While the College was not involved in developing the equity adjustor, it supports its use in Aotearoa New Zealand hospitals as a way of providing fairer access and treatment to surgical patients.

Chair of the Aotearoa New Zealand National Committee Associate Professor Andrew MacCormick says there are long-standing inequities which mean Māori and Pacific patients have poorer health outcomes compared to the general population.

He says clinical priority is still the most important measure for prioritising patients but by also considering time spent on the waitlist, geographic location, ethnicity and deprivation level, Associate Professor MacCormick says the system can better serve the total population without leaving any communities behind.

“We know there are biases, including unconscious ones, in the current system which mean Māori and Pasifika have more difficulty accessing healthcare and don’t get offered the same level of treatment as the wider population. This means more ill health and disability among these populations and ultimately a lower life expectancy.

“A major goal of the current health reforms is to reduce health inequities. We can’t do that if we don’t make positive changes that shift the dial away from institutional biases.”

He points out that the equity adjustor is aimed at so-called long waiters (those waiting more than 365 days for surgery) and that Māori and Pacific patients are over-represented on that list.

He adds that the equity adjustor is not the whole solution but it is a piece of the health equity puzzle.

“This is not about putting Māori and Pacific health above the health of other people in Aotearoa New Zealand”, he says.

“It’s not a zero-sum game. Elevating those groups that have been less well-served by the health system is a benefit to everyone. It means improved health across the population and the targeting of healthcare to those individuals who need it most.”



Associate Professor MacCormick is a Senior Lecturer in the Department of Surgery, University of Auckland and a Consultant Surgeon at Middlemore Hospital. Unfortunately he is in theatre and is unavailable for comment on 20 June 2023.