This article was first published by RNZ.
A group of Māori academics and health workers are asking the government to rescind its recent directive for public services to be based on need, not race.
In an editorial published in the New Zealand Medical Journal, academics including Papaarangi Reid, Elana Curtis and Rhys Jones said the directive will result in wasteful health spending by limiting the ability to target resources at those in greatest need.
One of the authors, public health physician Dr Belinda Loring, said they saw the directive as unjustified and dangerous.
“The government is concerned that ethnicity is being used as a proxy for need, but actually science tells us that ethnicity is not only an evidence-based marker of need, it’s one of the strongest and best markers of need that we have available to us.”
The directive threatened to take away one of the most sensitive tools that ensure health resources were spent on those most at risk, she said.
“It will encourage us to ignore some of the characteristics that we would normally use to identify those at risk. That threatens to waste healthcare resources, it undermines our efforts to address healthcare inequities and it means that people’s lives will be put at risk.”
There was a very misleading understanding at play that health risks were evenly distributed across the population, she said.
“For example, women are screened for breast cancer because they get breast cancer at a population level more frequently than men.
“So to suggest that things like ethnicity don’t impact on life expectancy, exposure to risk factors, access to care and health outcomes is to ignore the overwhelming mountain of scientific evidence.”
Ethnicity was a strong marker of health need in New Zealand, Loring said, stronger than deprivation, rurality, or age.
“This directive needs to be completely reversed. We have a duty to allocate scarce health resources to those most at risk and we need to use all the characteristics that we can to identify those people most at risk, it’s a fundamental tool of good medical practice.”
Public Service Minister Nicola Willis issued the directive earlier this month, saying it was a result of National being in coalition with ACT.
Willis admitted funding would be considered for services that targeted certain ethnicities if they had a “strong analytical case… based on empirical evidence” that explained “why such an intervention is necessary, like the disparity in the outcomes between the target and the general population, why general services are not sufficient to address that, an assessment of the opportunity cost in terms of the service needs of all New Zealanders”.
ACT leader and Associate Health Minister David Seymour said basing funding on ethnicity was “corrosive to an inclusive multi-ethnic society”.
“Targeting services like healthcare and education based on race is lazy and divisive. The emphasis for the public service should be fitting services to the needs of every New Zealander.
- RNZ
