Fears ethnicity-based health policy will impact elderly Northlanders awaiting surgery

Since February Auckland surgeons have been required to consider a patient’s ethnicity alongside other factors when deciding who should get an operation first. Photo / 123RF

A controversial new Government health policy that prioritises some ethnicities over others for surgeries in Auckland is no longer being rolled out in Northland or the rest of the country.

But with many Northlanders having to undergo surgeries in Auckland, some are still concerned Te Whatu Ora’s Equity Adjustor Score - which gives priority to Māori and Pacific Island patients on the grounds they have historically had unequal access to healthcare - could mean longer waiting times for other vulnerable Northlanders, including the elderly.

Since February Auckland surgeons have been required to consider a patient’s ethnicity alongside other factors when deciding who should get an operation first.

Kerikeri Retirement Village chief executive Hilary Sumpter said it would be “interesting” to see how the prioritisation tool pans out.

“We know the whole of Northland is underserved in the health sector and needs support.

“A lot of people have a fear or mistrust of accessing health services. I hope there are pathways to help people get prioritised when they can.”

However, Sumpter said she was concerned elderly people on waiting lists would be bumped back even further.

“Elderly are underserved in the health sector and get deprioritised because of their age.

“Those in our care facility are not usually on a waiting list for surgery anyway. Those hip replacements still need to occur but they usually go to Whangārei [hospital].

“But our village residents are predominantly non-Māori, they may struggle to get what they need when they need it.”

Kerikeri Retirement Village chief executive Hilary Sumpter said predominantly non- Māori village residents may struggle to get the surgeries they need under the new policy. Photo / Peter de Graaf

Te Whatu Ora - Health New Zealand introduced the policy in February with the aim of reducing inequity in the system.

The tool uses an algorithm to prioritise patients according to clinical priority, time spent on the waitlist, geographic location, 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.

Whangārei emergency medicine consultant Dr Gary Payinda backed the policy and said people should “acknowledge how bad” Māori and Pacific levels of healthcare deprivation are.

“On average if you are Māori, you’re going to be dying somewhere in the range of seven to eight years earlier than your peers.

“If you think that Māori person is getting a sweet deal ... they’re not. They’re getting a raw deal and have for decades.

“What people don’t realise, is that in general Māori and Pacific health is so abysmally worse than Pākehā health, even their access to doctors and medical treatments, is a world apart from what someone living in the North Shore or another affluent area would expect.”

The scores giving priority to Māori and Pacific Island patients will be confined to Auckland and Middlemore Hospitals, where many Northlanders have to undergo surgery. Photo / NZME

That non-Māori and Pasifika Northlanders already on long waiting lists could potentially see their procedures pushed further back was a “separate issue”, Dr Payinda said.

“Of course, people who are waiting for years on waiting lists should not be waiting.

“Just because one group needs better healthcare than it’s getting doesn’t mean we all also shouldn’t be getting better healthcare.

“But Māori and Pacific peoples are starting from such a place of deprivation we do need to do things to ensure they get better care than they’ve been getting.”

The Government had planned to roll out the adjuster scores nationwide, with Health Minister Ayesha Verrall saying so in a written parliamentary question from National’s health spokesman Shane Reti.

Te Whatu Ora interim lead for Te Toka Tumai Dr Mike Shepherd also said it was being rolled out across the other northern region districts.

However, it has been reported the Government has since put on ice plans for a nationwide rollout, with Prime Minister Chris Hipkins saying he didn’t want to see one form of discrimination replaced by another.

The scores are, at this stage, confined to Auckland and Middlemore Hospitals.

Whangārei emergency medicine consultant Dr Gary Payinda said people should “acknowledge how bad” Māori and Pacific levels of healthcare deprivation are.

Te Whatu Ora hospital and specialist services director Jo Gibbs would not comment on how the policy would affect Northlanders undergoing surgeries in Auckland and if non-Māori and Pacific patients could expect longer wait times.

“Clinical need is the greatest determining factor when prioritising our planned care surgery waiting lists,” Gibbs said.

“Those who are the sickest or in most need of care are prioritised and treated first.

“However, different people with different levels of advantage require different approaches and resources to get equitable health outcomes.”

Dr Reti said as a doctor he would refuse to rank patients based on their ethnicity.

Race has no place in surgical priorities, he said, and the Government should immediately drop ethnicity as one of the criteria surgeons have been told to use to rank patients.

“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.

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

Jenny Ling is a news reporter and features writer for the Northern Advocate. She has a special interest in covering roading, health, business and animal welfare issues.