In New Zealand, the healthcare sector is undergoing a significant reform that has sparked a range of reactions from various stakeholders. Spearheaded by Te Whatu Ora – Health New Zealand, a public health agency established in July 2022, this new policy introduces the “Equity Adjustor Score,” which calls for surgeons to consider ethnicity when prioritizing surgeries. The goal is to address historical disparities in healthcare access.
The Equity Adjustor Score takes into account five factors when determining the order of surgeries: clinical priority, duration on wait lists, geographical isolation, economic deprivation, and ethnicity. Notably, higher scores are assigned to Maori and Pacific Island or “Pasifika” communities, aiming to rectify long-standing healthcare inequities faced by these groups.
Although a similar concept was introduced in the Wellington region in May 2020, the current implementation has resulted in substantial debate. Despite assurances from the Capital & Coast District Health Board’s medical officer, concerns have been raised. Auckland surgeons have criticized the Equity Adjustor Score, describing it as “medically indefensible.”
Dr. Mike Shepherd, interim leader for Auckland at Te Whatu Ora, argues that the policy aims to address a systemic issue. Maori and Pasifika patients often face longer wait times to get on a surgery waitlist. By implementing an ethnic scoring system, the objective is to create an equitable timeline from diagnosis to surgery for all groups.
In response to public outcry, New Zealand Prime Minister Chris Hipkins has defended the system. However, he also acknowledges the need to investigate any complaints of “racial discrimination.” Opposition parties, such as the National Party, have condemned the system, stating that they would never prioritize patients based on ethnicity.
As the controversy continues, it is evident that the debate goes beyond the medical community, delving into social justice and the equitable distribution of resources. This policy serves as a small representation of broader global discussions on how to address systemic healthcare inequities.
The true impact and effectiveness of the Equity Adjustor Score in achieving health equity for historically disadvantaged communities in New Zealand remain to be seen. However, one thing is certain – the policy has ignited a conversation on healthcare equity that will have lasting implications, not only within New Zealand but potentially on a global scale.
As we await further developments, this initiative serves as a reminder of the complexities involved in addressing systemic biases and entrenched inequalities in healthcare systems.