Expert Warns New GP Funding Formula Will Worsen Māori Health Gaps

A public health expert has raised concerns that New Zealand’s updated funding formula for general practices will exacerbate health inequities affecting Māori communities. Starting from July 2026, the government plans to allocate funding to GP clinics based on age, sex, rurality, socioeconomic deprivation, and morbidity. Critics argue that the new formula neglects an essential factor—ethnicity—which is crucial for addressing health disparities.

Dr. Gabrielle McDonald, a senior research fellow at Otago University, stated that excluding ethnicity from the funding model is a significant oversight. “It’s illogical,” she remarked during an interview with RNZ. “Leaving ethnicity out means funding will not be allocated to those areas with the highest health needs, making it more challenging for Māori and Pacific communities to access healthcare.”

Data indicates that Māori individuals have a life expectancy that is seven years shorter than that of non-Māori. Furthermore, they encounter higher rates of serious illnesses, including cancer, even when socioeconomic factors are considered. Dr. McDonald emphasized that the current healthcare system does not adequately serve Māori and Pacific peoples, instead favoring the majority Pākehā population.

The revised funding formula will determine financial allocations based on the characteristics of enrolled patients. A comprehensive analysis conducted by the consultancy firm Sapere in 2022 recommended incorporating ethnicity into the funding formula, citing substantial evidence that supports this approach. Despite this recommendation, the government has opted to exclude ethnicity from its final version, a decision Dr. McDonald described as illogical.

She expressed concern that the absence of ethnicity in the formula would hinder efforts to reduce inequities in primary care. “General practices are the backbone of any good public health service,” she noted. “Failure to address inequities at this level means that the health system will continue to struggle with disparities downstream.”

Dr. McDonald, who has been a public health physician since 2011, has dedicated much of her career to addressing health inequities. She highlighted the stark disparities in child and adolescent mortality rates, noting that Māori and Pacific children often bear the brunt of systemic inequities. “These children pay for it with their lives,” she stated, referencing data that shows inequities in death rates across various demographics.

In response to the criticisms, Simeon Brown, New Zealand’s Minister of Health, acknowledged the challenges faced by many Kiwis in accessing timely GP appointments. He described the current funding model as outdated and stated that the new formula aims to better reflect patient needs. “The revised formula will consider factors such as rurality, multimorbidity, and socioeconomic deprivation, ensuring that resources are directed to those most in need,” he said.

Minister Brown asserted that the changes would particularly benefit Māori and Pacific peoples, as clinics serving these communities would receive increased funding. He emphasized that the reweighted formula recognizes the impact of various factors on health outcomes, aiming to ensure that resources are targeted effectively.

Despite these assurances, Dr. McDonald remains skeptical about the government’s commitment to addressing the needs of ethnic groups. She observed a growing reluctance within government policy to acknowledge the specific health needs of Māori and other ethnic communities, even in light of compelling evidence.

She advocates for a comprehensive, evidence-based funding mechanism that fully incorporates ethnicity, aligning with the government’s stated goals of needs-based funding. “We know our health dollar is scarce and should be spent where it’s most needed,” she asserted. “Excluding ethnicity means resources will not be allocated to areas of highest need, further complicating access to healthcare for Māori and Pacific communities.”

As the proposed changes loom closer, the debate surrounding the new funding formula highlights the ongoing struggle to achieve health equity in New Zealand and the critical need for responsive healthcare policies that address the unique challenges faced by diverse populations.