Government challenged to put its money where its mouth is and ensure health capitation funding is equitable

Aotearoa’s five Māori Primary Health Organisations (PHO’s) challenge the Government and the health system to ‘put its money where its mouth is’ and commit to providing equitable health funding for communities with high health needs.

The Department of Prime Minister and Cabinet’s Health Transition Unit quietly released their commissioned The Future of Capitation Funding Approach report earlier this month with little fanfare.

The collective of Māori Primary Health Organisation’s (PHO’s) say that while the report and its findings are welcomed, their focus is on action.

“This is not the first report that outlines the negative impacts of the current capitation funding model, and the need to consider, and weight ethnicity and deprivation, in capitation funding to ensure equitable health care,” Tumu Whakarae of National Hauora Coalition Rachel Brown said.

“The collective agree that the report just adds to a body of evidence including claims through the Waitangi Tribunal that continue to confirm the shortcomings in funding and the impact on Māori health and Māori Health Providers

“The challenge put forward is for the Government to commit to an equitable approach, including increasing funding to primary health care services who serve and make a difference to people with higher health needs. If they are not willing to accept this challenge, why not?”

The Māori PHO collective is made up of Ora Toa PHO (Porirua and Wellington) Ngāti Porou Hauora (Gisborne – Te Araroa), Ngā Mataapuna Oranga (Western Bay of Plenty), the National Hauora Coalition (Auckland) and Hauraki PHO (Waikato and Coromandel).

These PHO’s provide primary health care services at a very low cost and each has concentrated patient populations of Māori, Pacific and low income families with high and complex health needs.

“A significant proportion of our patient population are Māori, Pacific or low-income earners, with long term health conditions. They need more care and support from our general practice services. The current capitation funding model does not take this into account and instead ignores the fact that we care for people with higher needs,” Chair of Ora Toa PHO Ranei Wineera-Parai said.

“As very low cost Māori Health Providers we are not in the same position as wealthier mainstream general practices who charge their patients high fees to spread or recoup their costs.”

“Similar to Ora Toa, we provide health care to people who need it most. Our patients often end up on our books as wealthier practices recognise that they have higher needs and are not willing to dedicate the same time and resources to care for them,” Managing Director of Ngā Mataapuna Oranga PHO Janice Kuka said.

Ngāti Porou Hauora covers a large, rural and isolated geographical area and provides care to some of the most under-served communities in Aotearoa.

“It makes no sense that our funding model fails to address the distance, isolation, and deprivation of our communities. We need an equitable system that is focused on doing the right thing for our people,” Chief Executive Officer of Ngāti Porou Hauora Rose Kahaki said.

The Māori PHO collective recognise that the Government has been under increasing political pressure with an impending general election and say this may be their reason for the quiet release of the The Future of Capitation Funding Approach report in November, despite having had the report for some months.

“Everyone living in Aotearoa must remember that sitting at the very heart of this kōrero are people. People who are unwell and dying unnecessarily, from preventable disease and illness,” Chief Executive Officer of Hauraki PHO Taima Campbell said.

“We must all accept that some people need more healthcare and support than others, and so their providers must be given more funding to give them the support they need and deserve. There is no privilege in dying early.”

“As a collective of Māori PHO’s, we want to work with Te Whatu Ora and Te Aka Whai Ora on ways to make changes to the capitation funding model so that primary care providers are able to mee the needs of whānau with high and complex needs.”