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.
