Price had started True Proactive after discovering that bowel screening wasn’t routinely available until age 58 in New Zealand. It is available at age 50 in the UK, plus younger patients can buy their own tests.
Bowel cancer is the biggest cause of cancer deaths in Kiwis under 50.
Documents released to the Herald under the Official Information Act reveal Health NZ was unsure how to respond to someone offering bowel cancer screening outside the national screening programme.
Dr Clive Price. Photo / Supplied
An interview with Price on Newstalk ZB in April prompted emails among Health NZ staff.
Those emails reveal that a senior official “anonymously wrote to Dr Price” to ask questions masquerading as a patient. Price responded, and the information he provided was delivered to the National Bowel Cancer Screening Programme Clinical Oversight Group (COG).
This subterfuge was commended by colleagues.
The official’s manager responded “Thanks … useful for COG discussion” while another senior official replied “Definitely, great work!”
Chair of GP advocacy group General Practitioners Aotearoa, Buzz Burrell, was taken aback by Health NZ’s tactics when told of them by the Herald.
“It seems extraordinary. I naively assumed that Health New Zealand [as] an organisation would be cleaner, really.
“There’s something dirty tricks tactics about that sort of approach. It almost puts every doctor on notice that every patient coming in could be a secret shopper.”
The Health NZ emails also reveal staff pointing out that the contract Health NZ had to buy the tests was non-exclusive. “Maybe something that could be discussed at the next contract renewal in 2027.”
When asked about why it was considering using its buying power in this way, Health NZ told the Herald “Health NZ did not consider making its contract with the supplier exclusive. A check of the terms of the existing contract with the supplier was undertaken. At no stage was a change to the contract proposed or considered.”
Health NZ responds
In a statement, Alana Ewe-Snow, national director, prevention screening, National Public Health Service, told the Herald, “One of our staff members approached the company … using their real name and personal email address. They did not misrepresent their identity or seek confidential information.
“There was no intention to obtain information under false pretences. The issue is therefore not one of false identity or deception.
“We acknowledge that a direct approach to Dr Price would have been a more appropriate way to seek this information.
“Health NZ expects staff to act with integrity and transparency in carrying out their responsibilities. Where information is sought for Health NZ official purposes, staff should generally engage openly and in an official capacity.
“While some parts of Health NZ undertake covert information-gathering activities in specific regulatory settings, this matter did not arise in that context.”
Dr Buzz Burrell is chair of GP advocacy group General Practitioners Aotearoa / Corey Fleming
The screening team is reinforcing expectations, Ewe-Snow told the Herald.
Citing employment-related confidentiality, she would not comment on whether the official and the two managers who endorsed their deception would face disciplinary action.
Swamping the system?
Price repeatedly told the Herald he didn’t want to criticise Health NZ and, as a recent arrival to New Zealand, he wants to foster a positive relationship with them.
“I think most of the issues raised could be clarified or rectified relatively easily through direct discussion,” he said.
Various officials and clinicians had expressed concerns that private bowel screening tests like those offered by Price could swamp the public health system – because positive test results should be followed by colonoscopies and publicly funded colonoscopies are under pressure.
Just over a quarter of the funding allocated for lowering the screening age to 56 this September is for more colonoscopies.
It is feared that privately funded tests could therefore result in wealthier younger people taking colonoscopy spots in the public system.
Health NZ officials and other clinicians have raised concerns that True Proactive’s website didn’t make it clear that a positive result from a True Proactive test did not mean that a patient would be eligible for a publicly funded colonoscopy.
Price told the Herald his website always said this, but at one point it “was not as clear as it should be”.
Price told the Herald that almost all of True Proactive’s 59 patients with positive results had health insurance. Only four patients were potentially adding to the public system’s load, he said.
Second-biggest cancer killer
Bowel cancer is second only to lung cancer for overall cancer deaths in New Zealand. In 2023, 1313 Kiwis died from bowel cancer.
While the disease is most common in over-50-year-olds, it is the leading cause of cancer deaths in under-50s.
But New Zealand lags behind other countries in implementing one of the best prevention measures – population-based screening.
When caught early, bowel cancer has good survival odds – around 90% – but this drops to 14% when it is caught late.
In the UK and most of Canada, the screening age is 50, in Australia and some Canadian provinces it is 45. Meanwhile, in New Zealand the screening age will drop from 58 to 56 in September.
This still leaves 390,000 New Zealanders outside the Cancer Society’s recommendation of screening from 50, and an additional 324,000 who would be eligible for screening in Australia.
Early in his career, Price worked in a hospice. Seeing people his age die from bowel cancer led him to start screening himself annually.
Living in the UK, he purchased his own tests as he wasn’t eligible for the UK’s publicly funded screening programme. But when he arrived in New Zealand, he was surprised at how difficult it was to find and buy a test here and saw an opportunity, and a need for provision of tests and more personalised care in their delivery.
Burrell told the Herald that ideally screening would happen through GPs, but “there is a disappointing gap in health services that has been identified and filled by someone who is being honest”.
Chris Knox is a scientist turned data-journalist who investigates the stories behind the numbers, and creates interactives for Herald readers to explore them.