The tragedy of the budget is that the increased funding to support several initiatives has been achieved at the expense of pay equity settlements for many female-dominated, underpaid, professions across New Zealand. This includes primary care nurses whose pay equity claim, we are told, is likely to be delayed at least 12 months. We are firmly opposed to this approach and consider the way it was done, by changing the Pay Equity Act without public consultation, through an ‘urgency’ procedure through the House and backdating changes to retrospectively impact all current claims in progress, was cynical and unconscionable.  We are concerned for our nursing workforce at this time.

There were no new initiatives announced in the budget to support workforce improvement or retention in primary care. Minister Brown had already announced funding for the training of 120 further nurse practitioners along with a strategy to train 100 NZREX graduates through primary care pathways, and 50 NZ trained medical graduates through a similar primary care pathway. We were invited to attend a planning session with other sector representatives to help plan these pathways, which are due to commence in 2026. Of course, the graduates of these programmes will not necessarily practice in primary care; once complete they will be able to start on any vocational training pathway of their choice. Our hope however is that by exposure to primary care over an extended period of time, that they will see the attraction of this community-immersed specialty and want to practice in primary care. The potential problem is that we are asking already stressed general practices to take on a greater training role which, unless funded appropriately, could potentially paint primary care as a non-attractive proposition. Catch 22.

Unfortunately, there was no mention of any specific rural health initiatives in the budget. We would have been encouraged to see a Coalition Government, whose voter base is strongest in rural New Zealand, support pre-election initiatives to grow rural medical training through either a Waikato Medical School or an increased number of targeted rural programmes in the existing Schools in Otago or Auckland. But there was no mention of this, or the planned rural training hubs that are articulated in the 2024 Workforce Plan. Neither is there any further funding to help retain our existing workforce in rural areas. Our hope now is that when “capitation reweighting” is implemented, this finally recognises the increased costs of working in rural and remote areas, with more patients presenting with co-morbidities and chronic conditions that take more time to manage. We hope this is not too far away and will direct more funding to rural practices.

But let’s focus on some positive things that have happened.

The government did announce some training support money for practices willing to take on nurse graduates into primary care, with a $15K subsidy for urban practices and $20K for rural. I have checked with Health NZ about the uptake for the first tranche of 200 nurse subsidies. It was pleasing to see that the ratio of rural:urban practices taking up this offer was 19% which is in line with the percentage or rural:urban practices. There are now a further 400 nurse placements available, and I hope we see a similar uptake in the year ahead.

For us, the great news is that Health NZ has extended our Rural Locums contract for a further year. In a time of Health NZ closely scrutinising each dollar spent, we are pleased to see that our work is providing clear value to those in decision-making roles. Our NZLocums/NZMedJobs team have been particularly busy providing locum support to under pressure rural practices across New Zealand, as well as providing long-term and permanent doctors and nurse practitioners into those practices to boost the clinical teams. All of these services at no cost to the practices. The increasing limitation is how many locums we have available to mobilise around the country, and how many IMGs are willing to come to New Zealand to practice. A shout out to our great team of staff who deal daily with rural practice staff and have exceeded all of our contract targets for this contract.

We are also very pleased to see real progress on implementing a change process around rural urgent and unplanned care, which includes PRIME and after hours. We had been calling for review and action on this issue for a number of years and now we are in full flight with six pilot sites identified. The learning from these sites will inform the implementation of new processes and services to 70 rural practices over the following two years. Minister Brown has provided $164M of funding over four years (shared between urban and rural urgent care initiatives) which is very promising. Most importantly Marie Daly, our GM Advocacy is helping the Health NZ team develop the programme and we are utilising a number of sector advisory groups to look and advise on each component part. We have high hopes that this will result in positive results for rural general practices and the communities they serve.

Finally, it was amazing to see the lifetime achievements of Rev Bill Nathan recognised in the King’s Birthday Honours list at the weekend with the awarding of a Companion of the NZ Order of Merit (CNZM) for his services to Māori. Bill has recently retired as kaumātua to Hauora Taiwhenua Rural Health Network, and previously was kaumātua of the NZ Rural General Practice Network, for many years. Additionally, he has been Chair of Te Rōpū Ārahi, our Te Tiriti advisors since that group’s inception. Bill has been inspirational in his leadership as we transitioned to our new organisational structure, helping guide us to ensure we encapsulated thinking consistent with Te Ao Māori. He and his wife Donas have tirelessly served our organisation and trained our staff in Tikanga, te reo Māori, karakia and waiata. We are so pleased to see this award made to two people (as I see this recognising Donas as well), who have made such a lasting impression on Ngāti Pōneke, the Māori cultural development of young people across the Wellington region, and through his work with us, the ongoing health and wellbeing of rural Māori and non-Māori alike.  Ngā mihi nui Bill and Donas.

I look forward to catching up with members as I head around the country on a range of visits and events in the next few months:

• Next week at Fieldays Agricultural Showcase at Mystery Creek Hamilton from 11- 14 June. We have a stand at the Hauora Taiwhenua Rural Health and Wellbeing Hub. This includes hosting a Q&A session with Ministers Doocey and Patterson for the public, at the Hub, on Thursday 12^th June at 1pm.
• From July 1^st, Minister Doocey is continuing his series of Rural Roadshows with communities across New Zealand. Hauora Taiwhenua is Chairing each of these sessions for health professionals and community representatives from the areas he is visiting. A complete schedule of these events is available on our website.
• On July 16^th the Rural Communities Chapter is hosting our annual RuralFest event at Parliament. This is the opportunity for us to hold the Coalition Government to account for their efforts in improving rural health outcomes in the first half of their current term, and ask what they intend to do in the remaining 18 months of Government ahead of election 2026. We will also be asking Opposition MPs what they are intending pledge in their health manifestos if they are successful in 2026.  This is a critical time when we may still be able to influence political strategies in advance of the election cycles.

Take care and please feel free to contact me at any stage if you have any thoughts you want to share or discuss.

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Rural Support Trust 2024 Impact Report: Real Change, Powerful Results

The 2024 Rural Support Trust Impact Report, supported by Fonterra and conducted by the Ākina Foundation, reveals just how far-reaching and meaningful their support has been for rural communities across Aotearoa.

This year’s impact: •

• For every $1 invested, up to $5.50 in social value is created
• 94% of clients felt less stressed after engaging with them 
• Mental wellbeing scores improved by an average of 5.4 points on a 10-point scale 

Behind every statistic is a story — of connection, relief, and resilience. Whether it’s helping people through adverse events, providing a listening ear, or connecting them to essential services, the Trust continues to make a vital difference. 

Rural Support Trust National Chairperson Michelle Ruddell emphasises the heart of this work, "our purpose is to empower primary producers, their families and our rural communities with the support, tools and networks necessary to foster social connection. The ongoing work in destigmatising mental health challenges and normalising asking for help is critical to building strengthened rural communities. We want people to feel comfortable to reach out early before things feel out of control and we’re here to support regardless of the situation." 

The full report dives deeper into: 

• What clients are saying 
• The Social Return on Investment 
• The growing need across the sector 

Support graduate RNs — placement funding available now!

Following on from the Government’s announcement earlier in March, we wanted to share some important updates and opportunities that may be of interest and benefit to your organisation and other organisations you support.

Primary and Community Sector placement funding

The Government is committed to growing and supporting primary and community care. We are now sharing details on the funding to support primary and community, and rural providers to employ graduate RNs.

We know that hiring and supporting graduate RNs comes with cost, so we want to alleviate some of the financial pressure and support growing the primary care workforce. Funding is now available for primary care, community, and rural health providers who are committed to supporting graduate RNs as they transition into practice. To be eligible for the funding, graduate RNs must have completed their tertiary education in New Zealand and have not had a registered nurse job prior for a period of three months or longer (post-registration). 

We are encouraging employers to make good use of this initiative and apply for funding as soon as they decide on hiring a graduate RN!

About the funding

To be eligible for placement funding, employers must employ a graduate RN, provide preceptorship and clinical support, and hire the graduate RN for a minimum of 0.6 FTE for a period of 12 months or more. The funding is

• $15,000 for urban placements
• $20,000 for rural placements

How to Apply

1. Employers must ensure their organisation meets the eligibility criteria outlined above.
2. Employers must submit an Employer Eligibility Form so they can be assessed for funding.
3. Upon approval, the employer will receive a unique eligibility code.
4. The employer can then complete a Funding Application for each graduate RN they employ.

For more information about the initiative, please visit Primary and Community Care Employment Support Funding or if you have any questions, feel free to contact us at GraduateRN@TeWhatuOra.govt.nz.

Listing a vacancy with Kiwi Health Jobs

To support our graduate RNs into employment, Health New Zealand | Te Whatu Ora is offering free job listings for graduate RN positions until December 2025

All listings on Kiwi Health Jobs are also automatically posted to TradeMe Jobs, providing even more exposure for your vacancies.

To list a job:

Complete the attached Graduate RN Advertisement Request form and send to info@kiwihealthjobs.com with the following:

• The job description attached as a Word document and advertisement text (preferably as word document but URLs may be accepted)
• The email address or URL directing applicants to the job listing on your careers website
• Your organisation’s Logo attached as a PNG file (required only if this is your first time advertising with us)

For a limited time, we are sending out KHJ welcome packs so don’t delay, list your vacancy today!

There will also be other support and funding available for employers to support RNs to undertake postgraduate education and advance their nursing career. This includes postgraduate studies in prescribing and nursing, as well as NP training.  More information on this funding will be available by July.

Your support in helping graduate RNs connect with primary care employment is invaluable and will play a key role in supporting their professional development as they embark on their registered nursing careers.

We look forward to working with you as we support these talented graduate RNs into their first roles.

Regulation of Physician Associates Marks a Turning Point for Rural Healthcare

The Government has announced that Physician Associates (PAs) will be formally regulated under the Medical Council of New Zealand, a step that supporters say will strengthen patient care and help address staffing shortages. Regulation is expected to begin in 2026 and could pave the way for a New Zealand-based PA training programme.

While the PA role has long been embedded in the healthcare systems of the United States and United Kingdom, it is still emerging in Aotearoa. Around 50 PAs currently practise across New Zealand, all of whom were certified in the US, UK or Canada.

The move to regulate the profession has been welcomed by practitioners who say it will support safer, more consistent care and offer greater clarity for both patients and healthcare teams. Lee Spencer, PA at Te Kuiti Medical Centre, sees regulation as an overdue but essential shift.

“It gives the profession legitimacy and assurance to the public that these people are qualified and competent,” says Spencer. “They’re not doctors, but they are trained clinicians with defined scopes and a valuable role to play — especially in places like ours.”

PAs are medically trained professionals who work under the supervision of doctors. They perform a broad range of autonomous clinical duties, from diagnosing illnesses to managing treatment plans. They are considered essential team members who improve access and continuity of care.

“Without regulation, it’s harder to integrate PAs fully into the clinical team. There’s always a question mark for some people — even if the PAs themselves are highly skilled,” Spencer says. “Regulation removes that doubt.”

Supporters believe the regulation of PAs will enhance workforce efficiency, reduce appointment delays, and provide much-needed relief for overstretched doctors and nurses. However, not all voices in the sector have been supportive. In late 2024, several health organisations raised concerns about duplicating existing roles. They argued that the focus should be on bolstering the current workforce of locally trained professionals. Still, data from the 2010–2015 pilot programme and more than 340,000 patient visits since show high satisfaction and strong safety outcomes, reinforcing the value of the PA role in clinical settings.

“The goal isn’t to flood the system with a new profession,” says Spencer. “It’s about filling gaps in care where needed — and doing so with oversight, training, and public trust. PAs can play a key role to improving New Zealand’s health care crisis; by extending a doctor’s reach, we improve patient access, reduce wait times, and enhance the quality of care.”

For existing PAs, regulation represents not only recognition but a foundation for career development. With clearer scopes, accountability, and the backing of the Medical Council, the profession is poised to grow in both numbers and impact.

As New Zealand looks to innovate within its health workforce, regulated PAs could become a vital part of the solution.