7. Cancer Services—Intraoperative RadiotherapyDAVID SEYMOUR (Leader—ACT) to the Minister of HealthCancer Services—Intraoperative Radiotherapy7. DAVID SEYMOUR (Leader—ACT) to the Minister of Health: Does he stand by all his answers to Oral Question No. 6 on 6 June regarding intraoperative radiotherapy for breast cancer?Hon Dr JONATHAN COLEMAN (Minister of Health): Yes I do especially the statement This is essentially a debate between clinicians and scientists as to the most effective treatment and that the best advice is that the evidence around IORT is still emerging." and also the bit where I said that "We have to take the best expert advice and that is what I am going on."David Seymour: If the best advice is required why then did the Ministry of Health not provide the tier 3 report on the benefits of intraoperative radiotherapy to Deloitte when it commissioned Deloitte to carry out a health economics report on the practice and that seems to be the advice the Minister is relying on?Hon Dr JONATHAN COLEMAN: I receive a range of advice including advice actually that I had today at the opening of the new cancer centre here in Wellington where I spoke to a medical oncologist. I said to her: "What's your view on IORT?". This doctor said to me: "Well the evidence is very much out but what I can tell you is that the radiation oncologists here in Wellington are not in favour of it on the basis of the evidence." I can give you the person's name if you would like to go and meet them.David Seymour: Is the Minister really saying that the way he makes policy is through a collection of anecdotes from talking to random doctors as he goes about his business?Hon Dr JONATHAN COLEMAN: No what I am saying is that I rely on the best expert advice I read the clinical papers—the scientific papers—and then of course I go out and talk to people working the front line. That would be a great thing for the member to do too—it might help him in Epsom.David Seymour: Do not let it get to you Jonathan. Why then did the Ministry of Health's tier 3 report on the benefits of intraoperative radiotherapy say that "The TARGIT-A trial provided sufficient evidence to carry out work on the National Health Committee's other domains and there is reasonably good evidence that the follow-up period is sufficient and that non-inferiority has been demonstrated."? Why then if that report has vindicated the treatment is the Minister saying in his answers to my last oral question on this topic that he is waiting for 2020 when Australia Canada the UK the US and China are already successfully using this treatment?Mr SPEAKER: There are at least two questions in that one supplementary question.Hon Dr JONATHAN COLEMAN: Look the reason is the member is taking a small slice about that report and not quoting it in its full context. My advice to him would be to get out of the weeds and the details and focus on the wider issue which is the excellent performance of the health system in regard to cancer treatment. That is what the people in Epsom are really going to be concerned about. They are not focusing on these niche issues from some of your sponsors.David Seymour: Is the Minister of Health saying to the women of New Zealand that breast cancer and the best treatment for it is a "niche issue"?Hon Dr JONATHAN COLEMAN: No the member knows I am not saying that. It is an absolutely very important issue and that is why we are focused on providing the best-available evidence-backed treatment. That is why we have made massive investment in cancer services. That is why we have a very clear cancer strategy. That is why we have a cancer target that shows and strives for 90 percent of patients receiving their treatment within 62 days of being referred. That is the gold standard that is what we are aiming for and that is what we are hitting. That is what the member should focus on not all this detail—Mr SPEAKER: Order! [Interruption] Order! What does the member wish to do?David Seymour: Supplementary question Mr Speaker.Mr SPEAKER: No I am afraid the member has used all of his supplementary questions."