Another week and another example of National using dog whistle racism to stir up hatred and try and gain political advantage.
This time it is to attack the notion that our health system should be seeking to look after those most in need.
During Covid the Auckland District Health Board’s Clinicians noticed that the list system did not favour Maori and Pasifeka and set out to address this problem. The primary consideration was still need. But extra points were awarded to those ethnicities in an attempt to ensure that the allocation process produced a statistically fairer result.
Jo Moir at Newsroom describes the background:
During Covid-19 medical professionals in Auckland identified that Māori and Pasifika were disproportionately waiting for surgery compared with other population groups and sought to fix it when operating theatres were back up and running after the 2020 lockdowns.
All the health data pointed to ethnicity being a significant factor, so alongside clinical need – how urgently someone requires surgery – Auckland hospitals started working its way through waitlists using those two criteria for routine surgeries.
When doctors decide who should be front of the queue, everyone is first and foremost put into a clinical priority category of urgent, semi-urgent, or routine.
Duncan Bliss, Te Toka Tumai surgical services manager, is part of the team who created the algorithm for a new equity adjustor score that was rolled out in Auckland in February.
He tells Newsroom he can’t stress enough that clinical need “always takes precedence and the equity adjustor doesn’t interfere with that”.
So the policy, created by clinicians, appears to be rational.
And Sir Colin Tukuitonga has explained why results were so bad for Maori and Pasifeka and why an adjustment is appropriate. From the Herald:
Sir Collin Tukuitonga, a leading expert in Pasifika health, said Māori and Pasifika patients could be moved to the front of surgical lines due to the inequalities in the previous stages of the health system, such as the referral process.
“Māori and Pacific people tend to linger on the referral list… and inevitably, I think people will say that there’s also an institutional bias, possibly a racism that doesn’t put them where they need to be in order to get the surgery,” Tukuitonga said.
“The referral pathways are not that straightforward.”
Tukuitonga specifically used the example of bariatric surgery, which helps to aid those with morbid obesity, which he said was “much more” prevalent in Māori and Pacific communities than in Pākehā. He said this could be another reason why these patients are being brought forward in the waiting times.
“For most of the surgical interventions, Māori and the Pacific people don’t get to get the rates of interventions that might be warranted given their conditions,” Tukuitonga said.
He added: “In other words, it’s not acceptable to have a group in the population where obesity is a major problem and yet they’re not getting the physical intervention that they require.”
And the consequences of what Tukuitonga described are clear.
But National, egged on by the Herald and Newstalk ZB, sensed a chance to blow that dog whistle hard. And blow it they did. As well as blame the Government for something that Auckland’s clinicians had decided on.
And Luxon was not going to worry about reality getting in the way of a good old racist smear as this interaction with media yesterday shows:
Q – What evidence do you have to support the fact that there was a government directive?
A – Clearly the clinicians are saying there’s criteria that’s been passed down to them that they are expected to activate or to make priority and ranking decisions around patients on. In this case, what we’re saying is look, there is just no need for that.
Q – That criteria has been given to the clinicians by a multidisciplinary team who designed the algorithm. They were the same team who in COVID decided their clinical need and ethnicity should be the only two measures for waiting lists that’s now broadened out to five criteria, which is what we’re talking about today. So a multidisciplinary team of medical professionals, Maori Primary care groups, a whole bunch of medical professionals and clinicians came up with this. So what’s your evidence that the government told them to do this?
A – Very simple, very, very simple, there is no room or no need, we always look to prioritise health services and people’s medical needs and surgical needs not their ethnicity.
Q – That doesn’t answer the question. What evidence do you have that the government directed this?
A – Well, it’s clear you’ve had a reaction from from the surgeons to say that this is not something that we are comfortable with at all.
Q – I’ve just explained to you that a team of medical professionals …
A – I don’t care. There is no room.
Q – You don’t care about the facts?
A – There is no room for health services to be based on basis of ethnicity rather than the facts.
This transaction shows how disingenuous Luxon is.
Getting back to the heading of this post there is a saying in sport that winning ugly is fine as winning is the only important thing. Clearly National believes that this applies to politics too and is willing to win this election using ugly tactics and completely indifferent to the damage that it will cause to the country.
I hope they lose. If they gain power they will wreck the place.
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