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Hauora Taiwhenua Rural Health Network is a national peak body representing rural health professionals and the health/wellbeing of rural communities in Aotearoa New Zealand. We represent a broad coalition of rural health professionals, communities, and organisations committed to improving health outcomes for people living in rural and remote Aotearoa.
Our members are often in the front line when an emergency occurs, often caring for those in the community that are most vulnerable.
We welcome the opportunity to make a submission on the Mental Health and Wellbeing Strategic Framework 2026-2036.
Summary of position We oppose the Data and Statistics (Census) Amendment Bill. A move away from full enumeration to the proposed model of administrative data supplemented with a small rolling survey will have a disproportionate impact on rural communities. The capacity to support small-area statistics that are essential to describing the diversity of rural communities will be severely reduced, and several key variables will be entirely lost as no other source of this information exists. The data gaps will be largest for rural, and the data quality will be lowest for rural. This is unacceptable.
The reduced quality of ethnicity data is of particular concern as it is a key variable in health service planning, resource allocation, and equity monitoring. Census collects multiple-response ethnicity through a standardised question and process, collecting multiple ethnicities and detailed ethnicity levels that administrative data systems miss. Rural communities, and rural health services, require ethnicity data that is complete and accurate, but also spatially detailed.
There are many important variables, essential for describing thriving rural communities that are only collected for the whole population through the census. For instance, language use (e.g Te Reo Māori or NZ Sign Language), volunteer activities, disability, membership of rainbow communities, iwi affiliation, the presence of mould in housing are only collected through the census. Again, rural communities, rural service providers, rural researchers, and rural advocacy groups such as ourselves, require spatially detailed data which allows us to identify patterns for distinct rural populations.
Intersectionality is a key strength of the census. The availability of this data supports us in our advocacy and supports our network to make evidence informed decisions. For instance, we know that 73% of remote Māori live in areas of very high socioeconomic deprivation; we know that cigarette smoking rates are higher in rural compared to urban areas and are highest for rural Māori; and we know that Māori in rural and regional communities are more likely to participate in volunteer activities than non-Māori. This nuanced and intersectional information is essential for providing detailed and meaningful information about rural communities and cannot be gathered through administrative sources. The loss of this data will have a significant impact on our network, and the ability to use information and evidence to advance us towards our vision.
An increased burden on the rural health sector to collect data for statistical purposes. While administrative health data is often considered to be of high quality, we know that there are significant quality challenges. Health data is not collected for the statistical purpose of describing a population. It is collected to support health service delivery. Our rural health clinicians are severely stretched and work incredibly hard to ensure that they can provide high quality healthcare to their communities, with fewer resources than their colleagues in major cities. They are not trained in data collection for statistical purposes, and nor should they be, this is not the core focus of their jobs. We are concerned that there is a strong risk that rural clinicians and health services will face an additional burden around data collection with the move to an administrative data-based census, where the quality of such administrative data becomes even more important than previously. We are concerned about the risk of burnout for clinicians and rural health service teams, and about the considerable risk that resource constraints will mean that the quality of information collected from rural communities is lower than the quality of urban data.
Hauora Taiwhenua Rural Health Network is a national peak body representing rural health in Aotearoa New Zealand. We represent a broad coalition of rural health professionals, communities, and organisations committed to improving health outcomes for people living in rural and remote Aotearoa.
We welcome the opportunity to provide consultation advice on the proposed changes to ACC cost of treatment and definitions regulations.
ACC Targeted Consultation Document
The challenges facing aged care in rural communities are well understood; what is now required are targeted, practicable reforms that enable sustainable, high quality care to be delivered in the right place, at the right time. As this submission demonstrates, current funding, contracting, and regulatory settings often undermine the viability of rural services, restrict genuine choice for older people, and contribute to avoidable hospital admissions and premature entry into long term residential care.
The principles outlined in this document respond directly to the Advisory Group’s questions by identifying changes needed to support ageing in place, improve financial sustainability, enable innovation, and better align aged care with wider health and disability services. Central to this is the need for rurally appropriate commissioning, targeted use of bulk-funded flexible beds, integrated contracting models, and funding approaches that reflect the true costs of rural service delivery.
These reforms are not about treating rural communities differently, but about designing a system that works equitably across diverse contexts. By adopting the approaches proposed, government has an opportunity to strengthen rural aged care as an integral component of a cohesive national system, one that respects older people’s autonomy, supports whānau and communities, and delivers sustainable, high-quality care for all older New Zealanders, regardless of where they live.
Hauora Taiwhenua Rural Health Network is the peak membership body for rural health in Aotearoa New Zealand. We represent a broad coalition of rural health professionals, communities, and organisations committed to improving health outcomes for people living in rural and remote Aotearoa.
We welcome the opportunity to provide feedback on Pharmac’s proposal to update the Pharmaceutical Schedule for ambulance medicines, and Tenecteplase for pre-hospital use, in Aotearoa New Zealand. Our submission emphasizes the potential benefits, areas needing clarity, and recommendations to ensure equitable and effective implementation.
WE SUPPORT BOTH PROPOSALS:
1. Ambulance medications being added to the Pharmaceutical schedule
The inclusion of ambulance specific medications in the Pharmaceutical Schedule represents a significant advancement, supporting a more coordinated and consistent approach to funding and procurement for emergency medicines. This dedicated section within the Schedule will provide a clear and transparent framework for identifying- which medicines are funded for use by ambulance services and PRIME providers.
2. Tenecteplase for pre-hospital use
Funding Tenecteplase for prehospital administration in cases of ST- Elevation Myocardial I-nfarction (STEMI) will enable rural PRIME responders and ambulance services to deliver timely, evidence-based- care. This ensures that patients in rural settings receive treatment comparable to that available in urban areas.
We welcome the opportunity to make a submission on the Emergency Management Bill (No 2).
Summary Comments:
Hauora Taiwhenua supports the introduction of the Physician Associate role into Aotearoa. However, as a large and diverse membership organisation, we represent a range of perspectives.
In this submission we have reflected the breadth of views expressed by our members with both supportive and cautioned perspectives in response to each question, with a particular focus on rural context, safety, sustainability, and equity. We finish each question with a HTRHN Summary Position on the issue, having reflected on the spectrum of feedback from members.
Introduction Hauora Taiwhenua Rural Health Network is the peak membership body for rural health in Aotearoa New Zealand. We represent a broad coalition of rural health professionals, communities, and organisations committed to improving health outcomes for people living in rural and remote Aotearoa.
We welcome the opportunity to provide feedback on Pharmac’s proposal to expand funded emergency medicines access in rural and remote Aotearoa New Zealand. Our submission emphasizes the potential benefits, areas needing clarity, and recommendations to ensure equitable and effective implementation of this initiative.
Our CEO Dr Grant Davidson and Kaumātua & Board Member Peter Jackson presented to the Select Committee on the Pae Ora Amendment Bill, sharing the rural health perspective directly with the review panel.
If you weren’t able to join live, we’ve please find the link below so you can watch the highlights without going through the full recording.
Watch the presentation below:
We have reviewed the current Amendment Bill, utilising the Rural-Proofing principles, to develop the recommendations contained in this submission.
Our submission identifies clauses within the Amendment Bill that either: a) We agree with and recommend are adopted without change; or b) We disagree with and would accept with changes that we have submitted; or c) We disagree with and recommend should be deleted.
All our comments are written with the express purpose of designing Health legislation that will positively impact the health outcomes of all of New Zealanders, including the 20% that live in rural and remote regions.
Hauora Taiwhenua Rural Health Network Opposes the Regulatory Standards Bill in its current form. While we support the overall intent of the Bill to improve legislative transparency and accountability, we are deeply concerned that the Regulatory Standards Bill, in its current form, will undermine the ability of future governments to enact necessary public health regulations—particularly those that benefit rural communities, Māori, and other vulnerable populations.
We appreciate the opportunity to collaborate with our members to ensure a rural perspective is included in the Proposed Future Operating Model for the Air Ambulance Service. This service is crucial for rural health outcomes, and we value your engagement to ensure aeromedical services continue to provide high-quality, patient-centered care across New Zealand.
The impact of the future operating model must be evidenced by improvements in patient outcomes, with a reduction in morbidity and mortality of rural communities.
OUR COMMITMENT TO TE TIRITI O WAITANGI: Hauora Taiwhenua acknowledges that the Treaty of Waitangi comprises two documents: an English language version and a Te Reo Māori version. We have entered a Kawenata with kaumātua group Te Rōpū Ārahi which outlines a shared commitment to elimination of health disparities, especially for rural Māori through honouring the Articles of Te Tiriti o Waitangi. As the vast majority of the more than 500 Iwi Rangatira (Chiefs) signed the Te Reo Māori version, with only 39 signing the English language version, we will be referring to the Te Reo Māori version, Te Tiriti o Waitangi, throughout our submission. This is because the protections and rights offered by the Crown under this version are most at risk through this Bill.
Our biggest concern – Pae Ora Healthy Futures Bill: Rural as a priority population
The Ministry of Health’s Draft Suicide Prevention Action Plan 2025-2029 plan fails to acknowledge the significantly higher suicide rates in rural regions – 1.4 times higher than in urban areas. This issue is even more pronounced among Māori and those in the farming industry. Rural men aged 15-44 are 64% more likely to take their own lives compared to their urban counterparts.
There has been inadequate consultation with the rural health sector and communities they care for in the development of this document. Consequently, the Draft Plan omits to acknowledge existing rurally relevant suicide prevention programmes that, in most cases, has funding subsidised by the generosity of iwi providers, rural general practice or hospitals, and community groups. New initiatives proposed in the Draft Plan are unsupported by evidence of their effectiveness in rural populations
Hauora Taiwhenua Rural Health Network’s Rural Health Snapshot 2024 provides stark evidence of the significantly poorer health outcomes of the 25% of our Māori population who live rurally.
Health research and data provides evidence that the Government’s implementation of the Pae Ora Healthy Futures Bill, 2022, has yet to authentically prioritise the poorer health status of rural Māori. The Hauora Māori Strategy 2025 is an opportunity for this to be addressed
Thank you for the opportunity to make a submission on changes to ACC regulations for Chinese Medicine, Paramedics and Audiometrists. Hauora Taiwhenua Rural Health Network has a vision of healthy and thriving rural communities in Aotearoa New Zealand. We strongly support the proposed changes as they will contribute to achieving this vision.
The need for clinical services is unprecedented, with a growing older population with more complex health needs and an existing workforce which is struggling to cope currently, and certainly cannot in the future. These needs are exacerbated in rural communities where the immense pressure placed on the rural health workforce to meet that need is well-documented.
Our vision for the rural women of Aotearoa New Zealand Rural women enjoy a vibrant and healthy life, regardless of their age, ethnicity, or where they live. Hauora Taiwhenua Rural Health Network calls for the Women’s Health Strategy to set a bold path that reimagines and supports innovative approaches, and targets resources towards achieving equitable access to the health services that women who live in rural areas need.
Understanding who rural women are New Zealand’s total population of 4,699,000 is around 50% female. The rural population is 888,654 or 19% of the total population. Rural women make up 49% of the rural population, and only 9% of our total population. The University of Otago Geographic Classification for Health 2018 (GCH) analysis of Usually Resident Population data from the 2018 census provides information about New Zealand’s rural, women population.
