6. Question No. 6—HealthBROOKE van VELDEN (Deputy Leader—ACT) to the Minister of HealthQuestion No. 6—Health6. BROOKE van VELDEN (Deputy Leader—ACT) to the Minister of Health: What are the subspecialties to which the wait-list equity adjuster was being rolled out in the wider northern region and how if at all is ethnicity being used as a factor in prioritising access to health treatment outside of the equity adjuster tool?Hon Dr AYESHA VERRALL (Minister of Health): In answer to the first part of the question aside from the Auckland District defined by the former district health board (DHB) boundary I am advised that Te Tai Tokerau District has implemented the tool for urology and orthopaedic wait-lists and Waitematā has recently implemented the tool in gynaecology. I am advised that the equity adjuster is not used for acute care or cancer treatment. The equity adjuster is applied to planned care previously referred to as elective care. In answer to the second part of the question I am advised that Te Whatu Ora considers all factors when assessing people's needs for care. Most importantly this is primarily based on clinical need as determined by the clinicians involved but other factors are taken into account including ethnicity from time to time. Brooke van Velden: Is she aware that in November 2020 cancer and blood services at Auckland DHB had a policy to reduce inequity for Māori and Pacific peoples by putting them at the front of the prioritisation queue" and can she give a guarantee that ethnicity is not being used to prioritise the queue for cancer services in any Auckland hospitals?Hon Dr AYESHA VERRALL: I thank the member for that question. The document that that member is referring to incorrectly said that that programme of work has started; it in fact never occurred. Brooke van Velden: What then does she say to the medical professionals confidentially telling ACT that the practice is still going on and staff know about it? Hon Dr AYESHA VERRALL: Well those medical professionals have avenues for raising their concerns if any within Te Whatu Ora and I note that a number of health leaders including the Royal College of Surgeons have come out in support of the equity adjuster as applied to planned care. Brooke van Velden: Is the Minister aware that medical practitioners are afraid of speaking up on this issue such as the surgeon who texted to say "My concern is the lack of consultation from Te Whatu Ora and we are unable to express our concerns to the powers. Many of us feel this is wrong but there is no avenue to express it let alone change it."? However this person refuses to be identified for fear of retribution. Hon Dr AYESHA VERRALL: I have worked with surgeons for multiple years of my professional life and the courage it takes to be a surgeon is the courage to stand up for your conviction. So I encourage that person if they've got an issue to bring it forward and to take it up also with the professional leaders who have come out in support of that process for planned care. Teanau Tuiono: What advice has she received on the most effective ways to improve Māori and Pasifika life expectancy so that it is in line with the Pākehā life expectancy and is she committed to action on the best evidence available to address health inequities? Hon Dr AYESHA VERRALL: Yes I am committed to evidence-based action to address health inequalities and the advice that I have received is that the strongest thing we could do to address health inequities—the seven-year life expectancy gap between Māori and Pasifika—was to vote for the smoke-free legislation something the other side of the House showed a remarkable lack of moral courage to do so. Brooke van Velden: Is she aware that in February 2022 Auckland DHB said "Our focus for planned care is prioritisation of long-waiting patients over 200 days and long-waiting Māori and Pacific patients over 120 days" or did this also not happen?Hon Dr AYESHA VERRALL: At Auckland Hospital that approach would have been replaced with the equity adjuster."