Justice delayed is justice denied. https://twitter.com/rawirimj/status/1302703824289767424

Okay, a few more thoughts about the @minhealthnz decision not to extend the bowel cancer screening age range for Māori and Pacific people. (thread)

It's important to note that @minhealthnz have been advised from day 1 that the screening programme would be inequitable unless it accounted for ethnic differences in onset of disease. Yet they decided to go ahead with this (racist) programme.

Māori and Pacific experts - and many others - have been calling for the eligibility to be extended to include Māori and Pacific people from age 50.

Until finally...

In February 2019 a hui was called by the Ministry's National Screening Unit on achieving equity for Māori in bowel screening. All the major players were there, including key stakeholders and a host of experts from across the sector.

I had the privilege of facilitating the hui - we heard the latest evidence and expert advice, and engaged in robust discussion about the best way forward.

The highest priority recommendation was that screening eligibility should be extended down to 50 years of age for Māori.

In relation to timing, there was strong consensus that it would be unethical to wait until after the rollout to all DHBs was complete. We heard very clear evidence that the existing programme was contributing to inequity and doing harm to Māori.

It was therefore resolved that the age range extension should be introduced as soon as possible. No-one was left in any doubt that immediate action was required to ensure Māori were no longer denied equitable access to bowel screening.

A fono of Pacific health advocates and clinicians was subsequently held, at which it was agreed that this recommendation should be extended to include Pacific peoples.

So this issue has been going through the @minhealthnz processes and they have now rejected that recommendation, deciding that the appropriate time to consider adjusting the age parameters is once the programme is fully implemented (expected to be by December 2021).

That doesn't mean they'll implement the recommendation then - it means this issue will be "considered" then. By which time the landscape will no doubt have changed, so we'll need to review the evidence again and relitigate the case.

And we'll probably get the same outcome.

We've seen this many times before from the Ministry - decline to take pro-equity action (because reasons) and defer the decision to a later date. Rinse and repeat. The status quo persists unchallenged.

The Ministry of Health has a long history of this sort of behaviour. They have been sent clear messages recently that they are failing as a Treaty partner (Waitangi Tribunal health inquiry) and upholding structural racism in the health sector ( @HQSCNZ report).

And yet every time they are given an opportunity to take action that is pro-equity, they find reasons not to. There is always an excuse - in this case it seems to be health system capacity ("asking more of the system than it can currently deliver").

So who's currently receiving disproportionate benefit from what the system is delivering?

It seems Māori and Pacific people are always the ones who must compromise. @minhealthnz will do whatever it takes to avoid confronting #whiteprivilege.

And so we see continuing inaction in the face of need. One of the key manifestations of institutional racism.

There's only one conclusion that can be drawn from all of this:

The Ministry of Health is racist. Deeply racist. Shamefully racist. Irredeemably racist.

Inequities are not a bug in our health system - they're a feature.