13 March 2025
The Royal Australasian College of Physicians (RACP) has warned the NZ Government's decision to scrap the free bowel screening program for Māori and Pacific Peoples in favour of a population-wide program will exacerbate health inequities between Māori, Pacific Peoples, and non-Māori, resulting in more bowel cancer deaths, delayed diagnoses, and reduced life expectancy.
Dr Matt Wheeler, Chair of the RACP Māori Health Committee, states that “this program will do more harm than good, further widening the gap in health outcomes for Māori and Pasifika, where lives will be lost.”
“We ask the Coalition government to provide transparency and show its workings, tell the country how many lives will be lost by raising the age for free bowel screening for Māori and Pacific Peoples. They should disclose the amount of money saved. This will allow us to calculate the value the government places on Māori and Pasifika lives.”
"This reversal by the Government contradicts the Prime Minister's personal pledge during his election campaign to reduce the bowel cancer death toll and is another setback for Māori and this country.
“Decisions like these continue to negatively impact Māori health and breach Te Tiriti. By abolishing the Māori Health Authority, repealing supportive race-based policies, and pushing for a reinterpretation of the Treaty of Waitangi, the government is causing significant harm.
"These actions are devastating blows, the growing list of such decisions continues to deepen health disparities and severely undermine efforts to achieve equitable healthcare for Māori.
“Minister Brown stated that repurposing this bowel screening funding aligns with the government's policy of ensuring healthcare is delivered based on need. When we consider the data of bowel cancer for Māori and Pacific peoples, I believe Minister Brown has been ill-informed about the concept of ‘need’ and equity versus equality.”
“For example, the incidence of bowel cancer in Māori under 50 years old rose 10 per cent more per decade compared to the rest of the population.[1]
“Sixty per cent of Māori female and 50 per cent of Māori male bowel cancers are diagnosed before age 60, so making free screenings inaccessible until age 58 guarantees Māori and Pacific Peoples will fall through the cracks.[2]
“Bowel cancer disproportionately affects Māori and Pacific Peoples at younger ages, and we are already seeing increased incidences of bowel cancer in under 50-year-olds in this population of up to 36 per cent per decade in the past 25 years.[3]
“This all goes a long way to start explaining why there is a 7-8-year life expectancy gap we see between Māori and non-Māori.
“We need equitable healthcare that is based on the needs of communities and we need policy that is evidence-based and understands complex needs.
“All New Zealanders need access to preventative care to address long-term health outcomes, and Māori and Pasifika patients should have access to equitable screening that meets their needs.
“By proposing that Māori and Pasifika wait eight years for screening, the RACP believes there will be little that can be done by then.
“Experts, including Bowel Cancer NZ, know that expanding the program is incredibly cost effective, and we absolutely support the expanded accessibility of a $30 test to prevent an $80,000 cancer.[4]
"The RACP calls on the Government and Health Minister to seek guidance from the country's cancer specialists, including Hei Āhuru Mōwai.
“If we continue down this path, we will inevitably see the life expectancy gap worsen, and we will fail our Māori and Pacific Peoples, and we all lose. What value does the government place on Māori and Pasifika lives?" says Dr Wheeler.
[1] Bowel screening change 'totally unethical' | E-Tangata
[2] Position-Statement-Bowel-Screening.pdf
[3] Bowel screening change 'totally unethical' | E-Tangata
[4] There is money' - Call for the Government to stump up on cancer screening promise | RNZ News