Budget 2025 Fails Rural Health Promises – Hauora Taiwhenua Warns Of Growing Inequities
The health budget has increased by 4.8% overall which doesnt cover increases in the cost of health care delivery and population gains. The Budget lacks any specific commitment to address long-standing inequities in rural healthcare.
Hauora Taiwhenua Rural Health Network is sounding the alarm following today's Budget announcement, which has failed to acknowledge — let alone invest in — rural health.
'For a National-led Government, we would expect the word rural to appear somewhere in the health budget. Instead, rural New Zealand seems to have been sidelined once again,' says Dr Grant Davidson, Chief Executive of Hauora Taiwhenua.
The Government has also failed to act on the flagship rural health policy it entered the last election on and reiterated in its first 100-day plan once elected: the establishment of a third medical school at the University of Waikato focussing on rural general practice. In budget 2025 there is no investment or plan outlined for increasing rural medical placements, either through existing institutions or by establishing a new school. This inaction comes at a time when the rural workforce is in crisis and struggling to meet the needs of growing, ageing, and often underserved populations. We looked forward to congratulating a Government on implementing long-term planning for the rural health workforce but have been sadly let down.
The health budget has increased by 4.8% overall which doesn't cover increases in the cost of health care delivery and population gains. The Budget lacks any specific commitment to address long-standing inequities in rural healthcare. We are waiting to see what capitation uplift will be offered, but early signs are that this is likely to be less than the Health New Zealand calculated increase in the cost of health services of 6.4% which will mean any gap will need to be made up by further increases to patient co-payments, which will need to be well above 6.4%. Any increased fees will only decrease access to general practice to those who most need it and then cause a further decline in already poor health outcomes in rural areas where there are higher populations of low-income, older and Māori populations. The funding for Comprehensive Primary and Community Care (CPCT) Teams, which allowed extra funding for general practices to add allied health and healthcare workers to their teams to improve services, has also been discontinued.
Hopes that Budget 2025 would deliver pay parity for primary care nurses have also been dashed. Instead, legislative changes mean any progress will now be delayed at best. Primary care nurses, especially those working in rural settings, continue to be paid significantly less than their hospital counterparts, worsening recruitment and retention challenges.
Hauora Taiwhenua is also raising concerns about the proposed transfer of mental health crisis response responsibilities from Police to health services. Funding to support the transfer of responsibility of this from Police is included in the budget. This may offer long-term benefits in urban centres, but it raises serious questions for rural areas, where health teams are already stretched and crisis response capacity is limited or non-existent. We are waiting to see if any resourcing or rural contingency planning will be announced to support this shift in the implementation phase.
We acknowledge the pre-budget announcements to enact a Primary Care Action Plan, including funding for urgent and unplanned care initiatives. We are excited by the potential to finally deal with the major issue of providing after-hours and urgent care in rural and remote areas, including surges in demand during holiday times. But there is little detail around these and no ring-fenced funding for implementing them in rural areas.
The Minister's commitment to what he terms 'enhanced capitation funding' is for the delivery of extra services and targets that have not yet been announced, not for the support of already underfunded rural primary care. We understand that Health New Zealand's own analysis shows that delivery of primary care in rural and remote areas costs more than in urban areas, and yet the project to re-weight capitation formulas to provide increased base payments for those in rural areas where increased costs and high co-morbidity demands lie has been put on hold.
There is still some possibility that Health New Zealand may choose to commit some of its increased funding in operational spending to improve the sustainability of under-siege community-owned rural hospitals and interprofessional rural training hubs that are in the Health NZ workforce plan, but we have been holding our breath for over a year already on both of these projects.
'Budget 2025 was an opportunity to demonstrate that rural Aotearoa matters. Instead, it sends a message that the promises made before the election are not being honoured,' says Dr Davidson. 'Without urgent action, we risk further erosion of rural health services and deepening inequities for the communities who already struggle most to access care.'
Hauora Taiwhenua Chair, Dr Fiona Bolden summarises, 'This is a budget which will leave rural health providers and rural communities feeling even more despairing than before when it comes to the sustainability/viability of rural health services and the safety of patients.'
Hauora Taiwhenua will continue to work with the Government, policymakers, Agency staff, rural providers and the community to ensure that the voices of rural New Zealand are heard — and that future decisions reflect their needs and realities.
'We know that delivering healthcare in rural and remote areas comes with unique challenges and opportunities,' says Dr Davidson. 'Our members are ready to work with Government and Health New Zealand to co-design solutions that ensure rural communities receive equitable, high-quality care.'
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Scoop
7 hours ago
- Scoop
Two In Five Kiwi Men Die Prematurely, New Movember Report Reveals
12 August 2025 – Two in five men living in Aotearoa New Zealand die prematurely – before the age of 75 – most from causes we know how to prevent and treat. That's the stark reality revealed in The Real Face of Men's Health: Aotearoa New Zealand, a landmark new report from the Movember Institute of Men's Health. It's the most comprehensive look at men's health in New Zealand to date – and it makes the issue impossible to ignore. The report finds men are dying almost 4 years earlier than women, with heart disease, certain cancers and suicide leading the toll. Suicide is the number one cause of death for young men aged 15–34, and three in every four New Zealanders who die by suicide are male. Among young tāne Māori aged 25–44, the suicide rate soars to nearly 60 deaths per 100,000 – the highest of any group in the country. 'These aren't just statistics – they're sons, fathers, brothers, and mates. And their deaths send shockwaves through whānau, workplaces and communities,' says report contributor Dr Simon Bennett (Ngāti Whakaue, Patu Harakeke, Ngāti Waewae), Director of Clinical Psychology Training at Massey University and member of Movember's Global Indigenous Advisory Committee. 'Too often, men are falling through the cracks, missing out on the critical support they need, when and where they need it most – and it has gone on for too long.' The research exposes major barriers stopping men from getting care – from masculine stereotypes and the expectation to 'tough it out', to health systems that too often feel unwelcoming or dismissive. Six in ten men say their concerns aren't taken seriously by healthcare providers, while nearly two-thirds feel masculine stereotypes have negatively influenced their health. 'If we addressed just the top five preventable diseases in men, New Zealand could have saved $917 million in 2023 alone,' says Professor Simon Rice, Global Director of the Movember Institute of Men's Health. 'The solutions exist. Now is the time for national action.' Movember is calling on the New Zealand Government to develop a Men's Health Strategy – grounded in equity and partnership with Māori – to deliver coordinated action across policy, services and systems. Because when men live longer, healthier lives — everyone benefits. 'This is a critical opportunity to change the trajectory of men's health in Aotearoa,' says Professor Rice. 'Healthier men mean healthier families, stronger communities and a stronger country.' New Zealanders can read the full report, which details the premature mortality of Kiwi men, the economic cost of poor men's health, the impact whānau and caregivers, and what's proven to work – and join the conversation at Movember is the leading global charity changing the face of men's health. What began as a bristly idea in Australia in 2003 quickly grew into a global movement – one that has sparked millions of important conversations, raised over AUD $1.83 billion for men's health, funded more than 1,300 health projects, and helped break the silence surrounding men's health issues. From breakthrough prostate and testicular cancer research to bold investments in mental health and suicide prevention, Movember is transforming how health services reach and support men. The charity works to ensure more men recognise when they're struggling, more supporters know how to step in, and health systems are better equipped to respond to men in need. Movember champions inclusive, gender-responsive healthcare — improving health outcomes not just for men, but for the families and communities they're part of. Together, we can help men live healthier, longer lives. Learn more at
NZ Herald
16 hours ago
- NZ Herald
Rotorua: Hundreds of Māori nurses to gather for indigenous conference this week
Hundreds of Māori nurses will gather in Rotorua this week for the annual Indigenous Nurses Conference Aotearoa. The gathering has been organised by the Te Rūnanga o Aotearoa New Zealand Nurses Organisation (NZNO) union.
Scoop
16 hours ago
- Scoop
Heart Health Care System 'Verge Of Collapse' A Barometer Of Wider Public Hospital Verging
It has been said more than once that overcrowding in emergency departments is a barometer of how public hospitals as a whole are performing in Aotearoa New Zealand's health system. It has now emerged that another barometer is the rate of heart attack patients being treated within clinically accepted timeframes. According to a new Otago University report, Heart disease in Aotearoa: morbidity, mortality and service delivery, commissioned by cardiac advocacy charity Kia Manawanui Trust (the Trust), the rate of these patients not being treated within clinically appropriate timeframes is a massive one-half. While dramatic, this is not as surprising as one might think. New Zealand has just one-third the number of cardiologists it needs. It has led to the regrettably correct conclusion that the heart healthcare system is verging on collapse. Health journalists doing their job This scandal was well reported on 11 August by Radio New Zealand's health reporter Ruth Hill: Half of heart attack patients not treated within accepted timeframes. She quotes the Trust's Chief Executive Letitia Harding in a dramatic, but not overstating, manner observing that the findings exposed a system that was failing at every level. In her words: Heart care in New Zealand isn't just stretched – it's on the verge of collapse. We are failing in all aspects and it's costing New Zealanders their lives. TVNZ gave the report prominent coverage on 1News (11 August): Verge of collapse. Stuff journalist Nicholas Jones, like Ruth Hill, on the same day also gave a good outline of the report's findings: People are dying. Key Findings The reports key findings include: Life-threatening delays: Half of all heart-attack patients are not seen within internationally accepted timeframes. New Zealand has only a third of the cardiologists it should have. Māori and Pacific people hospitalised or die from heart disease more than a decade earlier, on average, than other New Zealanders. Heart disease costs the country's health system and economy $13.8 billion per year ($13 million in 2020). The biggest contributor is hospitalisations but also contributing are lost workdays, GP visits, prescriptions and mortality. [These are minimum costs as some other factors such as emergency department admission costs were not included in this analysis.] Regions with the highest death rates are Tairāwhitii, Lakes (Rotorua-Taupo), Whanganui, and Taranaki. They have the fewest cardiac specialists. Dr Sarah Fairley is a Wellington-based cardiologist. She is also the Trust's medical director. Her conclusion was that the findings by the Otago University study matched the experience of health professionals on the cardiac frontline. Cardiac workforce reality check Sometimes non-government organisations can be overly gentle and deferential in describing bad news such as this. However, the Trust does not pull its punches over the report's findings. It calls a spade a spade. This in the context of heart disease being the greatest cause of mortalities in New Zealand. It was responsible for one in five deaths and 5% of hospital admissions. The Trust is calling for immediate investment in public hospital cardiac care infrastructure – beds and equipment – and a national strategy to recruit and retain cardiology staff. This goes to the root of the 'verging collapse'. Drilling down further, in 2024 New Zealand had 173.2 full-time cardiologists (32.8 per million people). This is three times lower than the average (95 specialists per million) of all countries measured by the European Society of Cardiology. Contrasting the figures 32.8 and 95.0 speaks volumes. However, the cardiac workforce is not just medical specialists. The number of sonographers had dropped from 70.4 in 2013 to just 43.5 in 2024, despite the 17% population increase. Their ratio had nearly halved from 16 per million to 8.2 over the same period of time. Political reaction Health Minister Simeon Brown in response gave some acknowledgement to the report but passed the buck to Health New Zealand (Te Whatu Ora) as if its political leadership were not responsible in some way. He referred to it establishing a National Clinical Cardiac Network which is developing national standards and models of care. In fact, this network was established well over a decade ago when Tony Ryall was health minister (2008-14). The network did good innovative and collaborative work. But the vertical centralisation of the health system under Labour's Andrew Little meant that the network was brought under direct bureaucratic control thereby giving it less oxygen for its independent advice. A further dimension: clinical follow-ups Understandably the impression can be formed that the critical threshold for treatment is to have a first specialist assessment (FSA). In this context this is the assessment by a cardiologist of a patient's heart condition following a general practitioner referral for further investigation. Where, for whatever reason, treatment such as surgery was not consequentially scheduled after the FSA (including because further monitoring was considered more appropriate) a clinical follow-up would normally be scheduled within a clinically appropriate timeframe. In the mid to late 2010s, towards the end of my employment as Executive Director of the Association of Salaried Medical Specialists, I became aware of increasingly serious concerns of a range of medical specialists (not just cardiac) that these clinical follow-ups were being severely delayed As a result, their patients (including children) were facing increased health risks. This includes denial through excessive delay of access to treatment that might have improved these conditions. This was regardless of location – rural, regional or urban. Consequently, the powerful message given by Northland cardiologist and Trust Board member Dr Marcus Lee on Radio New Zealand's Midday Report (11 August) in an interview with Charlotte Cook, resonated strongly with me: Delayed clinical follow-ups. After pushing back on Minister Brown's use of statistics, Dr Lee referred to the downside negative effects on clinical follow-ups after patients' FSAs. The cause of these clinically unsafe delays is the sheer volume of FSAs which had to take priority. Coupled with severe workforce shortages, these patients were trapped in a vice. Consequently, for many, their health conditions worsened to the extent that those who might otherwise have been able to be treated could not be. In other words, they were denied access to necessary diagnosis and treatment. Moral injury Dr Lee also raised the issue of moral injury. In the context of healthcare it refers to the psychological, social and spiritual impact of events on health professionals who overwhelming hold strong ethical values over, for example, denial of timely access of patients to diagnosis and treatment. This includes when events are determined by factors beyond their control, particularly political (especially) and bureaucratic decision-making. In the context of Dr Lee's reference to moral injury it is the cardiologist that has to explain this situation to patients and families of the harm done by delayed diagnostic or treatment access even though it was not caused by him or his colleagues. Although responsibility rests with political and bureaucratic decision-makers they are not the ones who have to explain it to harmed patients and their families. Dr Lee made the point well that one consequence is the undermining of patient trust in him and his colleagues. The heart healthcare barometer and a 'wake up' call A standout observation by the above-mentioned cardiologist Dr Sarah Fairley really struck home with me. In her words: From inside the system, I can tell you that this report reflects what we see every day – a workforce stretched beyond safe limits, patients slipping through the cracks and no end in sight. While this comment was made in the context of the heart healthcare system, it also reads as a standalone comment for the whole public health system, regardless of branch of medicine or type of diagnosis and treatment. The verging collapse of the cardiac care system is a barometer of the public hospital system as a whole. Public hospitals across the health system are in all in this dire situation with differences being in degree, not kind. One only needs to read the latest travesty involving adult inpatient and related mental health services in Canterbury due to ineffective governance, understaffing and cumulative strain for a decade. This disaster was covered by Nadine Roberts in Stuff (12 August): Damming mental health report. Christopher Luxon's government can't be blamed for Aotearoa's deteriorating health system. While it has worsened under his watch, it is an inherited state of affairs. It goes back to the relative underfunding ('light austerity') of the National led government for much of the 2010s and the poor compounding health system stewardship of under the previous Labour led government whose solution was destructive restructuring through vertical centralisation. What characterised all three of these governments is their shared neglect of the severe medical specialist shortages that first became evident in the late 2000s. The last word should be left to the Trust's Chief Executive Letitia Harding. She said that the report should be 'a wake-up call for the government'. She nailed it in one. But it is equally a wake-up call for the government for the whole health system.
