STAKEHOLDER EPĀNUI | WHĀNAU VOICE DEEP DIVE
Whānau Voice: Access to Quality & Timely Primary Care
A regional analysis of primary care access, community experiences, and geographic variations across Te Matau-a-Māui Hawke’s Bay.
Primary care is the essential gateway to health and wellbeing, yet for whānau across Te Matau-a-Māui Hawke’s Bay, this gateway remains severely obstructed. Recent whānau voice engagement and regional data paint a stark picture: over 60% of whānau believe Māori do not have satisfactory access to healthcare services. This is not merely an equity failure—it represents an urgent economic and social imperative, costing the Hawke’s Bay economy $122 million in lost regional productivity every year due to unmanaged, preventable chronic conditions and premature loss of life.
What Whānau Are Telling Us
Whānau consistently describe a dysfunctional primary care system where systemic barriers prevent timely intervention and force people to delay seeking care until conditions become acute:
- Closed Books & Long Wait Times: Whānau face weeks-long delays for standard GP appointments. Across the rohe, 13 out of 24 GP practices are completely closed to new enrolments, locking families out of basic continuity of care.
- Cost & Pre-Payment Barriers: Upfront consult fees ($19–$60+) create immediate trade-offs. Whānau report having to choose between basic groceries, power, or paying for doctor visits and prescriptions.
- Cultural Safety & Gatekeeping: Brief 15-minute consultations, phone triage gatekeeping at reception desks, and an absence of culturally safe practice leave whānau feeling rushed, dismissed, or judged.
- Forced Reliance on ED: Unable to secure primary care appointments, whānau are routinely turned away or directed to Emergency Departments for routine, manageable health issues.
A Tale of Three Localities: Regional Variations Across the Rohe
Access to primary care across Te Matau-a-Māui varies sharply depending on geography, provider density, and transport infrastructure:
Locality & Demographics
Key Access Barriers
Impact on Whānau
Wairoa
(74% Māori Population)
- Serviced by only 1 GP practice and 1 pharmacy for ~9,000 residents.
- Severe geographic isolation and lack of resident specialists.
Whānau must travel hours to Napier/Hastings for basic care. High transport costs present a total barrier for households without vehicles.
Urban Napier & Hastings
(74% of Total Population)
- 21 of 24 GP practices concentrated here, but most are operating at full capacity.
- High reliance on 6 Very Low-Cost Access (VLCA) clinics.
Severe capacity bottlenecks leave un-enrolled whānau reliant on overstretched walk-in or urgent care clinics with long wait times.
Rural Southern Areas
(Central Hawke’s Bay)
- Serviced by just 2 GP practices and 2 pharmacies for ~15,000 residents.
- Complete absence of urgent care or local birthing facilities.
Rural whānau face long transit times and rigid clinic operating hours that conflict directly with primary industry employment shifts.
Key Regional Health Indicators
Data from our recent Community Health Plan and regional health profiles illustrate persistent, widening equity gaps between Māori and non-Māori across Te Matau-a-Māui:
Health & Access Indicator
Māori Rate
Non-Māori Rate
PHO Enrolment Rate (All Ages)
83.1%
94.6%
Average Annual GP Visits per Patient
2.5 visits
3.1 visits
Bowel Cancer Screening Coverage
48.0%
63.8%
Missed First Specialist Appointments (FSA)
11.1% – 12.9%
3.3% – 4.5%
Avoidable Death Rate
(Age-standardised per 100k)
186 (2.1x higher)
88
Building Solutions: Workforce, Innovation & Regional Action
Addressing these deep-seated inequities requires a combination of sustained long-term medical workforce development and immediate, flexible primary care service models. To grow our regional medical capacity, Tihei Tākitimu has partnered with the University of Waikato to support the recruitment and training of young Māori doctors within our region. While this pipeline is essential for future health sovereignty and clinical workforce stability, it will naturally take time to translate into increased GP capacity on the ground.
To bridge this gap immediately, Tihei Tākitimu is actively advancing alternative, community-focused access models that remove traditional obstacles to care:
- Nurse Practitioner-Led Care Models: Expanding nurse practitioner-led clinics (such as Te Ara Waiora) and nurse-led walk-in services across rural and urban hubs. Nurse practitioners provide comprehensive, autonomous clinical care—including diagnosis, prescribing, and treatment—offering immediate, high-quality care without GP gatekeeping.
- Workplace Health Services & Employer Partnerships: Partnering with major regional employers and Post-Settlement Governance Entities (PSGEs) to deliver primary care directly to industrial and agricultural sites. Bringing mobile consultations, health checks, and preventative screening into workplaces overcomes rigid operational hours and shift-work constraints for working whānau.
- Fully Subsidised & Capped GP Access: Advocating for capped consult fees and subsidies for high-need whānau, rangatahi, and kaumātua to remove financial barriers before health issues escalate.
- Sustainable Resourcing for Kaupapa Māori Providers: Securing flexible, multi-year funding for trusted Māori providers delivering integrated Whānau Ora services, rongoā Māori, and community-based mental health support.
Strategic Summary
“Improving primary care access is both an equity mandate and a regional economic necessity. By resourcing Nurse Practitioner-Led Care, expanding workplace health services, and supporting our partnership with the University of Waikato, Tihei Tākitimu is driving practical solutions that bring timely, high-quality care directly to where our whānau live and work.”
