Rural communities left out in health reform announcement

This morning the Minister of Health announced major changes to New Zealand’s health system. They focus on improved primary and community healthcare and a simplified national structure to ensure fairer access to healthcare for New Zealanders.

“The reforms will mean that for the first time, we will have a truly national health system, and the kind of treatment people get will no longer be determined by where they live,” Minister Andrew Little said.

The New Zealand Rural General Practice Network welcomes the Minister’s announcement of a major restructure which focuses on primary and community care to better support general practices to treat patients before hospital care is needed.

“Our current health system is not servicing people in rural communities. This was acknowledged in the Health and Disability System Review along with recommendations that major change was needed,” New Zealand Rural General Practice Network Chief Executive Dr Grant Davidson says.

“We welcome the approach of a national plan that will meet health needs of people no matter where they are, including a digital strategy to assist this.”

Dr Davidson says that the creation of a new Māori Health Authority will provide much needed support to rural Māori communities and involve them in decision making, design and commissioning of any new delivery structure.

“We applaud that Māori are identified as a priority need. Their health outcomes are consistently poorer than non-Māori and the current health system is failing them.”

Associate Health Minister (Māori) Peeni Henare says this new Māori Health Authority “will be able to directly commission services where needed, and to grow Kaupapa Māori services and innovation”.

However, Dr Davidson is disappointed in the lack of specific reference to rural people and communities as a priority population, despite rural health inequities being identified through the Health and Disability System Review as a serious issue, and acknowledged in person by Minister Little on several occasions recently.

“The ability for these major system changes to have positive impact on rural communities will now be in the detail of implementation.”

“Our concern is that without rural being identified alongside Māori, Pasifika and disabled people as priority populations, our voice risks being lost in those implementation discussions.”

The Minister has confirmed that, as recommended in the Health and Disability System Review, there will be a ‘locality-based’ approach to tailored delivery of primary and community health services.

This provides a real opportunity to identify and define specific rural localities so that solutions can be designed, built, and delivered by rural communities.

Dr Davidson says that as these changes are medium to long term in terms of potential impact, he is concerned they could cause a major distraction from the current crisis in workforce and funding that exists throughout rural New Zealand.

“The workforce is stressed, burnt out, and under-capacity. We need action to deal with that now until these changes come into effect”.

“The Minister has said that there are still policy changes to be announced around funding, workforce and digital. These are key areas we have identified for improving rural health outcomes”.

“We wait with expectation that these will at least identify specific rural solutions”.

Minister Andrew Little and Associate Minister Peeni Henare will both address the National Rural Health Conference at Wairakei Resort in Taupō next week.

The Network looks forward to them both explaining in further detail how these changes will make a positive difference to rural health outcomes and how the Network and its members can help be involved in, and shape, those changes.

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