Paediatric surgeon Alison Scott (Nga Ruahine, Te Atiawa) aims to increase awareness of the role surgeons can play in improving equity in health care in Aotearoa New Zealand.

Dr Scott believes that while government policy can shape healthcare available to Māori patients, surgeons and other medical professionals also have a responsibility towards providing more equitable care.

Earlier in the year she brought together speakers from a range of fields to discuss equity in healthcare in her position as convenor of the Indigenous Health section at the Annual Scientific Congress in Christchurch.

The congress exposed surgeons to a range of ideas around equity to ensure that they were not solely operating within their own silos.

Dr Scott said it was also important to shine a light on, and learn from, the positive change happening in the healthcare sector.

“One of the main aims of the session was highlighting good Indigenous health programs, not necessarily within surgery,” she said.

These included a session on how general practitioners are integrating Te Ao Maori into all levels of care in the programs provided by a primary healthcare provider, and the creation of a karakia (prayer) for the Australian New Zealand College of Anaesthetists (ANZCA) by tohunga Mark Kopua that can be used in the perioperative space by all patients.

Additionally, Dr Scott pointed to the work by the Māori/Indigenous Health Innovation (MIHI) group at Canterbury campus of Otago University to integrate cultural competency into the medical education framework through community outreach and innovative interactive sessions.

“I also thought it was important to give space to the young Trainees and pre-vocational doctors and students—give them a platform to share their research and give them the opportunity to attend conferences.”

Dr Scott is passionate about supporting Trainee surgeons in her role as a mentor.

“I like teaching and seeing the Trainees thrive. You get quite a bit of joy seeing them improve—not only in their technical aspects, but in their knowledge.

“And when they are successful in passing exams or getting on to the training scheme, then you feel very proud of them. And you know that you've made a small contribution, but they have done the work to get there.”

An interest in medicine developed slowly for Dr Scott, and she didn’t consider pursuing her career path until she was a young adult.

Growing up in a rural town in Aotearoa New Zealand’s north, the only doctor she had ever encountered was the local GP.

“Becoming a doctor wasn’t something I always wanted to be—it was something I briefly considered when I was 18 years old.”

However, after winning a scholarship to an international school in Norway, she decided to embark on a medical training.

She became one of the first Māori paediatric surgeons in Aotearoa New Zealand and chose the specialty as she was interested in working with children and enjoyed surgery.

“A big part of my job is looking after, not just the child, but the whole family. Often you get to know children when they are born, and see them grow up, develop, and go to school and how their life changes.

You are just a small part of that life, but you can contribute quite a significant part to their quality of life.”

Dr Scott feels frustrated that government policy is not focusing on closing the gap between the healthcare of Māori and non-Māori Aotearoa New Zealanders.

“Māori and Pacifika die on average a decade before non-Māori, and countless studies have shown that this is due to inequities in care and systematic poor access to care. It is not because of a patient’s comorbidities or them not seeking care—it is because the system has not been designed to help Māori and Pacific people and barriers to care include the delay in receiving treatment and differences in the provision of care. ”

Changes, she believes, surgeons and health services can make include triaging and addressing waiting lists to increase equity, particularly in areas where Māori communities are at greater risk.

Dr Scott also encourages surgeons to enrol in courses provided by RACS or associates to learn about Indigenous health and improve their practices. This engagement will make them better providers of care for their patients and their communities, which helps the health systems overall.

“I think that would be very beneficial for surgeons and for Indigenous health. Learning tools are available on the College website and could be a step in helping surgeons learn about equity and how they can address it. We have an ethical obligation to our patients to do so,” she said.