Inequity in cancer care from the 25th CNSA conference

The 25th Cancer Nurses Society of Australia (CNSA) Congress took place from 14 to 16 June 2023 in Adelaide, bringing together dedicated cancer nurses from across the country. The congress aimed to discuss developments in cancer care, exchange experiences and explore ways to improve care.

During the plenary morning sessions on Thursday 15 June, attendees experienced a vibrant atmosphere as nurses from different states formed bonds. The opening speaker, Anne Mellon, CNSA President and Board Chair, emphasised the importance of unity and collective action in creating a better future for cancer care. She highlighted the distinction between equity and equality in healthcare, urging nurses to understand individual needs and challenges.

Anne provided the following definition “Equality would mean that everyone receives the same level of treatment regardless of individual circumstances such as age, socioeconomic status, gender, and geographic location. However, this approach may not address the disparaging issues that they must address when accessing cancer care”.

“Equity, on the other hand, recognises that people have different needs in society, and it involves providing individuals with the necessary tools and support based on their specific circumstances to ensure fair and just outcomes.”

Inequities in remote cancer care

Dr Lynette Liddle delivered the first presentation, sharing her experience with inequities in remote cancer care. She discussed the challenges she faced as a patient herself from Alice Springs when an unexpected Non-Hodgkin lymphoma diagnosis saw her travelling quickly to Adelaide for treatment by the Royal Flying Doctors service.

The associated costs when seeking specialist services in a different city were difficult and Dr Liddle highlighted the financial impacts of her diagnosis, such as being unable to work for the duration of her treatment and when in aftercare upon returning to Alice Springs.

“…Following treatment was where a lot of the good work was undone. Doctors and nurses need to understand that the patients do not begin their contact or treatment from the same place, circumstances, or situation,” Dr Liddle said.

To address these inequities, Dr Liddle proposed providing consistent healthcare provisions across all states and territories, ensuring continuous care from Adelaide to remote regions like Alice Springs.

Closing the gap: apologising for inequity

Professor Karen Strickland presented the second session, focusing on inequity for First Nations peoples in the nursing and midwifery sectors, as First Nations people have been impacted by institutional racism in this industry . Prof. Strickland emphasised the need for tangible actions to effect change, including evaluating university programs for cultural inclusion and support for Indigenous students.

“The culture of the institution is not well enough supported through other impacts such as employment of Indigenous academics. The students may be less likely to succeed because they can’t see their cultural leaders in place,” Prof. Strickland said.

This, Prof. Strickland says, can result in less First Nations students completing their study. To achieve improved outcomes, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives and the Council of Deans of Nursing and Midwifery have taken actions to ensure First Nations nursing and midwifery leaders are working towards an inclusive end equitable future. They also defined their goals to achieve higher rates of Aboriginal and Torres Strait Islander academics within educational institutions.

Equity in Cancer Care: Meeting the challenge

The last presentation was delivered by Dr Ranjana Srivastava, who emphasised the importance of equity in cancer care. She shared a personal story of a nurse who supported her through a difficult time, highlighting the significant impact nurses can have on patients’ experiences. Dr Srivastava drew attention to the challenges faced by disadvantaged and marginalised populations in accessing care, emphasising the need for individualised treatment that considers patients’ circumstances.

“Equity means prioritising the treatment which offers the individual patient the most benefit for the least amount of risk – more is not better.”

For people with cancer who are disadvantaged, the choice to pay for transport to their treatment, or putting food on the table while being the breadwinner is a reality. Dr Srivastava explained that treatment needs to be individualised to suit each patients’ circumstances.  Without addressing this issue, we will continue to see disproportionate mortality rates.

The CNSA congress left attendees motivated to continue making a difference in the lives of Australians impacted by cancer.