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.

© E-Tangata, 2023

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