Expert Critiques New GP Funding Model for Ignoring Ethnicity

The New Zealand government’s revised funding formula for general practices is under scrutiny for potentially exacerbating health inequities among Māori and Pacific communities. Effective from July 1, 2026, the updated model will allocate funding based on patient demographics, including age, sex, rurality, socioeconomic deprivation, and morbidity. Critics, however, argue that by omitting ethnicity as a key factor, essential health needs of specific communities may go unaddressed.

Public health expert and senior research fellow at Otago University, Dr. Gabrielle McDonald, stated that neglecting to consider ethnicity in the funding formula contradicts expert recommendations and undermines efforts to improve health outcomes. “It’s illogical,” she remarked during an interview with RNZ. “Leaving ethnicity out means funding will not be directed to the areas of greatest need, making access to healthcare more difficult for Māori and Pacific communities.”

Data reveals significant disparities in health outcomes, with Māori individuals living an average of seven years less than their non-Māori counterparts. Furthermore, they experience higher rates of serious illnesses, including cancer, even when accounting for socioeconomic factors. Dr. McDonald emphasized the importance of a funding model that acknowledges these disparities, stating, “We have a system that does not respond adequately to Māori and Pacific people; it primarily serves the majority, Pākehā.”

The new funding formula has been designed to replace a 20-year-old model that primarily considered age and sex. A 2022 analysis commissioned by the government and conducted by the consultancy firm Sapere recommended a comprehensive approach that included ethnicity. Dr. McDonald criticized the government’s decision to exclude this important demographic, calling it “illogical” and detrimental to efforts aimed at reducing inequities in primary care.

Access to primary care is critical, as it often serves as the gateway to the broader health system. Dr. McDonald warned that without addressing inequities at this level, the entire healthcare system would continue to fall short. “General practices are the backbone of any effective public health service,” she noted. “If we do not reduce inequities in accessing primary care, we will be playing catch-up throughout the health system.”

She further asserted that including ethnicity in the funding formula was necessary to ensure that resources are directed where they are most needed. “Our health dollar is limited, and it needs to be spent wisely. Excluding ethnicity means funding will not reach the communities that require it the most, which will hinder access to healthcare for Māori and Pacific peoples,” she stated.

Dr. McDonald, who has been a public health physician since 2011 and has extensive experience in reviewing child and adolescent health disparities, highlighted the stark inequities faced by Māori and Pacific children. “The inequity is very, very obvious,” she said. “Māori and Pacific children are disproportionately affected by negative health outcomes, and they ultimately pay for it with their lives. We see inequities in death rates among children and adolescents across nearly all areas.”

In response to the criticism, New Zealand’s Minister of Health, Simeon Brown, acknowledged the need for a revised funding model that better reflects patient requirements. In a statement to RNZ, he noted that the current system had become outdated and did not adequately address the needs of patients. “Too many Kiwis are waiting too long for a GP appointment,” he said. The new approach aims to ensure that funding is directed towards communities with higher health needs.

Minister Brown emphasized that the reweighted formula would consider age, rurality, complexity, and socioeconomic deprivation, ensuring that resources are targeted to those most in need. “Māori and Pacific peoples, in particular, will benefit from this change,” he asserted.

Despite these assurances, Dr. McDonald remains skeptical about the government’s commitment to a truly equitable funding model. She pointed out that the final version of the funding formula lacked the “state-of-the-art, fully fit-for-purpose” characteristics that had been anticipated. “Data shows that health outcomes differ for Māori and non-Māori, even when poverty and other factors are taken into account,” she explained. “Māori face additional barriers to accessing appropriate care and receiving equitable treatment once they do.”

Dr. McDonald highlighted broader trends in government policy that reflect a reluctance to address the needs of ethnic groups. “There is significant pushback against discussions about the needs of specific ethnic communities, even when compelling reasons exist to focus on ethnicity,” she stated.

She advocates for a comprehensive, evidence-based funding mechanism for general practices that aligns with the government’s stated objective of needs-based funding. The ongoing debate over the funding formula underscores the urgent need for policies that genuinely address health disparities and ensure equitable access to healthcare for all New Zealanders.