Tuesday, July 11, 2023

More racial discrimination looming in the health sector

FREE cervical screening will be rolled out from September this year.

Free, that is, to Maori and Pacific women (or to use Te Whatu Ora’s terminology, “people with a cervix”), those with a community services card, and those who have never been screened or not within the last five years.

Te Whatu Ora claims the new initiative is about improving access.

Yes, the rates of cervical screening are lower among Maori and Pacific but the same is true of Asian women. If targeting by race is to achieve equity, why omit Asian women from the free service? In any case, while NZ European women have the highest screening rate, in absolute numbers they still make up the largest group of non-screened.

Alternatively, if preferential treatment is simply to satisfy another new-found Treaty of Waitangi principle, why are Pacific women included?

In practice, Maori and Pacific women who can afford and have regularly used the screening service will be switched to the free programme while other ethnic groups will continue to pay. That’s certainly not equitable.

The truth is many women put off testing due to discomfit, inconvenience or fear of cancer. The new self-tests will hopefully remove some of these barriers, but they should either be free for all or a cost for all. Analysing their take-up will be confused by varying accessibility.

Making Maori and Pacific ethnicity a condition for free eligibility cannot be justified on any sound basis. A publicly funded health system can never guarantee equal outcomes, but it can do its utmost to offer equal opportunity.

Prime Minister Chris Hipkins recently took a step back when the public reacted adversely to the use of ethnicity to decide priority for surgery saying he would get the Health Minister to “make sure there’s no discrimination.”

But Te Whatu Ora just steamrolls on with exclusionary policies based on race. There is no other name for this approach than discrimination.