Thanks so much for getting behind the collective vision we have created of healthy and thriving rural communities in Aotearoa New Zealand. Also, please help us spread the word to get others to become part of this ‘advocacy bus’ that we are building. With enough people moving in the same direction we can hopefully be driving an Advocacy Steamroller in the near future that is so strong it can’t be ignored! 

There is no doubt that the health sector has experienced stress, lack of direction and turmoil over the past year. For all of you at the front line that is sometimes a difficult place to be with staffing and funding issues. I hope that we have been able to provide some small rays of hope at times through that fog!  

I am pleased that we were able to deliver increased funding for PRIME for both medical call-outs and clinical triage calls. We managed to finally get paramedics recognised for funding purposes in GP clinics and when responding to PRIME calls. We achieved an uplift in rural funding allowances through the PSAAP negotiations and managed to get HNZ to provide relocation funding for international doctors moving to New Zealand to work in rural practices for the first six months of the year – a shame that has now been stopped!  A further outcome was the negotiation of a premium payment for rural practices delivering child immunisations and more recently there was the $20K incentive for rural practices that employ nursing graduates. Our NZLocums team managed to place more locum doctors in rural practices, and import more Internationally Trained doctors for rural positions, than ever before.  And yet our research shows that we are still short of more than 130 doctors to fill existing positions, before we allow for the fact that those doctors are working with more patients per doctor than is recommended for a full-time position by the GP College. 

Looking to the future, hopes are high for the implementation of recommendations from the Review of Urgent and Unplanned Care (RUUC) in rural areas, and the Rural Hospital Sustainability project recommendations. These are also tied to the bigger Capitation Review work that Health NZ is undertaking, in which there was rural representation on the technical advisory group.  I understand that this group has identified key differences in delivering healthcare in more remote rural areas. We hope that this will lead to a new capitation model that recognises these increased costs and moves away from the current urban-centric model of one-size-fits-all funding. 

In this newsletter, a number of the Hauora Taiwhenua managers reflect on their key achievements throughout the year.  Some significant achievements are listed here by a committed team. 

I want to acknowledge that a lot of what we have listed here would not be possible without the support of the relatively new Rural Team within Health NZ. Rachel Pearce and her worker bees are to be congratulated in embracing the sector, engaging directly with us, and working within the system to provide evidence-based solutions within the confines of a resource-stretched agency. There is no hiding from the fact that HNZ is under serious pressure to cut spending and we fear what that will mean for rural health. The first sign of these moves was the non-renewal of our contract to promote health careers to rural rangatahi across Aotearoa. The hundreds of volunteer hours donated to this initiative by health students currently studying in tertiary programmes made this very cost-effective. But it has been discontinued with one stroke of a pen and is another telling blow that there is little focus on longterm solutions to the workforce crisis by building the future pipeline of young people into study. 

On a positive note, the start of 2025 is looking very exciting. We are beginning the year with a Rural Māori Health Summit, hosted at Pipitea Marae in Whanganui-a-Tara / Wellington in mid-February. We believe that being halfway through this three-year term of the Coalition Government, and 18 months since the launch of both the Rural Health Strategy and Māori Health Strategy, it is time to take stock of what has been achieved and what is planned for the next 18 months.  We are inviting representatives from Government, Government Agencies and grassroot community recipients of health to provide their views on how rural Māori health equity is being improved. HTRHN Board and Council, along with our Te Tiriti partner Te Rōpū Ārahi members will be present. If you have a particular interest in this mahi and would like to attend then please get in touch with us. 

In early May we will have our National Rural Health Conference at Te Pae in Christchurch.  Let’s get together and celebrate our collective efforts at this pinnacle event for rural health. It is encouraging to see that we have had a record number of abstracts submitted for presentations. I hope you can prioritise your time and budget to get there. The peer support and laughter is worth the trip by itself. 

We will be heading to Parliament for our Annual RuralFest event later in May to hold both the Government and Opposition parties to account for progress in rural health. Then in mid-June, we will be attending Fieldays at Mystery Creek near Hamilton to mix with rural communities first-hand to hear their concerns and also promote the concept of regular visits to health professionals for better wellness outcomes. 

I hope to catch up with as many of you as possible at one or more of the events listed above, or as our team travel the country to visit rural practices and rural hospitals on our regular regional visits. 

In the meantime, I hope you are all able to find time to relax and have fun with whānau and friends over the holiday period.  On behalf of our whole team here, Meri Kirihimete me te Hape Nū Ia! (Merry Christmas and a Happy New Year!)

Ngā mihi nui

Dr Grant Davidson

Chief Executive, Hauora Taiwhenua