Surgery by race

I read an alarming story this morning on the Herald website of Auckland surgeons being asked to consider a patient’s ethnicity when prioritizing operations. Some are not happy being asked to do such a thing, claiming operations should be decided on how sick a patient is and how long they have been waiting, not on the fact they are of a particular race. I agree.

The last time I nursed was in 1980, when I took up a position as a doctor’s nurse. Before that I had trained as a Registered General Obstetric Nurse through the hospital system, as one did in those days. Every single patient was treated with dignity and respect, those in life-threatening positions were given priority and more care if that was necessary, but each person received what they needed in terms of nursing and doctor care. Even the drunks, who arrived after pub closing at 11pm, and the bikie gang members who had fallen off their motorcycles were treated in the same way as everyone else. Patients entered Accident and Emergency as it was called in those days and were either treated and discharged or admitted to the hospital. Those patients who had arrived with a letter of referral from their doctors or by ambulance entered in this way as well. If it was decided a person needed surgery that night, a team was called in. There was never ever any hint of a person’s race or social standing being used to prioritise someone either ahead of or behind another. It was simply a matter of life-threatening patients being attended to first and those who could wait being seen in the order in which they had arrived.

When working on the wards, everyone was treated as to their needs. It did not matter what race someone was.

I know waiting lists have become a bone of contention in many areas. My gripe is the health boards’ ability to tell the world how wonderful they are in keeping up with their wait lists. ``We only have a dozen people on our waiting list.’’ What they don’t say is that they have 200 people waiting to get onto that waiting list. If a person is waiting for an operation, then they should be included in the figures released about waiting lists. The reason the health boards record figures in this way is because they can’t keep up with the number of people requiring operations. What we need is more surgeons and anaesthetists, more operating theatres, more nurses and more wards in which to recuperate patients in. We don’t need people coming out and saying now, when prioritising a patient for surgery, one has to consider their ethnicity.

To be fair, the ethnicity is not the only factor being asked to be used for prioritising patients. Other factors include clinical priority, time spent on the wait list, geographic location and deprivation level. One wonders about the meaning of deprivation level.

It was pleasing for me to see these surgeons against this latest directive. Yesterday, I included in my blog, the hierarchal system often seen inside hospitals. So, whilst some of these high-up people can have arrogant attitudes to those they work alongside, they are still maintaining a balanced approach to their patients. As one surgeon was quoted in this Herald article ‘’It is ethically challenging to treat anyone based on race, its their medical condition that must establish the urgency of the treatment.’’

Well done to you for speaking up.