Doctors have expressed fears that Canberrans suffering from gynaecological cancers could face "potentially compromised" care unless the government urgently commits funding to a permanent surgical unit for gynaecological oncology in the nation's capital.
A group of doctors have been lobbying both the territory and federal government for funding for a permanent surgery unit for gynaecological cancers and a specialist is prepared to establish a service in Canberra but they have not yet received a firm commitment.
The ACT has never had its own permanent public gynaecological cancer surgery service, instead the Royal Women's Hospital has provided a fortnightly clinic to Canberra for about 30 years but it is set to finish at the end of the year.
This fortnightly clinic has too many patients and there is not enough time to provide the service to all patients, meaning sufferers have to go to Sydney for most operations and post-operative care.
For women like Wendy Dodd, the travel for surgery is very taxing.
Ms Dodd was diagnosed with ovarian cancer earlier this year. She has undergone four rounds of "pretty severe" chemotherapy and recently had surgery in Sydney, which included a complete hysterectomy and a bowel resection.
"I'm a widow and I needed somebody to take me and fortunately my brother was prepared to take me," Ms Dodd said.
"The doctors in Sydney told me to come ... [but] as soon as I was well enough I had to go home, they didn't want me hanging around Sydney and so I had to make a trip in weather that was pretty ghastly."
Gynaecological oncology surgeon Dr Greg Robertson has been providing a fortnightly service in Canberra for more than two decades. Multiple specialists used to also provide services at the same clinic but it has dwindled in recent years due to retirements and Dr Robertson is the only specialist who still travels to the capital.
Dr Robertson is also set to retire at the end of this year, which could potentially leave a huge gap if the government does not commit to further funding. Gynaecological oncology surgery is a rare sub-speciality and there are only about 60 people in Australia qualified in the field.
However, Dr Leon Foster, a Canberra local working in Sydney, said he is prepared to establish a permanent clinic in Canberra. There have been lobbying efforts over recent years to the government to commit funding to this service.
It is time critical as Dr Foster is set to complete training in the incredibly rare speciality this year. If government funding is not forthcoming, he will be forced to take a job elsewhere.
"Canberra has grown up and is mature enough and big enough to support its own service," Dr Foster said.
The doctors have ramped up lobbying efforts in recent months. Multiple letters have been sent to ministers at both a federal and territory level.
Health Minister Rachel Stephen-Smith said she supported a gynaecological cancer surgery "in-principle" but could not provide a budgetary commitment at this stage. Ms Stephen-Smith said work was under way to plan a phased approach to a phased service within available resources and Canberra Health Services was in consultation with Dr Foster.
The service isn't costed, but funding is being asked for three people in the first year, five people in the second year. There would also need to be some funding for equipment.
"It's not an ideal situation and Canberra has the opportunity now to no longer be the only major city that doesn't have this service," Dr Robertson said.
"This is the time where you have all the ducks in a row, you've got an oncologist who is properly trained and has committed himself to come back. This is the time to do it because you will not get it otherwise."
Australia New Zealand Gynaecological Oncology Group scientific adviser Dr Alison Davis said she was "quite nervous" that Canberrans could be left without any local care by the end of the year.
"[It could mean] that the women who have gone through treatment and are currently in the observation phase will be getting less follow up care than would be expected ... what I'm worried about is that we'll enter into a period of very splintered care," she said.
"That care will be potentially compromised."
Dr Davis works at Canberra Hospital and is involved with the fortnightly clinic, she is a medical oncologist whose speciality is in gynaecological cancer. She said the service had worked well over the years but Canberra had now reached a point where a permanent unit could be established.
"Over the years it has functioned very well actually and they have provided us with a very good service," she said.
"But I think over the last 10 years, and five years in particular, we've matured so that medical oncology-wise, I think we're very comfortable in the space and the service that Greg has been able to provide has become increasingly a struggle.
"I wouldn't have said that 10 years ago, to be very honest but I definitely feel it now, I feel it's over time."
The group had sent a letter to Ms Stephen-Smith about the funding on March 23 2022 but did not hear back until Wednesday morning. The Health Minister responded to Dr Robertson at about 10.30am on Wednesday morning, an hour after The Canberra Times had sent questions about the situation.
"I apologise for the significant delay in formally responding to you but can assure you that your correspondence was referred to relevant officials in a timely way," Ms Stephen-Smith wrote.
"The ACT government understands it is not ideal for women to travel to other jurisdictions for services and is committed to improving specialist services in the ACT.
"I agree the opportunity to bring this important service to the ACT should be explored and I support in principle the development of a gynaecology oncology service in the region which will also provide care for women in Southern NSW Local Health District."
Ms Stephen-Smith told The Canberra Times the government was committed to improving specialist services, she said any announcement about funding was unable to be made at this stage as it was part of the budget process.
"I support in-principle the development of a gynaecological cancer service in the ACT when the government can be assured of patient safety in the provision of this service away from the larger speciality centre in Sydney," she said.
"This type of service is highly specialised and requires detailed consideration to ensure there is sufficient demand in the ACT and surrounding regions to sustain a permanent service with the right supports for the health professionals that would provide it.
"Travel to other jurisdictions for services is not ideal and I recognise that this places additional burden on patients who are accessing specialised services, which has been particularly difficult during the COVID-19 pandemic.
"However, it is also vital that specialised services are safe and high quality, and this can be a challenge in smaller jurisdictions and cities where there is not sufficient demand for specialists to maintain and update their skills.
"I am receiving briefings on the work Canberra Health Services is doing to work through options to ensure ACT patients are best supported to access treatment for gynaecological cancers."
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