Photo: RNZ/Jarred Williamson

The story that set the political tone for the week came out on Monday morning.

Since February, Auckland hospitals had been using an algorithm to help determine patients’ positions on the waitlist for non-urgent surgery. One of the weightings was priority for Māori and Pasifika patients.

It was part of a matrix of other factors to be taken into account. Clinical need was first and foremost, but time already spent on a waitlist, geographic isolation, and socio-economic deprivation were in the mix. 

Prime Minister Chris Hipkins said the equity tool was designed to right past wrongs when it comes to health outcomes.

“The facts are pretty clear at the moment. If you’re Māori or Pacific … you have been waiting longer, with the same clinical need, compared to other New Zealanders,” he said.

In spite of that he’s asked his health minister to take another look at the policy before it gets rolled out nation-wide. 

The National and Act parties decried the policy as promoting racial discrimination in the health system.

“Race shouldn’t play any part in determining surgical need,” National Party leader Christopher Luxon said.

Newsroom‘s political editor Jo Moir tells The Detail that adjusting waitlist priority based on ethnic background has been a routine feature of Auckland’s non-urgent surgeries for years now.

What made the waitlists blow out in the first place was the Covid-19 pandemic, she explains.

“In terms of waitlists, you’ve got backlogs now at record lengths. One of the latest figures I saw was over 90,000 people overdue for treatment or a specialist appointment.

Health officials don’t expect the backlog to go away until 2025, Moir says.

Facing down serious delays for thousands of patients, Auckland health administrators created a new priority system for non-urgent surgeries, seeing an opportunity to proactively address the well-known deficiencies in health outcomes for Māori and Pasifika people.

There were two criteria: firstly, clinical need – which Moir says “will always be the first, and will always take precedent … in terms of whether you get surgery or not” – and secondly, ethnicity.

Clinicians felt the tool was too blunt, and encouraged the development of more criteria for assessing priority.

This ultimately led to the equity algorithm introduced in February.

When Moir spoke to one of the people behind the algorithm, Te Toka Tumai surgical services manager Duncan Bliss, he told her there was no arguing that what ethnicity you are has an impact on what sort of healthcare you get in New Zealand.

In every piece of data from the health system, Māori and Pasifika people were falling behind, he said.

“I said to him, ‘Did you take into consideration how [the algorithm] would be received? Have you been surprised by the backlash that’s come from this?’

“And his response to me was, ‘Well, we haven’t looked at it from race … it was based on data. We come at these things from a health perspective, we don’t come at it from a political one’.”

But the fact the country is hurtling ever-closer to the general election has added an extra layer to political debate over the issue.

“Race and ethnicity and culture wars, and all this stuff that’s really divisive … it’s been an ugly debate for a number of years, but I think increasingly so in more recent years, especially since the Covid-19 pandemic,” Moir says. 

“I don’t think politicians necessarily want to be having that debate … but it’s politics, and there are certain politicians that are going to jump on something that they see as a trigger point for people.”

Hear more about how the equity algorithm was received across the political divide by listening to the full podcast.

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