Playing politics with peoples lives

Written By: - Date published: 2:23 pm, March 10th, 2025 - 25 comments
Categories: act, health, Maori Issues, national, same old national, simeon brown - Tags:

Simeon Brown has been busy lately.

His latest announcement was that the scheme allowing for screening for bowel cancer for Maori and Pacifica over 50 would be cancelled and instead the age for screening for everyone would be reduced from 60 to 58.

From Radio New Zealand:

The government has announced plans to lower the age for free bowel cancer screening for all New Zealanders by “redirecting” money previously set aside to lower the age for Māori and Pacific people.

In December the government announced the end of a pilot programme that allowed Māori and Pacific people to access bowel cancer screening starting at age 50.

Health Minister Simeon Brown said the age of eligibility for free bowel screening would progressively drop from 60 to 58 at a cost of $36m over four years.

He suggested that more lives would be saved through this reallocation of resources. He backed this with figures and suggested that cancer rates for pakeha and Maori and Pacifica were similar.

Act supported the announcement with this graphic which is patently not true.

Screening would be reduced for Pakeha from 60 to 58. For Maori and Pacifica it would be increased from 50 to 58. Act’s statement was only true if they don’t count Maori and Pacifica as humans.

Brown’s figures will need to be interrogated properly. His statement that rates were similar does not necessarily justify the change. If, for instance, the targeted screening picks up more cases in younger persons then the number of years of life preserved may be different.

This paper, published by Otago University’s Department of Surgery, suggests this may be the case.

[T]he results show CRC rates in Māori are increasing disproportionately in comparison to the overall population, driven by increasing numbers of younger Māori patients. While overall incidence of CRC remains lower in Māori compared to the total population, incidence rates of colorectal cancer in Māori under 50 years rose by 36 per cent per decade on average, faster than the rates seen in the total population (26 per cent). Māori are also disproportionately affected by EOCRC, with 18 per cent of all cases diagnosed in Māori in 2020 being under the age of 50 years, compared to 8.5 per cent in the overall population.

“This is of grave concern, because once they are diagnosed with colorectal cancer, Māori are more likely to die from their disease than non-Māori, and also more likely to be diagnosed with stage 4 advanced disease, possibly due to delayed diagnosis and inequitable access to cancer treatment,” Dr Waddell says.

“If these increases go on unchecked, we will see colorectal cancer rates in Māori overtake those of the general population.”

On the back of these findings, the study authors are now calling for the bowel cancer screening age in Aotearoa New Zealand (currently 60 for non-Māori and 50 for Māori) to be extended and lowered further, to help combat inequity.

“We believe screening for average-risk people in New Zealand should start at at least age 45,” Dr Waddell says.

Otago University’s study concludes that the trend for Maori is worsening. Decisions should be based on trends rather than current statistics.

Brown’s change to the screening policy has been savaged by a number of people who know what they are talking about.

From Mary Afemata at Radio New Zealand:

CEO of Hei Āhuru Mōwai Gary Thompson called for a pause on the decision, citing it’s conflict with current medical evidence and the lack of notice, which left no time to assess it’s impact or inform providers and whānau.

“Returning to the 60-year age limit for Māori and Pacific peoples means that the bowel screening programme will increase inequities in bowel cancer incidence, survival and death rates between Māori and non-Māori,” he warned.

“It will harm Māori and Pacific peoples and worsen the 7-8-year life expectancy gap.”

…

Doctor Rawiri McKree Jansen explained that most Māori diagnosed with bowel cancer were under the age of 60, compared to just under a third of non-Māori.

“Bowel screening detects small, potentially curable cancers and prevents cancer by removing precancerous polyps.

“Both Māori and non-Māori have a similar chance of getting bowel cancer, but over half of Māori who get bowel cancer are diagnosed before the age of 60 years (58 percent in females and 52 percent in males).

“This is compared to just under a third for non-Māori (27 percent in females and 29 percent in males).

“For non-Māori, three-quarters of people are diagnosed over the age of 60. Keeping bowel screening available to Māori and Pacific peoples from age 50 would make the national bowel screening programme fair.”

…

CEO of Bowel Cancer NZ Peter Huskinson expressed his disbelief at the abrupt cancellation of the programme, especially without a formal statement in the House.

“This decision will mean unnecessary suffering and deaths among Māori and Pacific communities – deaths that could have been prevented with proper screening at the right age,” he said.

…

Medical advisor for Bowel Cancer NZ professor Sue Crengle said, “More Māori and Pasifika bowel cancer is diagnosed before age 60 years.

“As a result, these groups had less opportunity to benefit from bowel cancer screening than other ethnic groups.

“Starting screening for Māori and Pasifika people at age 50 years mean’t the benefit from the programme was equal across all ethnic groups. It would be incredibly disappointing if this has been stopped.”

If you want to understand the core of the problem, and why “preferential” treatment is appropriate you have to look no further than the figures for life expectancy.

This 2024 report from Te Whatu Ora noted that Maori and Pacifica life expectancy is 77 years. It is 84 years overall. If you are Maori or Pacifica you can expect to die 7 years earlier than your average kiwi.

Of note is that the difference was 8.3 years in 2001 to 2003 and had reduced to 6.6 years by 2020 to 2022. Also of note is that New Zealand’s life expectancy went up during the Covid years, one of the few countries that saw an actual increase. Take that Ardern haters.

The other aspect of this is National’s promise before the last election to reduce the screening age to 45. This suggests more cash would be provided. This current proposal involves taking from one budget to top up another.

The decision is retrograde, has more than a slight element of dog whistle about it, will worsen life expectancy for Maori and Pacifica and is in breach of National’s campaign promise.

How typically Simeon.

25 comments on “Playing politics with peoples lives ”

  1. Mac1 1
    10 March 2025 at 3:37 pm

    As my Pakeha oncologist said to a meeting of prostate cancer survivors, 'the health system is racist'.

    Here's what I wrote on the Standard then, comment #9. 20 https://thestandard.org.nz/nationals-very-bad-day/#comment-1789164

    One point was that detection for Māori came at a later stage, a factor being that the disease came earlier than for Pākehā.

    [Link fixed – Incognito]

    Reply
    • Barfly 1.1
      10 March 2025 at 4:01 pm

      "One point was that detection for Māori came at a later stage, a factor being that the disease came earlier than for Pākehā."

      That I think is a heck of a reach, personally I suspect a greater unwillingness or disinclination to seek medical assistance on the appearance of symptoms related to cost and or cultural issues.

      Reply
      • Mac1 1.1.1
        10 March 2025 at 4:11 pm

        You're right, as well, Barfly. I did say 'a factor'.

        But, this was said by medical advisor for Bowel Cancer NZ professor Sue Crengle, “More Māori and Pasifika bowel cancer is diagnosed before age 60 years." That means either these two groups contract earlier or are diagnosed earlier than Pākehā.

        We are also talking about many cancer types. My oncologist was focussing more on prostate cancer where factors such as distance, male reluctance, and later referrals for treatment for Māori by health professionals all came into play, and as you say cultural and cost reasons.

        Reply
      • Incognito 1.1.2
        10 March 2025 at 6:40 pm

        Your reasons are some of the reasons for later detection and diagnosis, which makes treatments harder, more costly, and less successful thereby contributing to the overall lower life expectancy.

        Reply
        • gsays 1.1.2.1
          11 March 2025 at 12:16 pm

          I've been wrestling with why is primary health care generally privately run and yet it is so important for early diagnosis of these things?

          My sister-in-law is a nurse in the local health center her wages are a lot lower than nurses in hospitals. She doesn't belong to a union anymore. But thinks the government should top up her wages.

          Meanwhile the shareholders (G.Ps) of the health centre return a profit to themselves every year.

          Surely increasing private health practice nurses wages is just a subsidy to said shareholders.

          Reply
          • Incognito 1.1.2.1.1
            11 March 2025 at 7:33 pm

            Good questions and fair comments.

            I don’t think access barriers for patients to primary healthcare are due to funding issues only – it isn’t that simple. NB, a patient is a healthy person until they set foot in the door of healthcare provider and are diagnosed with something.

            Reply
  2. Tony Veitch 2
    10 March 2025 at 3:42 pm

    It should also be noted that ALL the money allocated for various initiatives is not new money, just redirected. As Craig Renney points out:

    https://craigrenney.substack.com/p/not-in-rude-health-just-rude

    Reply
  3. Davi 3
    10 March 2025 at 5:02 pm

    Bowel cancer detected early enough has a far better outcome, than when it is detected late. This is an issue for all people, irrespective of race or skin colour.

    When it comes to cancer, many people ignore symptoms until it’s too late. Often it’s those with lower incomes, poorer levels of education and those who have no or limited access to primary health care, are the people who suffer the greatest, irrespective of their skin colour.

    Lowering the age for bowel screening, across the board, (to 58) will result in more lives being saved, than keeping it at 60 years for the bulk of the population, while lowering it for Maori and pacific island people. This is assuming that all people who qualify to have bowel screening take action (unlike me, I filed my test kit in the to do later, when I have time).

    Ideally bowel screening should be 50 years or younger, and for those who have a family history it should be about 30 years.

    Reply
    • Barfly 3.1
      10 March 2025 at 5:26 pm

      "Often it’s those with lower incomes, poorer levels of education and those who have no or limited access to primary health care, are the people who suffer the greatest, irrespective of their skin colour."

      Often it’s those with lower incomes, poorer levels of education and those who have no or limited access to primary health care, are the people who suffer the greatest, unsurprisingly in New Zealand that is a higher % of people with dark skin colour.

      FIFY

      Reply
      • David 3.1.1
        10 March 2025 at 8:20 pm

        People of european descent (especially Scottish decent) are more likely to develop bowel cancer early, 40’s and 50’s than people of maori and pacific island decent.

        Dropping the age for screening to 50 for Maori/pacific island, while keeping the age for screening at 60 for all others will save fewer lives, than Lowering the age from 60 to just 58, for everyone across the board. The greater the number of people who are treated early, will save more lives, improve the overall quality of life for survivors of bowel cancer, and cost less.

        One way to close the life expectancy gap between maori and non maori, would be to deny life saving healthcare to non maori. Somehow this will be a very hard sell to non maori/pacific voters.

        Reply
        • Drowsy M. Kram 3.1.1.1
          10 March 2025 at 8:30 pm

          One way to close the life expectancy gap between maori and non maori, would be to deny life saving healthcare to non maori.

          Another way would be to improve the delivery of life-saving healthcare to Māori, but this would go against Simeon and Seymour's ‘ideology’.

          Maxine Ronald: Why do we have to keep explaining the ethnicity gap?
          It’s so frustrating and it’s tiring. There’s an actual physical tiredness of having to deal with it, especially when it’s been landed on us as a surprise, as a headline out of the blue, which creates the conditions for racist reactions and interpretations.

          I wouldn't want my surgeon to be tired – how about you?

          Reply
          • David 3.1.1.1.1
            10 March 2025 at 9:10 pm

            The specialist physician, as well as the surgeon who I’m referred to see it somewhat differently. They would like genetic testing at an early age for people who have a family history, and across the board screening from age 50.

            When it comes to bowel cancer, testing only maori/pacific people at age 50 has a limited impact on saving life. At an earlier age non maori/pacific people have a lower risk of bowel cancer the european people.

            You have simply rephrased my statement, improving healthcare to only Maori/pacific people, may well improve the overall life expectancy of maori/pacific people, while allowing greater numbers of non maori/pacific people to simply die, simply due to their race. What is needed is better access to primary healthcare across the board, especially targeting those with lower levels of education, lower income, and those who have higher levels of risk of developing cancer, diabetes, heart disease etc.

            Again good luck selling a policy that targets just maori/pacific people, while ignoring all others who are already on lower incomes.

            Reply
            • Drowsy M. Kram 3.1.1.1.1.1
              11 March 2025 at 8:08 am

              You have simply rephrased my statement, improving healthcare to only Maori/pacific people…

              Did I say that only Māori/Pacific people should have improved healthcare?

              What is needed is better access to primary healthcare across the board…

              yes It's one thing that's needed, and it might not come cheap – here’s hoping.

              Again good luck selling a policy that targets just maori/pacific people, while ignoring all others who are already on lower incomes.

              Only you mentioned "ignoring all others [all non-Māori/Pacific people] who are already on lower incomes" – that’s a very tired race-baiting distraction, imho.


              https://thespinoff.co.nz/society/16-08-2022/the-side-eyes-two-new-zealands-the-table

              Nicky Hager: Beware the smooth talker with a forked tongue
              David Seymour and Act know exactly what they’re doing.
              …
              Act billboards say End Division by Race, but it is
              actually more like Defend Division by Wealth.

              Reply
        • joe90 3.1.1.2
          10 March 2025 at 8:45 pm

          People of european descent (especially Scottish decent) are more likely to develop bowel cancer early, 40’s and 50’s than people of maori and pacific island decent.

          Cite?

          Reply
          • David 3.1.1.2.1
            10 March 2025 at 9:18 pm

            Without providing you access to my medical records, that will be difficult. However I have no reason to doubt what both my specialist physician, and surgeon advise me. This BTW is something that I’ve lived with since the late 80’s. There however are other diseases/cancer that maori/pacific people are more predisposed to develop.

            Reply
            • Incognito 3.1.1.2.1.1
              10 March 2025 at 9:33 pm

              The problem with anecdata is that no one can verify anything, which makes for poor debate when trust levels are sub-optimal.

              https://www.stuff.co.nz/wellbeing/350262323/compounding-factors-increase-bowel-cancer-risk-southland

              Reply
            • joe90 3.1.1.2.1.2
              10 March 2025 at 10:29 pm

              Thing is, your evidence free assertion is you buying into the racism in health care policy trope that drove the furore over free GP visits for young Maori/PI in HB when in reality, it was sound public health policy.

              In HB, high needs youngsters regardless of ethnicity were catered for with free GP visits and the next cab off the public health rank was young people who for one reason or another had not seen a GP early enough in the piece and were presenting to ED in acute stages of whatever it was that ailed them.

              And the majority of those young people with health issues that could have been nipped in the bud by little more than a timely visit to a GP were bunging up ED's, requiring hospital admissions, more complicated and expensive interventions and outpatient care, were Maori and PI.

              So despite extending free GP visits to that cohort having nothing to do with ethnic privilege and everything to do with sound public health policy, it was just too fucking much for smooth-brained ZB denizens and off they went.

              Again, can you cite evidence to support your assertion?

              Reply
              • David …
                11 March 2025 at 9:00 am

                You seem to be going around in circles. Healthcare, along with preventative screening, should to be determined by need and actual clinical risk, not race. As soon as we bring race into the equation, we provide ammunition for the likes of ACT.

                we know that people living in poverty, have little education etc fare worse. Yes maori/pacific people make up a greater percentage, however the numbers are less than the general population. Why should a poor, uneducated person of european or asian decent be discriminated against purely because they are the wrong race and poor?

                Reply
            • Belladonna 3.1.1.2.1.3
              11 March 2025 at 12:41 pm

              There appears to be research on the topic. Results appear to show that colorectal cancer has a significantly higher rate among Scots- but this is not shown for other varieties of cancer.

              “Does the ‘Scottish effect’ apply to all ethnic groups? All-cancer, lung, colorectal, breast and prostate cancer in the Scottish Health and Ethnicity Linkage Cohort Study”

              https://bmjopen.bmj.com/content/2/5/e001957

              Reply
    • alwyn 3.2
      10 March 2025 at 7:26 pm

      I know very little about the subject but surely the following actions should increase the chance that people who have the disease get picked up earlier.

      Some of the primary causes of bowel cancer appear to be obesity, smoking, Type 2 diabetes, excessive alcohol consumption and high red meat consumption.

      Why can doctors automatically note whether a patient they see seems to have a number of these factors and if so refer them for screening, regardless of age or race?

      Reply
      • David 3.2.1
        10 March 2025 at 8:44 pm

        Currently people who have a genetic predisposition, or family history of bowel cancer are encouraged to have bowel screening from a much earlier age. I’ve had the colonoscopy every few years, however I’ve had to pay myself for this. The newer screening kits are cheaper and do a similar job, however with my family history the colonoscopy is recommended. Ideally I could have a genetic test/screening to determine my risk, I’ve been waiting about 4 years to get a referral. I believe this testing is far cheaper, but it’s very limited.

        Reply
  4. Drowsy M. Kram 4
    10 March 2025 at 5:30 pm

    “It will harm Māori and Pacific peoples and worsen the 7-8-year life expectancy gap.”

    Simeon's ideology will aggravate this gaping wound – Seymour (unsurprisingly) loves it.

    I thought it couldn't get much worse than our CoC govt repealing smokefree legislation.

    Repeal of smokefree laws means thousands will die, researchers warn
    Researchers from the University’s ASPIRE Aotearoa Research Centre branded the repeal as “shameful”, saying it lacked evidence, logic and popular support.

    I was very wrong.

    "The Government’s privatisation agenda has been well and truly exposed in Minister Brown’s priorities," said Fleur Fitzsimons, National Secretary for the Public Service Association Te Pūkenga Here Tikanga Mahi.

    https://www.nzdoctor.co.nz/article/undoctored/no-place-privatisation-health-alarm-bells-should-be-ringing

    Where Is the Resistance to Privatisation and Austerity? [8 March 2025]
    Here, we must heed another warning from America. If left unchecked, the wealthy elite will run society into the ground. Donald Trump and Elon Musk are taking a sledgehammer to the already-broken federal government, stripping back every piece of social and environmental legislation they can get their greedy hands upon. The same phenomenon is taking place in Argentina under libertarian President Javier Milei — poverty has soared as a result, with over half of the country now living below the poverty line.

    This is the future that David Seymour wants for Aotearoa. The ACT Party represents ultra-wealthy libertarian donors who are hell bent on increasing their profits at all costs. Healthcare privatisation is just the start — this corporate elite will tear our society apart with its insatiable, rapacious greed.

    We have to stop them before this oligarchic American horror story is unleashed upon our country.

    Reply
    • KJT 4.1
      10 March 2025 at 6:51 pm

      Too late. Been happening since the 80's.

      Just that our system prevents immediate fascism. Imagine the damage with four year terms?

      Which is why we have to fight for frequent elections and more democracy.

      Reply
      • Drowsy M. Kram 4.1.1
        10 March 2025 at 8:03 pm

        yes three-year terms, even if they only delay the inevitable consequences of greed – with the 'right' settings, NZ healthcare could be more profitable than banking.

        The 'Silent Violence' of Corporate Greed and Power [8 Dec 2024]
        But corporate culture, marinated to the core with endless cravings for ever-growing easy profits, is very hard to change – especially when it is so easy to extract more and more premium dollars from powerless consumers who lack adequate regulatory protections.

        I used to do health insurance company PR. Here’s what I think the backlash is missing [11 Dec 2024]
        Every year, my colleagues and I across the [healthcare and insurance] industry devoted massive amounts of the money — money our customers paid us to cover their medical care — on lobbying, campaign contributions, deceptive PR campaigns, and even charitable donations to buy goodwill. All of that was spent for the sole purpose of maximizing shareholder return.

        So why not invest in our CoC govt's 'healthcare for profit' plans – 'sorted' here I come!

        Private Financial Actors and Financialisation in Global Health [Jan 2025]
        The era of the Sustainable Development Goals has become the era of private finance. Decades-long political, economic and social trends have seen rapid growth in the size and scale of private finance relative to public finance, and the increasing political power of private financial actors. In global development, this has taken form in narratives and actions that establish and quantify investment gaps, call for greater and greater levels of private finance to fill these gaps, and create new financial instruments with which to realise the expansion of private financial capital. These changes are sometimes referred to as ‘financialisation’.

        This briefing paper responds to the expansion of private finance in global health, demystifying the process of financialisation and offering a vital counter-perspective to an increasingly pervasive but questionable narrative that positions private finance as necessary to the future of global health. The paper charts the expansion of private finance across global health, pointing to how actors once marginal to this sector are becoming central to its financing and governance. Drawing on several case studies and a growing body of evidence, the briefing paper highlights three overlapping concerns associated with the financialisation of global health: the high cost of private investment; the undermining of public health principles and values; and the weakening of democratic governance and regulatory capture by powerful private financial actors.

        The paper raises the alarm that many aspects of financialisation in global health are harmful and calls for three sets of action:
        1. challenge the common fallacies and false narratives regarding private finance and associated financial instruments;
        2. press for change in public and multilateral policy and practice;
        3. advocate for alternative models of financing and governance that are more strongly rooted in the public interest.

        Corporations and billionaires are increasing their wealth at astounding rates while the rest of us are suffering the consequences of their greed.
        https://www.oxfamamerica.org/explore/stories/how-are-billionaire-and-corporate-power-intensifying-global-inequality/

        Reply

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