The Māori Health Advisory Group (MHAG) of the Royal Australasian College of Surgeons says the data shows being Māori or Pacifica, or from a lower socio-economic or rural community, are all risk factors for poorer health outcomes.
They say that while the Equity Adjustor Score introduced by Te Whatu Ora - Health New Zealand is still evolving and doesn't account for every at-risk patient group, such as the disabled, it is a necessary step.
Dr Maxine Ronald, a general surgeon based in Te Tai Tokerau and a member of MHAG, states that ethnicity is an independent risk factor for poor health outcomes. She points to research that shows Māori women from high and low decile groups have the same survival outcomes for breast cancer unlike non-Māori that have different outcomes depending on decile. This shows that wealth is not protective for Māori and that ethnicity is a risk factor in and of itself.
"This is not about Māori and Pacific patients leapfrogging up the waitlist but rather ensuring they are seen within appropriate timeframes; something that isn't always happening under the current system. We can see that in the research into health outcomes and in the disproportionate number of Māori and Pacific Peoples among the long waiters (patients waiting more than 365 days for surgery)."
She adds that the tool, being trialed in Auckland and Northland, is of most relevance for patients with benign, non-life-threatening conditions. Patients with high risk, potentially life or limb threatening conditions will not be pushed down the list out of their allocated, urgent timeframes.
"Clinical priority is always going to take precedence and the equity adjustor tool won't change that."
In addition to clinical priority, the tool will also consider time spent on the waitlist, geographic location, ethnicity, and deprivation level when prioritising patients.
She says the equity adjustor isn't the total solution but after having met with the group responsible for developing it from Te Toka Tūmai, she feels optimism the tool is a step in the right direction.
"This won't solve the problem of health inequities by itself. It is just one part of what needs to be a much broader equity strategy that looks at healthcare at every stage, from prevention to diagnosis and treatment."
Dr John Mutu-Grigg, orthopaedic surgeon and chair of the Māori Health Advisory Group points out that the data from Te Toka Tūmai shows that prior to the tool being implemented, Māori and Pacific patients were waiting much longer than other ethnicities. Now with this tool in place, Māori and Pacific Peoples wait the same time as other ethncities. Whilst using the new tool, the evidence shows that no ethnicity has preference over any other, and only with this tool do we help address ethnic inequity.
Dr Ronald says she expects the tool will be evaluated before it is rolled out to other parts of the country.
