Human factor in making Cancer control program a success
Dr. Syed Javaid Khurshid
In the previous two articles, I have discussed the Cancer Scenario in Pakistan and need of a National Cancer Control Program (NCCP) to reduce the number of cancer cases, deaths and to improve the treatment and quality of life of cancer patients. Here I would like to discuss the human resource, the very important and required factor needed to implement National Cancer Control Program (NCCP).
As mentioned earlier incidence of cancer is increasing all over the world and also in Pakistan, so does the need of skilled cancer care professional to fight the growing epidemic. Many programs can be adopted, online information should be provided about the most prevalent cancers namely cervix, breast, head and neck and prostrate.
The cancer care services are already overburdened in Pakistan by acute shortage of facilities only 25% as per requirement, therefore patients are getting long waiting time before getting any treatment. This is worsened by shortage of trained doctors, staff and nurses in this specialized field. First thing which is hindering is misunderstanding that working with radiation & cancer patient will cause cancer and second career development conditions has to be improved in order to overcome human resource short fall. Here I like to emphasize on main stakeholders responsible in Pakistan to play a positive role in enhancing cancer care in the country. Some of them are the largest provider of oncology services as yet, it is incumbent upon these stakeholders to ensure growth of capacity and scope of the cancer care facilities under their aegis. It would also be easier for them to evaluate the current status of cancer care human resource and come upon suggestions to overcome the issues.
Teaching and Training should be enhanced by introducing higher level program to advance knowledge transfer, professional mentorship and continuous learning. This can be done through already present centers of learning by increasing their capacity and capabilities. Capacity to train Nuclear Medicine and Oncology FCPS should be increased and PhD program should be started in both fields.
Second we have to stop the brain drain by controlling the outside flow of trained manpower from Pakistan particularly in this field. It has been estimated that about100 FCPS are produced in nuclear medicine & Oncology and out of these only 50-55 are available in Pakistan. Many qualified trained/professional leave the country every year in search of better salaries and conditions and some do not return to the country after getting training abroad. This “brain drain” not only having negative impact on the quality and availability but also causing a huge loss to government’s financial investment in professional education and training.
The return of trained medical professionals will be difficult to achieve, but we can overcome this by expanding nuclear medicine and radiotherapy facilities, teaching and training facilities and improving working conditions, salaries and offering better career prospects to the cancer care professional. The crux of this problem also lies with the inflexible induction policies and the inordinate delay of the induction process. With greater flexibility of policy and a fast-tracking of the induction process, it should be possible to get more appropriately trained individuals who are not averse to joining any of the locations in the country.
The stakeholders should also ensure that there are structured Continuous Medical Education (CME) and Continuous Professional Development (CPD) programs that ensure that our physicians, nurses and technologists are up to date with current knowledge. There is also a need to induct more Human Resource into the established centers depending upon the existing patient load and projected increase in patient population. Again, the existing policies do not enable rapid induction of Human Resource, even the replacement of the normal and expected attrition in Human Resource as people retire, transfer out, leave service or pass away. Standards need to be established that relate facilities with patient population, it is useless to expect quality work from understaffed, poorly equipped facilities. It needs to be realized that highly trained medical personnel are in demand world-wide. To attract and retain talent the Government or for that matter any hospital needs to compete for what is available at the prevailing “market-rates”, one way to get over this relative dearth is to invest in quality post-graduate programs that creates appropriately skilled and knowledgeable personnel. It is time that a conscious and deliberate break is made to provide the trained personnel that Pakistan needs. Current training programs need to be enhanced and diversified. The personnel that are trained should be handsomely paid, having strong career planning, are more likely to remain within Pakistan, this has already been demonstrated by the various existing post-graduate programs. Pakistan Nuclear Society is in the capacity through its Scientific Advisory Board (SAB) to develop National Cancer Control Program for Pakistan.