Needless attack on government directive by public health academics

In September 2024 the government issued a directive to government agencies not to prioritise services on the basis of race. Shortly after, a group of public health academics from Auckland and Otago Universities wrote a paper which was published in the NZ Medical Journal strongly opposing the directive.

They began by objecting to the term "race" because it is "discredited terminology" which "suggests that the foundations of white superiority are still alive and well in New Zealand today."

They argue that Maori ethnicity is an "evidence-based marker of need" and is "superior to many other markers of need." The example is given of the bowel cancer screening programme failure to recognise that "over half of Maori cancers occurred before the screening threshold of 60 years." The inference is, in this instance, being Maori is a "superior" marker of need.

It isn't. It is an additional and relevant marker. The government directive deals with this possibility as follows:

8.1 when considering proposals for services targeted to specific population groups, agencies should engage responsible Ministers early about choices or options being considered and:

8.1.1 provide a strong analytical case for targeted investment (based on empirical evidence about why such interventions are necessary, i.e. the disparity in outcomes between the target and the general population and why general services are not sufficient to address this), and an assessment of any opportunity costs in terms of the service needs of all New Zealanders

Yet the group persists with an overarching dismissal of the directive saying:

"This directive, and the political discourse surrounding it, is an affront to scientific and public health knowledge, and requires explicit rejection from health professionals and the scientific community."

The hyperbole only increases culminating with a threatening reprimand: 

"The Government’s directive is not just an attack on Māori, but an attack on science and good medical practice. Anyone who supports this directive, either actively or complicitly through their silence, is supporting the undermining of our collective scientific knowledge and commitment to evidence-based medical practice."

This implies that any health professional who quietly supports the directive will be perceived and painted as some sort of traitor. Heavy stuff.

But then, in an astonishing, concluding, admission which undermines their own credibility the authors write:

"Our concern is that this circular will be interpreted as shorthand for “no more ethnicity-based anything” when this is not what the directive actually says, and certainly not what is needed."

Indeed. The directive, issued by the Department of the Prime Minister and Cabinet, is quite clear and considered.

Not so the lead author, Belinda Loring,  who told Radio New Zealand, in justifying her stance:

"The good outcomes and high level of high quality service that Pākehā receive isn't the same for other ethnic groups. So it's that inequity that continually needs to be adjusted."

This comes as something of a surprise from one who values "regard for evidence" so highly. The escalating inability to access primary healthcare due to the diminishing availability of GPs; the consequent long waits at ED and after hours clinics; the long wait times for elective surgery; the shortage of ambulances etc are all well-documented and affect all New Zealanders, especially those who live in rural areas.

With that statement the author has only contributed to the "political discourse" she rails so angrily against.