Prime Minister Chris Hipkins has defended a new equity-based surgery waitlist prioritisation tool but says he will ask his health minister to examine how it's being rolled out after suggestions it is "racial discrimination".
The PM said the new system had become a "political football" after being pushed on the story by reporters at his post-Cabinet press conference this afternoon.
"Those who are arguing we should do nothing need to explain why they think we should expect those on low incomes, in rural areas and Māori and Pacific to wait longer."
The new algorithm-based waitlist tool is currently being rolled out in Auckland and is being used to score patients for care on surgical care waitlists.
The sickest patients and those who've waited longer are still given the highest priority by the new tool, before other factors, such as their ethnicity, geographic isolation, and socioeconomic deprivation levels, are then taken into account.
National and ACT have come out hard against the policy, suggesting the system would be removed if there was a change of government in October.
Hipkins told media that he asked Health Minister Ayesha Verrall to take a look at the new system, but affirmed that disparities in waitlist data spoke to existing "systemic bias".
"I've seen concerns that have been raised about the mechanism that they are using to do that, and I've asked the minister of health to look at that to make sure that there is a reassurance that we are not replacing one form of discrimination with another."
Figures show they make up less than 4% of those who are assessed by a leading provider. (Source: 1News)
Research and experts agree that accessing healthcare for Māori and Pasifika is inequitable in New Zealand, with some research suggesting that inequities have grown during the pandemic for health outcomes.
The chair of Te Whatu Ora's planned care taskforce, Dr Andrew Connolly, said the new scoring was particularly relevant to ordering excessively long waits for non-urgent care.
"The key thing is that clinical priority absolutely predominates the score anyone gets. The relevance of this debate is really for those non-urgent cases that have been waiting excessively long," he told 1News.
"What this is doing is for those who have waited utterly unacceptable lengths of time, it's highlighting those cases and trying to introduce more fairness into how those cases are ordered."
Surgeon Dr Michael Booth, who specialises in bariatric care, said he continued to have questions and concerns about the new policy.
"Bringing ethnicity into the debate is gonna be problematic in some respects," he said. "It's difficult to define what is a Māori, for example."
"As doctors, ethnicity has never really been one of the main considerations when it comes to treatment. It's really been around need, acuity."
Speaking to 1News, Society of Anaesthetists president Dr Morgan Edwards supported using the "important but small tool" to address health inequities.
"Clinical judgement will always be the most important factor, and nobody is suggesting otherwise with this policy or any other," she said.
"Nobody is suggesting that we don't use our clinical judgment when making choices.
"It's that when you've done that, and you've treated the most unwell people, then you can consider the other things we know contribute to health inequities, and one of those which is race, but there are many other things as well."
National and ACT slam waitlist system
The opposition's health spokesperson Dr Shane Reti said "a National government would not rank patients by ethnicity," pledging to stop roll-out of the system.
"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," he said.
"The way to improve Māori and Pasifika health is through better housing, education and addressing the cost of living, not by disadvantaging others.
"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."
Meanwhile, ACT leader David Seymour said in a media release this morning that the new system and policy were "indefensible".
"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.
"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.
"Racial discrimination has become the official policy of the New Zealand Government. Moving sick patients up and down health waitlists based on their race is fundamentally un-Kiwi," Seymour said.
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