New Zealand is engaged in a charged race debate over the prioritisation of surgeries to certain demographics, including Maori and Pacific people, who suffer worse health outcomes.
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Public health authority Te Whatu Ora introduced a new 'Equity Adjuster Waitlist' tool for non-urgent procedures in Auckland, which ranks patients to undergo surgeries.
The top two factors are a patient's clinical urgency and the length of time the patient has spent on the wait list.
The hospital also takes into account the patient's geographic location, prioritising isolated patients, as well as their deprivation level, and most controversially, their ethnicity.
"These adjustments are based on evidence which shows these groups often have inequitable health outcomes which often begin at the start of their healthcare journey," Te Whatu Ora spokesman Mike Shepherd said.
Maori and Pasifika, on average, live several years less than other New Zealanders.
Dr Shepherd likened the algorithm to Maori or Pasifika getting an extra one or two points out of 100.
The rankings drew the ire of right-wing radio station Newstalk ZB and its sister publication the NZ Herald, which published a story of anonymous surgeons speaking out about the "ethically-challenging" rankings.
They were joined by opposition National party leader Chris Luxon, who called the promotion of ethnicities "nuts".
National health spokesman Shane Reti told AAP the party would scrap the ethnicity weighting, relying on the deprivation and geographic weighting to get to those most in need.
"While there has been historical inequity that has disadvantaged Maori and Pasifika people, the idea that any government would deliberately rank ethnicities for priority for surgery is offensive, wrong and should halt immediately," he said.
Prime Minister Chris Hipkins backed the idea of prioritising those in need, while ordering a review to ensure the tool is "not replacing one form of discrimination with another".
The debate is the latest in a long line of spats on race relations in New Zealand, an issue which will colour this year's election.
National is opposed to Maori-specific service delivery and has fought the Labour government's introduction of Maori power-sharing models.
For their part, surgeons appear desperate to address inequities, though in different ways.
The Royal Australasian College of Surgeons offered fulsome support, with NZ chair Andrew MacCormick saying "elevating those groups that have been less well-served by the health system is a benefit to everyone".
"It's not a zero-sum game ... this is not about putting Maori and Pacific health above the health of other people in Aotearoa New Zealand", he said.
Christchurch-based Orthopaedic Association spokesman John McKie said there was division in the industry, which he called "desperately underfunded".
"Being asked to positively discriminate in favour of Maori and Pacific peoples ... there are a lot of people who feel fairly uncomfortable about that," he told AAP.
Vanessa Blair, president of the New Zealand Association of General Surgeons, said the disparities suffered by Maori and Pasifika was "an uncomfortable truth".
"There's massive support in our organisation to tackling inequalities in our system and at all levels, rural inequities, particularly inequities around Maori and Pasifika," she told AAP.
The anaesthetists association also gave their support for the tool.
LIFE EXPECTANCY IN NEW ZEALAND
Maori: men - 73.4 years, women - 77.1 years
Pasifika: men- 75.4 years, women - 79 years
Non-Maori: men - 80.9 years, women - 84.4 years
Australian Associated Press
