Expert urges govt to include ethnicity in GP funding formula

The government’s new health funding formula for general practices promises to “better reflect patient needs”, but ignores expert advice to include ethnicity as a factor, a researcher says.

Set to take effect in July 2026, the updated formula will allocate funding to general practices based on patients’ sickness levels, poverty status, and whether they live in rural areas.

Dr Gabrielle McDonald, a senior research fellow in public health at the University of Otago, supports the inclusion of rurality, poverty, and morbidity but questions the exclusion of ethnicity.

Speaking to William Terite on Pacific Mornings, McDonald describes the removal as “a serious omission” that puts Māori and Pacific communities at a disadvantage.

“It goes against the evidence,” he says. “We know that ethnicity is something that affects our health status, not because of who we are intrinsically, but because of how our system treats people who aren’t European.

“We systematically marginalise Māori and Pacific communities. From the starting point, you’re not coming in at an equal playing field, and then it’s harder to get access to care. Within the system, we’ve got good evidence that people don’t receive the same level of treatment.

Listen to Dr Gabrielle McDonald's full interview below.

Health Minister Simeon Brown announced the changes to capitation funding at a conference for general practitioners in July.

He criticised the current model as outdated, saying that it “doesn’t reflect the needs of patients.”

He says the revised funding formula considers more than just age and sex, incorporating multimorbidity, rurality, and socioeconomic factors to ensure a more equitable distribution of funding, especially benefiting GP clinics that cater to populations with higher health needs.

Health Minister Simeon Brown. Photo/File

Dr Angus Chambers, chair of the General Practice Owners Association (GenPro), supports the review. In a statement, he says the plans to update the formula and establish a structured approach for feedback from the sector are positive developments.

He also endorsed the inclusion of criteria such as deprivation, which indicates high health needs, and the emphasis on rurality, as rural areas currently have less access to health services.

Chambers welcomed the announcement of a group tasked with advising the minister on primary care, highlighting the detrimental impact of past decisions made based on poor advice from the Ministry of Health and Health New Zealand, which has contributed to the current workforce and funding crisis in General Practice.

He called for better advice to foster a high-performing healthcare system.

An evidence-based solution

McDonald criticised the coalition Government’s approach, which he says seeks a “colour-blind” health system, calling this perspective too simplistic.

“A colour-blind public health service would be great, but not in the way that they mean it. If Māori and Pacific people didn’t experience discrimination throughout the system, then that would be fine, but the reality is that there is discrimination.”

An expert says the government should follow the evidence when it comes to funding GPs. Photo/Unsplash

She warns that without incorporating ethnicity into the funding formula, practices serving predominantly Māori and Pacific communities would receive insufficient funding.

Life expectancy for Pacific people is significantly lower than for other groups, with Pacific men living an average of five years less than their counterparts from different ethnic backgrounds.

McDonald wants to see a truly effective funding model that adheres to expert recommendations.

“The one that was proposed was based on really well-thought-out, high-quality research and included age and sex, ethnicity, deprivation, and morbidity. That would be a good formula.

“Ignoring the evidence just leads to inferior public policy, and we know that our health dollar is very scarce. We need to spend it in the best way possible to get the best outcomes. It would be nice if the government followed the evidence.”