The Royal New Zealand College of General Practitioners has published its submission on the government’s Health and Disability System Review. The College’s overarching message is that much more needs to be done to remove inequity from the health system. “There is clear evidence that some people are not receiving the health care they need,” says College President Dr Samantha Murton.

“Our submission identifies several barriers to accessing health care in New Zealand, including racism, location, cost of care, and rurality,” she says.

“It is our view that health equity must be at the centre of any redesign of the health and disability system. It is unacceptable that different groups of New Zealanders, particularly Māori, Pasifika, rural and high-needs patients, should receive lower standards of care or face higher barriers to access, than other members of our community.” 

In preparing the submission, the College sought member feedback via its chapters, professional interest groups, and from its Māori representative group, Te Akoranga a Māui. 

In total it received and synthesized 124 member contributions, enabling it to prepare a submission which makes 10 recommendations for improving the current health system:

1. Ministry of Health to ensure that the ethnicity of the providers or patients is not a detrimental factor for funding or monitoring any health and disability contracts for service.
2. Cultural competence and cultural safety training are core requirements for all health and disability workers. 
3. Implement a national system designed to deliver equitable outcomes, supported by cross-party political agreement for the direction of New Zealand’s health and disability system. 
4. Implement infrastructure that enables providers at different levels to be able to talk to each other, eg: a single national, electronic health record.
5. Review district health board boundaries according to current population health needs and population mobility information. 
6. Appropriately fund different approaches and resources to achieve equitable health outcomes. 
7. Investigate and remedy the current shortfall of vocationally registered general practitioners, rural hospital doctors and other health professionals in order to meet current demand for services, and also to make recommendations to future-proof New Zealand’s medical workforce in light of the high numbers that will retire in the next 10 years.
8. Create and implement a single definition of urban and rural for universal use within New Zealand’s health and disability system. 
9. Investigate the mobile, technology-based and outreach services provided to rural populations to gauge their effectiveness in reducing health inequities in those communities. 
10. Implement the proposed National Interprofessional School of Rural Health. 

“The College has a Māori Strategy He Ihu Waka, He Ihu Whenua, He Ihu Tangata, which aims to increase the number of Māori GPs, enable a culturally and clinically competent GP workforce, and provide leadership and advocacy to achieve equitiable health outcomes. Our submission is just one way we’re achieving this,” says Dr Murton.

Read the submission.