Patrick Gower: 'Race-based' preference meaningless for 'medical refugees'

OPINION: The health system is so broken I question if the "race-based" preference would even work with some surgeries.

It goes like this: You can't give preference for surgeries that don't exist. You can't jump the queue when there is no queue.

The debate around giving groups preference over others for crucial operations is very important, don't get me wrong. But what about if these operations don't exist?

This week on Paddy Gower Has Issues my issue was with 'medical refugees' - ordinary Kiwis forced to flee New Zealand to get the operations they need.

We looked at the example of bariatric surgery. I was staggered to find we only did 294 of these operations in the public system last year.

Literally thousands of people want or need this but the criteria is so high most of them can't get on the waitlist.

Our example was Colleen from Rotorua. She is Māori. But despite being 140kg and disabled from a stroke she comes nowhere near qualifying for bariatric surgery. Her former DHB, Lakes, did not even offer bariatric surgery. Like I said - there is no queue for her to jump.

I was also staggered to learn from Middlemore Hospital surgeon Richard Babor that the criteria was in his words "dreamt up" to rule people out.

So people waiting to get a knee operation, a hip operation, a cataract operation, but don't meet the criteria, will no doubt be wondering if those have been "dreamt up" too?

I like frontline people like Babor - they know their stuff. He was upfront and said our health system was "crawling". Babor told the truth.

So I found it ironic to hear there was an "algorithm" that takes whether someone is Māori/Pasifika into account when working out where they go on waitlists.

An algorithm like this is pretty pointless if our hospitals are "dreaming up" the criteria to ration out operations.

So that leaves us with these 'medical refugees'. They're putting their health at risk, maybe even their lives at risk and they're raiding their KiwiSaver to do it.

They're going overseas to get operations that they should be able to get done here in our health system.

To get bariatric surgery done privately here, it would cost you $22,000.

But what if I said you can get it done for $13,000 in Mexico? All flights and accommodation paid for. And you can take your KiwiSaver out to do it! Sadly, this is a realistic (but risky) solution for people now.

There is no point in waiting around for any race-based algorithm because there is next to no chance they could get these operations done here.

The debate about "race-based" preference or "equity" in our health system is important. But only when we have a health system that can actually provide the operations.

Patrick Gower is the host of Paddy Gower Has Issues on Three and ThreeNow

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