They will have real problems when it comes to the election and subsequent elections and they will be doing the people affected by cancer in New Zealand - which is just about everyone - a major disservice.
"They made all sorts of promises before the election - we all know about that - they promised a national cancer agency, and then they backed off on that and they seem to have gone very quiet."
Before the 2017 election, Labour promised to establish a national cancer agency to "streamline cancer care" in New Zealand. It also promised a national cancer plan.
The Health Minister is promising the Government will stand-by its "promise of action on cancer care", telling Newshub "significant announcements" will be made.
The Government announced on Sunday it would purchase 12 radiation therapy machines over the next three years to be placed in the regions.
Kerslake labelled the announcement a "small start" in a "major process" of building cancer treatment resourcing across the country.
"It's good to get as much coverage as possible so people in the provinces can get access to radiation therapy."
There's also the Government's "Interim Cancer Action Plan" which the Health Minister told Newshub is currently being designed.
But in Parliament, the Health Minister said the Government's cancer action plan will start off as a consultation document, which the National Party has labelled "yet another extended period of talking".
"What we're seeing is yet another extended period of talking and consultation from this Government, which will do nothing to improve access and diagnoses," National's health spokesperson Michael Woodhouse said.
Woodhouse was one of three National MPs to accept a petition last month calling for better cancer care for New Zealanders by establishing a national cancer agency.
The petition by Southland farmer Blair Vining - diagnosed with stage four terminal bowel cancer in October last year - received more than 140,000 signatures.
Woodhouse said Vining's situation was "compelling", telling Newshub he wanted to accept the petition because "everybody can relate to Blair's situation and knows somebody in their family or friends' circle that has been affected by cancer".
Last month National leader Simon Bridges promised to establish a national cancer agency and set aside $200 million over four years dedicated to buying cancer drugs, if elected in 2020.
Woodhouse said he has "no idea" why the Government has held back on pre-election promises around cancer care.
In response to criticism, the Health Minister told Newshub decisions around which new drugs are publicly funded are made by the Government's drug-buying agency, Pharmac.
"This Government respects the independence and impartiality of their work. It is not for us as politicians to second-guess the experts at Pharmac about which drugs it purchases.
"We have listened to the calls from people living with cancer that they want faster access to new medicines. I've asked Pharmac and the Ministry of Health to accelerate work on options to achieve this."
How New Zealand compares to Australia
Pharmac's spending on cancer drugs was thrust into the spotlight in October last year when women presented petitions to MPs on the steps of Parliament asking for two breast cancer medicines to be funded.
It led to Wiki Mulholland - who has advanced breast cancer - and her husband Malcolm, to call for an inquiry into Pharmac and unfunded cancer medicines. But it was voted down at the Health Select Committee.
In comparison to Australia, New Zealand lags behind when it comes to cancer drugs - an issue Mulholland brought to the attention of MPs.
The Prime Minister earlier this year said it's unfair to compare New Zealand's cancer drug purchasing to that of Australia. She said Pharmac has been "pointed to as being the envy of others".
But comparisons are available on Pharmac's own website. It says Australia funds 35 cancer medicines that New Zealand doesn't. There are 89 cancer medicines that are funded in both countries.
The Breast Cancer Foundation says while these numbers may be accurate, the 13 New Zealand-only drugs "are older drugs that have been superseded in Australia by newer, better medicines".
Kerslake said while cancer medicines may not provide a cure, it helps "people who are young and in their prime, good contributors to the economy, and we need to be able to help them".
Pharmac argues that out of the 35 cancer drugs not funded in New Zealand, "only three provide real, meaningful benefit".
The agency says it's already funded one of these, pertuzumab for breast cancer, and is considering funding two others. It says 17 of them provide only moderate or poor benefits, and the rest could "cause harm".
In a breakthrough on Wednesday, Pharmac said it's considering whether to fund the breast cancer drug Kadcyla - the medicine Mulholland petitioned for - as well as two other cancer drugs.
Pharmac got a $10 million annual funding increase for the next four years in Budget 2019. It wasn't enough, according to charities like the Cancer Society, who labelled it "disappointing".
In a statement to Newshub, Pharmac said it has a current budget of $995 million for medicines. In total, 16 new cancer medicines have been funded since 2011/12, until 2017/18.
The amount of money Pharmac spends on cancer medicines has been increasing every year and is now $220 million gross, the spokesperson said.
"It is important to remember that cancer medicines are just one tool for treatment. The majority of cancers are controlled using surgery and radiotherapy."
National's Woodhouse said while it's complicated comparing Australia and New Zealand models, "The drug regime is not funded as well here as it is in Australia and [Pharmac is] taking too long to make decisions".
He argues Pharmac "needs more money, it needs greater transparency of its decision-making, and it needs to make those decisions more quickly than it currently is".
Woodhouse asked the Health Minister in Parliament in June if the increase in Pharmac funding in Budget 2019 was enough to deliver appropriate access to medicines for New Zealanders.
Dr Clark responded, "Everybody in this House will acknowledge that health got a considerable chunk of the Wellbeing Budget because mental health, in particular, was prioritised."
The minister said last week he stands by the amount of funding given to Pharmac in Budget 2019.
Kerslake said while he's pleased with the treatment he's had over the years, if there are cancer medicines available that could extend the lives of other Kiwis, Pharmac should "look to quickly embrace it".