Peter Davis on ethnic weightings for surgeries

The usual suspects portray anyone who opposes having ethnic weightings for surgical weight lists as a right wing racist. Bearing that in mind, they may find this article by Professor Peter Davis of interest:

I was an elected member of the Auckland District Board when, shortly after the board convened in early 2020, our Chair, Pat Snedden, challenged us about the issue of ethnic inequalities in health outcomes and access to health care. What could we, as a major DHB, do about this? We debated this long and hard and eventually, perhaps as an interim measure, this resulted in some patients being bumped up the waiting list. Far more useful and defensible in my view was the introduction of “navigators” to help Māori and Pacific patients through a complex system faced by many professional and personal barriers.

No one would object to resourcing support for people to access the health system. That is very different to having an ethnic weighting which would see David Seymour moved ahead of Chris Hipkins on a surgical waiting list because Seymour is and Hipkins is not.

Davis explains his objections:

  • The did not seem to support the need. For example, I worked out from 17 service directorate waiting lists that, except for one or two directorates, Māori and Pacific patients had waiting times somewhere between 20% below and 20% above other patients. 
  • You don't want to mess with objective clinical criteria. This has been a hard-won system from the 1990s designed to remove subjectivity and arbitrariness from waitlist decisions.
  • If you wanted to pick up on disadvantage, more inclusive than ethnicity would be socio- position – such place of residence – as a bit of a broader catchall.
  • The danger that, if taken the wrong way, this initiative might be taken as a signal to other groups that the public system is not for them and they start to migrate wholesale to the private sector.

All very sound points.

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