There’s been a deluge of coverage about inequities in the health system and whether a new tool to help fix them is fair.
But, as Connie Buchanan argues here, the whole thing wasn’t a health issue at all, but a media one.
The close attention paid by the Herald to the RNZ pro-Russia scandal would be better applied to its own skewed output on issues closer to home.
Last week, it allowed a story about action on health inequities to be framed as something that might be racist against Pākehā.
The headline, angle and interviews were sifted and tweaked to create a slant which implied that non-Māori might unfairly miss out as the result of a new waiting list prioritisation tool.
Just like the Russia stories, it was a slippery and careful rearrangement to suit a specific purpose.
The headline read: “Auckland surgeons must now consider ethnicity in prioritising patients for operations — some are not happy.”
How many were “some” surgeons? It didn’t say. Why could we not learn who they were? We weren’t told.
Still, the story led with the opinions of these secret complainers, who were apparently “disgusted” at the “elitism” of the tool.
There are a hundred other ways it could have been written.
“Auckland Hospital tackles unfair wait lists.”
“Auckland Hospital must now consider geography, socioeconomic status, ethnicity and other factors in prioritising patients . . .”
“New tool aims to address unequal surgery wait times for rural, poor, Māori and Pacific people . . .”
And so on.
But the story was put together by two political editors, not by health journalists.
And Barry Soper and Jason Walls could clearly see the political potential in an angle that hinted at special and unfair treatment based on race.
Never mind that the tool has been programmed to always prioritise clinical assessment over any other factors.
Never mind that ethnicity is just one of five categories for wait-list management.
Never mind that ethnicity is included because it’s a proven independent factor in health outcomes.
Never mind that health inequities based on ethnicity cost the system over $860 million a year and everyone agrees targeted action is needed.
Never mind that lifting Māori and Pacific up won’t push others down.
Never mind all of that. Barry and Jason went ahead anyway and isolated ethnicity, used one or two anonymous voices to attack that aspect, and then piled up the article with on-the-back-foot justifications from the health minister, Te Whatu Ora and others.
As if there’s a two-equal-sides debate to be had about not wanting some people to die early.
It was piss-poor journalism, but it promised a shitload of clicks.
The Herald obviously thought so too and rolled the story out of the NZME barn and into a prominent spot on its home page. Sure enough, everyone jumped on.
Soon there were opinions, explainers, and alternative points of view pouring in across all platforms and outlets, including at the Herald.
Look at all the traffic balance! Look at all the good, healthy free content debate! You could almost see the NZME bosses winking at each other.
So many well-informed people spoke out to dismantle the angle and try to correct the damage it was doing. This often involved other media outlets interviewing Māori experts and health professionals for their deep knowledge of the research and data that has fed into the tool’s development.
Here at E-Tangata, we also talked about doing an interview that would help provide real balance and get us closer to the truth. And so I called a surgeon who, despite being extremely busy performing cancer operations, agreed to find time to talk because she was truly worried that the way in which the story had been manufactured would hurt her patients — of all ethnicities.
She used her name. She spoke on behalf of herself and as a member of the Royal Australasian College of Surgeons, which supports the tool. She explained things in a calm and measured way. She talked about why equity measures work and why they improve outcomes for everyone. She talked about how the tool isn’t perfect but how it’s one small part of trying harder for people who’ve been failed over and over again. If you’re interested in fairer healthcare, you should read her words here.
She also told me she’s found the media coverage exhausting and painful.
Maxine Ronald, who spoke to E-Tangata last week. (Photo: John Stone)
Our conversation left me wondering why Māori and Pacific medical professionals are left to justify and defend action that’s being taken to fix a problem that they didn’t create. When, really, the central issue the story raises is one of media responsibility.
Why was there no rush to demand that the people who kicked it off justify their angle, their selection of voices, and their framing? To ask who leaked things to them and why? Why did they give the hidden surgeons priority and protection — when there are so many others who will go on the record saying the exact opposite, as we’ve now seen happen in floods?
If we’re going to call out bias in a system, then let’s call it out in media. These guys knew exactly what they were doing. They knew how to set the story up so it started out looking a bit like health news, but was really a lot more like politics.
Sure enough, Christopher Luxon soon decried that “race has no place in surgical priorities” and David Seymour popped up saying the tool is “actively promoting racial discrimination”.
Cue another round of interviews, op-eds, responses, clicks and content, all of which, in order to make sense as reaction, had to further disseminate some form of the original shit-stirring piece, which was constructed on purpose to self-perpetuate in that way.
News stories don’t just pre-exist somewhere out there, walking around intact and whole, waiting for an equal chance to step through the door of a media outlet and into the public arena.
They exist in tiny bits and pieces, among heaps of junk and distortions and agendas — and the bits are selected, assessed, ranked, and assembled, according to the rigour and professionalism, or the whim and worldview, of the journalists and outlets involved.
Barry and Jason chose to construct a pretty ugly beast out of their scraps. The Herald chose to parade it. Then they stepped back and let everyone else feed it, until the whole thing became something big and real-seeming enough to cause genuine uncertainty and fear, and to prompt genuine attempts to do the proper journalistic work of understanding what this new health initiative is all about.
If anyone has selected and prioritised ethnicity for unfair treatment with potentially damaging outcomes to others, it’s them.
There’s no doubt this was a story about racist tools. Just not in the health system.
Connie Buchanan is an E-Tangata editor and writer. This piece was made possible by the Public Interest Journalism Fund, through NZ On Air.
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Hey Guys… Please… Cut the Herald some slack! For goodness sake, its election year and NZME is only trying to make a buck out there. Massaging the prejudice of their readership sells more copy, spawns more controversy, generates more advertising revenue and makes for happy shareholders; whats not to like? Objectivity and balance comes in a remote second to the omnipotence of the marketplace.
Well, Cam Hunter, maybe on reflection you might find that their marketplace is full of rotting produce. The rhythm of life at the Herald hasn’t seen much change in recklessness, has it? Take a backward step and you’ll trip over the Heralds’ origin story. Dr Newman 1881, and Archdeacon Walsh 1884 in worship with Dr Featherston 1885 glancing through their monocultural lens had this to say. “The Maoris are dying out, and nothing can save them. Our duty, as good compassionate superior health professionals and race-baiting colonial politicians, is to smooth down their dying pillow”. Add a dose of 2023 to the produce aisle and we have Dr Reti on the RNZ “Mata” podcast wanting to exercise the same superior veto power instead of checking out the facts. Why do politicians sound like 1881 rap artists, dancing to the hussle on repeat, side-stepping all the price-fixing problems on offer we have a solution. Te Tiriti o Waitangi is our all-purpose model of care for everyone.
I concur wholeheartedly Ngawai. I understand Messer’s Wilson and Horton published a number of articles in support of Maori land confiscation at Ihumatao? Turned out to be quite productive farmland and after 3 generations of Wallace family ownership, earned them and the Fletcher intermediary a not insignificant capital gain.
The other problem here is how issues of class are conflated with issues of race. There are plenty of poor Pākehā, who struggle with access to health care, and for at least some of the same reasons as Māori. This is being forgotten.
My own view is that putting a decent weighting on issues of socio-economic status would pick up most of what people were attempting to do with the weighting for ethnicity, but I would welcome feedback on this.
Tēnā koe Ross. The issue is that Māori receive poorer quality care and less safe care in our health system just because they are Māori. This difference persists across the class / socioeconomic spectrum. That is, even Māori who are wealthy are more likely to receive poorer quality, unsafe care compared with wealthy non-Māori. The difference is even more marked for poor Māori vs poor non-Māori. That’s what this Connie means when she says “independent risk factor”. The differences are due to institutionalised racism in our health system. We have many years’ worth of evidence showing this racism across multiple parts of the system. The result of this is Māori carrying a bigger burden of disease and dying younger. This is why these sorts of tools must include ethnicity to try to compensate for the bias built into our system against Māori. Racism like this against Pākehā is something Pākehā like me would never tolerate if the tables were turned. Can you imagine the response? We would be marching in the streets demanding action to address such appalling, unfair outcomes. Fortunately for me the system is built to advantage me and structurally disadvantage others. This has to change. I hope this helps clarify and thanks for your question.
Thank you so much for calling out the biased ‘reporting’. I am glad you called it a story as it certainly is not journalism and correspondingly the authors are not journalists. I thought when we left Australia last year, we were leaving behind the Murdoch style press – sadly, not the case.
Race is a blunt weapon. There are plenty of European New Zealanders and other Avila backgrounds, who are far worse off than my Maori family members. You simply cannot justify race as a factor in anything, it must be need.
Hope you like trawling Maxwell Ritchie, because today is your lucky day for answers. Let’s get you started, you never know you might do a better job than the rag reporters at the Herald. Before we start we need to talk about your attitude, race baiting statements are unhelpful so drop them. If you’re serious about wanting answers on the basis of health needs, you might want to give the monocultural lens a miss for a sharper tool. Your best friend for a clear focus is a multicultural lens to capture everyone Māori, Pākehā, and other populations by ethnicity and then by deprivation. Just remember, statistical coverage is important. Numbers matter. Before you go off and find your answers there’s just one more all-important instrument you’ll need in your detective toolkit. Pick it up before you hikoi into the political headwinds. The support of Te Tiriti o Waitangi guarantees research validity. Let’s start: All-cause public hospitalisations by deprivation and age grouping admissions, this is a busy information highway it should keep you happy for a while. Next up take your pick, respiratory disease, and circulatory system (IHD) Ischaemic heart disease admissions are a big grouping, you’ve gotta be in it for the long haul. Cancer: Māori admission rates outnumber everyone else on the Richter scale but you’ll find that out when you start ticking off your long to-do list. You could make life easier if you have a plan, critical care covers ED, short-stay observation units, medical assessment, intensive care, theatre suite, etc, acute care covers medical ward surgical ward, step-down care covers stroke, rehabilitation, transitional care, post-op surgical, etc. By the time I’ve finished with you, you’ll have all the answers you need and more. Take care.
Ngawai, Maxwell – to pick up on your points:
* Race and additional need do overlap, but not completely
* Maxwell – Māori are far more likely to be poor than Pākehā, for a large number of reasons, hence their poor health status. The relationship between poverty and ill-health has been understood since at least Victorian times
Kia ora Ross. The difference persists across socioeconomic status. That is wealthy Māori are more likely to receive poorer, unsafe care vs wealthy non-Māori. Poor Māori are also more likely to receive poorer, unsafe care vs poorer non-Māori (the gap is even greater for the latter). Māori are also more likely to be discriminated against in education, justice, social services, employment, housing etc. All the things people need to stay well and healthy in the first place. These are called the determinants of health and account for about 85% of your health status. That is, Māori experience structural racism across more than just the health system itself. Hope that helps.
This is such a brilliant explanation of how deep systemic racism runs and how it is thinly disguised in plain sight. Health system, media system, political system—all interconnected and reinforcing each other—and the multiple harmful impacts that each of those reinforcing ripples continues to cause every day. The role of the media in priming, stoking, and shaping the worldviews of people whose perspective on the world resides in a narrowly defined set of assumptions needs a massive spotlight shone on it. Thank you.
Love this wonderful mahi Connie Buchanan, you’re awesome. I totally agree with your views on this kaupapa. About time we tested this instrument, now let the blade respond. The roots of hatred run deep within the veins of colonial media outlets. Take for example the NZ Herald’s colonial legacy to deny decry and defend its track record without investigation or evidential scrutiny. Their racist fantasies are a shared social structure that manifests itself in Māori cultural bloodsport for Newstalk ZB’s daily morning rituals. To feed the beast and its cacophonous heartland worshipers is the order of the day. The colonial legacy newspaper tells us a lot about the kind of values running hot at the Herald and Newstalk ZB when the white supremacist financial backers show up. But if they don’t like cryptic answers, I can always communicate via hand signals.