Several surgeons say they are upset by the policy, which was introduced in Auckland in February and gave priority to Māori and Pacific Island patients - on the grounds that they have historically had unequal access to healthcare.
Health officials stress that ethnicity is just one of five factors considered in deciding when a person gets surgery, and that it is an important step in addressing poor health outcomes within Māori and Pacific populations.
Te Whatu Ora - Health New Zealand has introduced an Equity Adjustor Score, which aims to reduce inequity in the system by using an algorithm to prioritise patients according to clinical priority, time spent on the waitlist, geographic location (isolated areas), ethnicity, and deprivation level.
In the ethnicity category, Māori and Pasifika are top of the list, while European New Zealanders and other ethnicities, like Indian and Chinese, are lower-ranked.
Some surgeons, who spoke on the condition of anonymity, said the new scoring tool was medically indefensible. They said patients should be prioritised on how sick they were, how urgently they needed treatment, and how long they had been waiting for it - not on their ethnicity.
One of the surgeons said he was “disgusted” by the new ranking system.
“It’s ethically challenging to treat anyone based on race, it’s their medical condition that must establish the urgency of the treatment,” the surgeon said.
“There’s no place for elitism in medicine and the medical fraternity in this country is disturbed by these developments.”
A document on the equity adjustor which was leaked to Newstalk ZB shows two Māori patients, both aged 62 and who have been waiting more than a year, ranked above others on the list. A 36-year-old Middle Eastern patient who has been waiting almost two years has a much lower priority ranking.
An email by Te Whatu Ora business support manager Daniel Hayes in April said: “Hi team, Heads up. This is going to be the new criteria for outsourcing your patients going forward. Just putting this on your radar now so that you can begin to line up patients accordingly. Over 200 days for Māori and Pacific patients. Over 250 days for all other patients.”
When contacted by ZB, Hayes said he would not comment until he had verified who he was speaking to. He did not return further requests for comment.
Health Minister Ayesha Verrall said when it came to prioritising healthcare, there were important reasons why ethnicity was a factor.
She pointed to the Government-commissioned, independent review of the health system in 2018, which found the system did not serve everyone well and produced unequal outcomes, particularly for vulnerable populations.
“The reformed health system seeks to address inequities for Māori and Pacific people who historically have a lower life expectancy and poor health outcomes,” Verrall said.
Sir Collin Tukuitonga, a leading expert in Pasifika health, said Māori and Pasifika patients could be moved to the front of surgical lines due to the inequalities in the previous stages of the health system, such as the referral process.
“Māori and Pacific people tend to linger on the referral list... and inevitably, I think people will say that there’s also an institutional bias, possibly a racism that doesn’t put them where they need to be in order to get the surgery,” Tukuitonga said.
“The referral pathways are not that straightforward.”
Tukuitonga specifically used the example of bariatric surgery, which helps to aid those with morbid obesity, which he said was “much more” prevalent in Māori and Pacific communities than in Pākehā. He said this could be another reason why these patients are being brought forward in the waiting times.
“For most of the surgical interventions, Māori and the Pacific people don’t get to get the rates of interventions that might be warranted given their conditions,” Tukuitonga said.
He added: “In other words, it’s not acceptable to have a group in the population where obesity is a major problem and yet they’re not getting the physical intervention that they require.”
Te Whatu Ora interim lead for Te Toka Tumai (the former Auckland District Health Board) Dr Mike Shepherd said the causes of health inequity were complex and required a sophisticated solution to reduce inequitable outcomes that already existed.
“It’s important to note that ethnicity is not the only element considered in the scoring system,” Shepherd said.
He said the equity adjuster waitlist score helps reduce barriers and inequities in the healthcare system, to ensure that people have equitable outcomes, regardless of their ethnicity, socio-economic circumstances or where they live.
“These adjustments are based on evidence which shows these groups often have inequitable health outcomes, which often begin at the start of their healthcare journey. Early analysis shows the tool is effective at helping to eliminate the existing inequities.”
Shepherd said the tool was rolled out in Auckland in February and, due to positive evidence that it is helping to eliminate inequities in the healthcare system, it is now being rolled out across the other northern region districts.
Before the Health New Zealand reforms came into force last year, around half of the then District Health Boards had considered or committed to prioritising Māori and Pacific patients for some elective surgeries.
A number of studies and reports show Māori and Pacific people are less likely to be referred or accepted for treatment in the first place, and once in the system generally get less treatment. The Auckland District Health Board’s own data show Māori and Pacific patients take longer after referral to have a procedure confirmed.
Barry Soper is Newstalk ZB’s senior political correspondent. He was ZB’s political editor for many years after first joining the station and the press gallery in 1980.
Jason Walls is Newstalk ZB’s political editor. He was previously deputy political editor and chief political reporter for the station.
9 comments:
“It’s important to note that ethnicity is not the only element considered in the scoring system,” Shepherd said. Yeah Right!!!!
Would a gang patch qualify one to regarded as Maori and jump the queue ?
Or is a certain percentage required ?
Please re-read Michael Basset's recent article on who the subject "Who is a Maori ?"
It's hard to believe we live in nz isn't it? A very sad day for all nzers. Last weekend one of the librarians at my local library in sth akl, had written a quote on the clapboard outside "everyone is welcome here regardless of your race or nationality. We are all new zealanders" I think some of the library staff are getting sick of the woke bs being pushed on them as well. We all need to stop this and vote these evil.marxists in govt out. How can the medical people be ok with this? We need more whistleblowers
Face it - an ethnocracy is already in place. And now, very hard to cancel.
Because - no one ( including the right wing parties) has insisted on a full public debate and referendum.
So - here we have the result.
Are they Marxist though???Labour are certainly racist;with totalitarian tendecies bordering on fascist!
Just another step in the short march to apartheid.
Pity Meng Foon is gone, for he would have called this out in a heartbeat. Ha!
Isn't this just another true attempt by this government to introduce actual institunalized racism further into New Zealand society. Now I know what the jews felt like during the 1930s.
Yet more babying of a population who can’t get to grips with a knife and fork.
You eat you wear it, and you take responsibility for the consequences.
Orowhana, marxism and fascism are two sides of the same coin ( or, if you prefer - digital currency)
They are both totalitarian regimes with a collectivist mindset within which the rights of the individual to freedom of expression, and basic control of their own lives are stripped.
You will have heard of the ‘importance’ of ‘sustainability’. This is to be achieved through ‘sustainable capitalism’ as the way to solve all our problems. Another phrase for this is ‘stakeholder capitalism’. For there to be stakeholder capitalism though there must also be a council of ‘expert stakeholders’ whose unchallengable wisdom will dictate exactly how the system will operate. So we end up with a council ( in Russian, the word for council is ‘Soviet’) who are unelected and untouchable and who will dictate exactly how the rest of us must live in order to achieve this ‘sustainability’ ( think here, the Chinese social credit system, ‘15 minute’ cities you must not leave, the WHO with their international ‘one health’ plan to order you to take any medication, undergo any test they dictate is necessary to keep ‘everyone’ ‘safe’, digital ‘passports’ and the universal basic income - otherwise known as the universal basic straightjacket)
These stakeholders will be the heads of the multinational companies who stand to make trillions from this brave new, reset, world. We will own nothing and be happy. We will rent what ever it is we need. But the elephant in the room is - if we are renting everything, WHO is the owner from who we must rent it and to whom we must pay?
Stakeholder capitalism is a euphemism for ‘productive socialism’ ( which never works). In material ways, it is in fact no different to fascism- you have a totalitarian government in bed with big business, with control of a military ( or, in communism, its brutal red guard youth equivalent) and with complete suppression of freedom of thought and expression, and no peaceful way ( ie democratic elections) to transfer power through the will of the people.
The group driving stakeholder capitalism in the west is the World Economic Forum. These people are angling everything so that THEY become the ‘expert’ stakeholder council - the Soviet Politburo - whilst the regulatory screws are tightened and tightened until we own nothing and are under their complete control.
And guess whose sculpted bust Klaus Schwarb, the head of the WEF, has chosen to sit in pride of place on the valuable realestate of his office bookshelf? It is none other than that of Vladimir Lenin himself. Lenin, the soviet architect of hundreds of millions of deaths (you have to crack a few eggs if you want to make an omelette) all sacrificed in the name of creating his own, perfect, sustainable utopia.
This is all we need to know.
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