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'I would refuse to rank patients based on ethnicity': Dr Shane Reti blasts equity rule

Author
NZ Herald,
Publish Date
Mon, 19 Jun 2023, 12:50PM
Photo / Mark Mitchell
Photo / Mark Mitchell

'I would refuse to rank patients based on ethnicity': Dr Shane Reti blasts equity rule

Author
NZ Herald,
Publish Date
Mon, 19 Jun 2023, 12:50PM

National’s health spokesperson Dr Shane Reti has slammed the Government’s new policy which ranks ethnicities to determine who should get an operation first, calling it “offensive” and “wrong”.

As a medical doctor himself, Reti said race should have no place in surgical priorities and he is urging the Government to drop the criteria.

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

“The way to improve Māori and Pasifika health is through better housing, education and addressing the cost of living, not by disadvantaging others.”

He said he would refuse to rank patients on their ethnicity.

“I completely side with surgeons who are alarmed and affronted by this priority tool implemented by Health New Zealand.”

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.

Health officials said ethnicity was just one of five factors considered in deciding when a person gets surgery, and that it was an important step in addressing poor health outcomes within Māori and Pacific populations.

ACT Leader David Seymour also opposes the use of an ethnicity criteria and says if the other four criteria are working then “racial discrimination” should not be needed.

“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,” said Seymour.

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

He feared that the system would push other ethnicities such as Chinese and Indian down the list.

“This is the Government actively promoting racial discrimination in the health system and it’s causing massive anguish and hurt. It’s a classic example of what’s happening everywhere in the bureaucracy: arguing over identity rather than solving problems,” he said.

ACT Leader David Seymour said there is no need for the race criteria. Photo / Marty MelvilleACT Leader David Seymour said there is no need for the race criteria. Photo / Marty Melville

Seymour claimed that New Zealanders are frustrated that others get access to things they may not just because of their race.

“This is the Government actively promoting racial discrimination in the health system and it’s causing massive anguish and hurt. It’s a classic example of what’s happening everywhere in the bureaucracy: arguing over identity rather than solving problems.”

Te Whatu Ora Auckland interim district lead Dr Mike Shepherd said they designed the point-like algorithm, partially based on race, because there was a gap for Māori and Pasifika between the time they present with symptoms, needing an operation through to actually getting that operation.

”We’ve been working to solve this and this is part of the solution,” he told Newstalk ZB’s Mike Hosking.

He said for Māori and Pasifika, they would maybe get one or two extra points out of about 100 because of their ethnicity.

”Our people want to get out of bed every day and ensure that all of our population is getting the best health care possible and this is the part of that solution,” said Shepherd.

Shepherd said the algorithm first and foremost prioritised clinical needs.

”It’s not about getting to the front of the queue,” he said.

”It’s about adding some ratings and keeping an eye on the clinical prioritisation.”

He said the index is only in play in Auckland currently, but will also be rolled out through Northland.

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.

“First and foremost, wait lists for treatment are prioritised by clinical need, followed by wait time.”

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