Top Māori doctor says ethnic focus needed to address health inequities

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By James Perry of Whakaata Maori

Te Aka Whai Ora chief medical officer Dr Rāwiri McKree-Jansen says prioritising Māori and Pasifika patients on public surgical waiting lists is the quickest and best way to achieve equity in the health system.

NZME revealed Te Whatu Ora – Health NZ is introducing an “Equity Adjustor Score” to determine which patients are given treatment in Auckland. It is based on clinical priority, time spent on the waitlist, geographic location, deprivation level and ethnicity.

“Mai ra anō ka mōhio tāua ka āhua takaroa nei ngāi tāua e tatari ana i tērā rārangi mō ēnei tūmomo haumanu, te poka. Nā reira ka tika ēnei mahi kia whakatika i tērā raru – taku mōhio,” McKree-Jensen told teaomaori.news. (We know that for a long time we have been left waiting and waiting to get into surgery. So I believe by making these changes those circumstances will also change).

“Ahakoa ko te turi, ko te hope te aha rānei, he roa tonu rātou e tatari ana. Ko ētahi ko taua āhuatanga mai i te tari hauora i te hapori, engari ka tae rawa rātou ki runga ki tēnei rārangi, mā mātou te whakatika i wā rātou ki hōhipera kia tika wā rātou haumanu, me kī te poka.” (Whatever the type of surgery is, knee replacement, hip operation etc, our people are waiting longer than others. Some of the blame lies with the community health boards but, when our people end up on a waiting list, it is on us to ensure they get the treatment they need).

A 2019 report by the Health Quality & Safety Commission highlighted a number of issues of institutional racism in the health system that it said severely harmed and killed Māori patients including specialist appointments having long wait times and occurring less often for Māori. Māori patients were also often prescribed the wrong treatment.

However, National health spokesperson, Shane Reti says, despite accepting the historic inequities faced by Māori and Pasifika, the addition of an ethnicity element to the Adjustor Score is unnecessary.

“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 says as a registered doctor, he would refuse to rank patients based on ethnicity and is on the side of surgeons who have said they are “alarmed and affronted” by Health NZ.

In response, McKree-Jansen says it is up to Health NZ and the ministry to address the inequities in the health system.

“Hei aha hoki tērā, mā mātou o Te Whatu Ora e whakatika tēnei raru, kia tika te tiaki nei i ngā tūroro katoa, engari i tēnei wā me tika tēnei wahanga mō Ngāi Māori, ka tika.” (Never mind the criticism, Te Whatu Ora has to fix this and ensure everyone gets the treatment they need, and right now that means making sure Māori are looked after).

He says critics who say the system already address inequality and inequity and is already geared to deliver treatment to the most in need are wrong.

“Koinā te raru, ehara i te kōrero kei te ōrite katoa ngā iwi o naiānei. Ko ngā tūroro Māori o te naiānei ka mōhiotia e tāua ko ngā āhuatuanga kei runga i ā rātou te whakararu i wā rātou haerenga ki ngā whare hauora, ki te hōhipera. Nō reira me whakatika tuatahi i tēnei āhuatanga, ā tōna wā, kei te pai tonu mō te ōritetanga, engari inaiānei e pēnei ana te kōrero, ko te kaikiri ko te kaikiri tonu.” (That’s the problem. Right now we can’t say there is equity among all people. We all know that Māori patients are the most affected by access to health clinics and hospitals. So in time, once we get this right we will have true equity across all ethnicities, but for now any criticism against this policy is racist.)

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