ACT leader David Seymour has slammed the Government for promoting racial discrimination after a report showed surgeons are having to consider ethnicity to decide who gets operations first.
It comes after a report by NZ Herald showed Auckland surgeons are now being required to consider a patient’s ethnicity alongside other factors when deciding who should get an operation first.
This has caused several surgeons to hit out at the policy, which was introduced in Auckland in February and gave priority to Māori and Pacific Island patients, on the grounds they have historically had unequal access to healthcare.
But health officials have been quick to stress ethnicity is just one of five factors considered in deciding when a person gets surgery and it's an important step in addressing poor health outcomes within Māori and Pacific populations.
The five factors weighed up when prioritising treatment are clinical priority, waitlist time, geographic location, deprivation level, and ethnicity.
Seymour told AM on Monday it's "completely wrong" that ethnicity is part of the decision-making process and it has to stop.
"We've got a Government that is actually actively promoting racial discrimination now and it's got to stop... but if you're getting the other things right, the clinical judgement of the doctors, the level of deprivation, how long they've been waiting, if they live in a remote area, then you should actually already be capturing the very disadvantages that leave Māori and Pacific worse off," Seymour told AM co-host Ryan Bridge.
"The advantage of doing it based on the practical observation of the patient, not just categorising people by race, is you don't catch people who happen to be Māori but actually doing very well thank you very much. We've got to stop running people down just because they're Māori.
"On the other hand, you do also manage to catch people who may be not Māori but have all of those disadvantages."
He told the show what used to be called "prejudice and discrimination" is becoming official government policy and is dividing New Zealand.
Green MP Chlöe Swarbrick, who was appearing alongside Seymour in their weekly political panel, said it's important to remember ethnicity is one of five factors used to consider who should get an operation first.
"I think it's really important we take a step back here and consider all of this in context because I can understand how a story like this can get whittled down into a soundbite and then all of a sudden we're having a moral panic debating things over here," she told AM.
"The context of research out of the likes of the University of Auckland, tells us that particularly Māori and Pasifika patients are far less likely to get timely access to diagnosis and therefore the flow on effects throughout the rest of the medical health system."
Some surgeons who spoke to NZ Herald said the new scoring tool was "medically indefensible" and one said he was "disgusted" by it.
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.
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.
Swarbrick told AM if she was the minister she would be asking questions about this policy but said it needs to be unpacked properly.
"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 said.
But Seymour hit back saying it's wrong and is pleased this is out in the open as he's had doctors tell him it's a "disgrace" and "absolutely unethical".
National's Health spokesperson Dr Shane Reti is calling on the Government to drop the criteria saying race has no place in surgical priorities.
"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," Dr Reti said.
The way to improve health for Māori and Pasifika is through better housing, education and addressing the cost of living, not by disadvantaging others, Dr Reti said.
"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 in a statement.
"A National government would not rank patients by ethnicity."
Te Whatu Ora defended the new policy telling Newhsub in a statement health inequities exist in virtually every country, even those with high-quality healthcare, like New Zealand.
A spokesperson said the causes of health inequity are complex and require a sophisticated solution to reduce inequitable outcomes that already exist.
"True elimination needs sustained and innovative solutions embedded across the health system and beyond," the spokesperson said.
"One contribution to reducing inequity is the application of targeted equity adjustors. Te Whatu Ora, Te Toka Tumai Auckland team developed an Equity Adjuster-Waitlist Tool, which is helping to reduce existing barriers and inequities in our healthcare system, to ensure that our population has equitable outcomes, regardless of their ethnicity, socio-economic circumstances or whether they live in a city or rural location."
Te Whatu Ora added the COVID-19 pandemic negatively impacted equity globally, so it's hugely beneficial to have this equity adjuster to help address the problem.
"In addition to reducing inequities, the adjuster helps us to identify early those patients who need a bit of extra help to access care. This means we can put in place some assistance and support sooner to ensure a smooth pathway to care for all our patients and whānau," the spokesperson said.
"The establishment of Te Whatu Ora, and Te Aka Whai Ora, is helping transform the health system even more, to create a more equitable, accessible, cohesive and people-centred system that will improve the health and wellbeing of all New Zealanders.
This includes helping ensure greater access, experience and outcomes for those traditionally not well served by the system, such as Māori and Pacific people, and those living in places where access to health services is not always straightforward."
Health Minister Ayesha Verrall told NZ Herald there are important reasons why ethnicity was a factor when it came to prioritising healthcare.
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.
Watch the full interview with David Seymour and Chlöe Swarbrick in the video above.
