NZ Prioritising Maori, Pacific Island Patients in the Name of ‘Equity’

Family members visit Intensive Care patient at Westmead Hospital in Sydney, Australia, on March 12, 2007. Ian Waldie/Getty Images

New Zealand’s National and ACT parties have decried the Labour government for promoting racial discrimination after it was revealed that surgery waitlists in Auckland take ethnicity into consideration when prioritising healthcare.

National’s health spokesperson, Dr Shane Reti, has called on the government to drop the ethnicity requirements “immediately.”

“While there has been historical inequity that has disadvantaged Maori and Pasifika people, the idea that any government would deliberately rank ethnicities for priority for surgery is offensive, wrong and should halt immediately,” he said.

Reti said rather than simply disadvantaging other ethnic groups, Maori and Pasifika health is better addressed through housing, education, and lowering the cost of living.

“As a doctor, I would refuse to rank patients based on their ethnicity, and I completely side with surgeons who are alarmed and affronted by this priority tool implemented by Health New Zealand,” he said.

“A National government would not rank patients by ethnicity.”

It comes in response to a report by Newstalk ZB which revealed that Auckland surgeons had been required to prioritise Maori and Pacific Island patients since February.

Health officials have said ethnicity was one of five factors when prioritising people on a surgery waitlist.

Maori and Pasifika are given priority, while Indians and Chinese are pushed down the list.

One surgeon anonymously told Newstalk ZB that he was “disgusted” by the new 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.”

ACT Leader David Seymour said this revelation was just another example of what is happening across the New Zealand bureaucracy—“arguing over identity rather than solving problems.”

“If the first four criteria of clinical need, time already waited, geographical location, and economic deprivation are doing their job, then racial discrimination is not needed,” he said.

“The only possible effect of racial discrimination is to make sure a person in greater need waits longer for an operation and may die on a waiting list because they had the wrong ancestors.

“A person who is in great clinical need, has waited a long time, lives far from major medical facilities, and is poor could be Maori, European, Pacific, Indian or Chinese, and they should all be treated equally.”

Seymour expressed his disappointment that similar policies derived from the increasing presence of identity politics have caused “massive anguish and hurt” to the New Zealand people.

“New Zealanders are sick and tired of race and the Treaty [of Waitangi] being injected into everything from water infrastructure and resource management to healthcare and education,” he said.

Answering Discrimination With Discrimination

Health Minister Ayesha Verrall said the new reforms were implemented to address historic inequalities against Maori and Pasifika people, who have shorter life expectancies and poorer health outcomes.

The New Zealand Association of General Surgeons says in its mission statement that it is committed to “prioritising Indigenous health” to “better meet the health needs of Maori and Pacific Islander peoples.”

The New Zealand Society of Anaesthetists (NZSA) have also come forward in support of the policy.

“This is an attempt to try and achieve more equity, rather than give any advantages,” NZSA President Dr Morgan Edwards said.

“Many Maori patients are likely to have experienced health inequalities before even reaching surgical waitlists.

“At a basic fundamental level, when a Maori patient hits that surgical waitlist, they’re already far behind their non-Maori counterparts. This is a small step to address that inequity.”

Meanwhile, Green MP Chloe Swarbrick urged people to “step back” and remember that ethnicity was just one of five factors.

“I think we should hear those concerns of those surgeons and those within the medical profession, but again, I’m really concerned whenever we’re having a political debate based on so few facts that we end up completely misinforming the public debate,” she told the AM show.

But in light of the increased scrutiny of the policy, Prime Minister Chris Hipkins has asked the health minister to review the equity tool for discrimination.

“At the moment, there is clear evidence, Maori, Pasifika, rural, and low-income communities have been discriminated against by the health system, and they are working to address that,” he told reporters on June 19.

“I’ve seen the concerns that are being raised about the mechanism ... and I’ve asked the minister of health to look at that to make sure there is a reassurance that we’re not replacing one form of discrimination with another.”

Hipkins emphasised that clinical need has always been, and will always be, the “first and foremost” factor in decisions around clinical care.

But he added that the policy was about ensuring “everybody is treated equally” and recognising that that was currently not the case.

However, Seymour says the tool is doing exactly what Hipkins said—replacing discrimination with more discrimination—and called for its abolishment.

“The health minister’s review of Te Whatu Ora’s ‘waitlist equity adjuster tool’ must end the policy of moving sick patients up and down health waitlists based on their race,” he said.