The "Ethnicity Score" for surgery
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Auckland surgeons must now consider ethnicity in prioritising patients for operations
Auckland surgeons are now required to consider a patient’s ethnicity alongside other factors when deciding who should get an operation first.
Several surgeons say they are upset by the policy, which was introduced in Auckland in February and gave priority to Māori and Pacific Island patients - on the grounds that they have historically had unequal access to healthcare.
Health officials stress that ethnicity is just one of five factors considered in deciding when a person gets surgery, and that it is an important step in addressing poor health outcomes within Māori and Pacific populations.
Te Whatu Ora - Health New Zealand has introduced an Equity Adjustor Score, which aims to reduce inequity in the system by using an algorithm to prioritise patients according to clinical priority, time spent on the waitlist, geographic location (isolated areas), 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.
Some surgeons, who spoke on the condition of anonymity, said the new scoring tool was medically indefensible. 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.
One of the surgeons said he was “disgusted” by the new ranking system.
“It’s ethically challenging to treat anyone based on race, it’s their medical condition that must establish the urgency of the treatment,” the surgeon said.
“There’s no place for elitism in medicine and the medical fraternity in this country is disturbed by these developments.”
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.
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Why the hell is anybody waiting a year for an operation, let alone two years?
