Adding race to waitlist criteria fatally flawed
Govt should look at what is truly causing health failures
New Zealand has been the topic of international media headlines this week. No, I’m not talking about the embarrassment of the Prime Minister needing to bring a spare plane with him while he travelled to China, the other topic that has piqued people’s interest is the news that New Zealand is now considering ethnicity as a factor for health waitlists.
The fact that a modern country could possibly be using ethnicity to decide who is getting access to healthcare is mindboggling for most people.
On the surface it seems like a deeply regressive policy, a far cry from modern sensibilities that tell us things like ethnicity, gender and sexuality shouldn’t have any bearing on how you are treated. That is why the world is watching.
Somehow, here in New Zealand this sort of discrimination has become government policy.
No one will deny that statistics show Mā ori and Pasifika have worse health outcomes, but adding race to the waitlist criteria won’t make one iota of difference. 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.
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.
Any Government that seriously wanted to address health problems for Mā ori and Pasifika would look at what is causing them — poor housing, dietary upbringing, environmental quality, immunisation . . . These are tough challenges for any government to address, but they’re the only realistic way of helping. Separating by ethnicity is a lazy way for the Government to claim they’re helping without doing any of the tough parts.
It is also a fundamentally un-Kiwi way of doing things. I’ve had friends tell me that their doctors have advised them to revert to their maiden name because it is Mā ori and would get them faster treatment, surgeons have told me about the stress of meeting quotas of Mā ori surgery, a cancer specialist told me that even cancer treatment is being ranked by race, which is backed up by Auckland DHB minutes.
A person who is in great clinical need, has waited a long time, lives far from major medical facilities, and is poor could be Mā ori, European, Pacific, Indian or Chinese, and they should all be treated equally.
It’s a distraction from a far bigger problem in New Zealand’s healthcare system: everyday New Zealanders of all races and backgrounds are unable to access acceptable healthcare.
I asked the Minister of Health for data to show whether Te Whatu Ora is delivering on planned care. They’re not even coming close. Between July 01, 2022 and March 31, 2023 Te Whatu Ora fell 16,130 procedures short of its planned volume of 132,469. Only two of 12 areas of care met their targets. Areas such as orthopaedics and ear, nose and throat were thousands of procedures away from meeting their targets.
The health system is slipping away from first-world status and the Government seems uninterested in fixing it.
It has focused on a costly administrative restructure that has created two new mammoth bureaucracies and is prioritising waiting lists by ethnicity.
Much of the problems within the health system can be traced to New Zealand’s general decline in productivity and prosperity. People like to think of New Zealand as a firstworld country but our income figures tell a different story.
Until we have a government focused on economic growth we will continue to see tragedies in our health system.
One of New Zealand’s greatest exports is our experts. And who could blame a nurse for leaving when the Australian median wage is $23,403 more than the Kiwi median wage? Five years ago, it was $17,422. People used to stay here because the great lifestyle and culture made up for the wage gap. Now Kiwis struggle to get medical appointments, are separated by race and are earning even less comparatively.
The next Government needs to raise productivity and wages, make the Government’s books sustainable, and create a culture where work, savings, investment and innovation are rewarded. We won’t have better health services if every year we plunge further into deficit.
With sustainable economic management and a focus on supporting frontline health workers who are making a difference, instead of expensive new bureaucracies, things can improve. Act has already pledged a $163 million boost for General Practice capitation, with ongoing increases in outyears. That increase provides enough funding to equal the subsidy for 2.5 million extra GP visits.
Labour’s health priorities have been all wrong. They’ve wasted billions of dollars on massive restructures only to find they haven’t provided anyone with what matters — that when you need treatment you can get an appointment. Their racial targeting is just a lazy way of papering over their inadequacies.