A kaupapa Māori general practice in Marlborough is being backed with new funding amid growing pressure on the health system, with evidence showing its early intervention model improves outcomes for high-needs patients and reduces reliance on hospital care.
Manu Ora, the region’s only kaupapa Māori general practice, has received $165,000 over three years from Rātā Foundation to help sustain its not-for-profit model, which serves Māori, Pasifika, and people with complex medical and social needs.
Rātā Foundation is the South Island’s largest community investment fund, distributing around $25 million each year to support initiatives across Canterbury, Nelson, Marlborough and the Chatham Islands.
Despite working with patients experiencing trauma histories, homelessness, mental health challenges and addiction issues, the practice achieves comparable or lower emergency and urgent care presentations, alongside higher engagement with health services.
“Prevention and early intervention have a profound impact on positive health outcomes,” says co-founder Dr Rachel Inder.
“By serving our Māori and vulnerable members of society well, it reduces the cost and ‘burden’ on whānau and the strain on the wider health system minimising the need for more expensive downstream health interventions. If we don’t deliver complex medical care in the community like this, you can guarantee it’s going to cost the health system an enormous amount more in the long run.”
An independent evaluation by Sapere in 2022 found that many Manu Ora patients would not otherwise have engaged with general practice.
“Stakeholders identify to us that these high needs vulnerable whānau likely would not have [otherwise] connected with general practice or would not have received an appropriate level of service, and only occasionally would have been seen by the DHB in its hospital, usually in a crisis situation.” the report found.
The Manu Ora model differs significantly from traditional general practice, operating with a patient-to-GP ratio of around 1 to 900, compared with the national average of 1 to 1,700. Initial enrolment appointments are at least 90 minutes long and focus on kōrero and pātai to understand a patient’s holistic needs.
Nearly 50 percent of the practice’s patient roll is Māori, compared with around 13 percent at other Blenheim practices.
“In Marlborough, many of the other practices are a three-week minimum wait, but some are out to four months, so to be able to offer appointments within a couple of days and same-day acute care is so important,” says co-founder Dr Sara Simmons.
“Everyone in their first consult will see the team for an hour and a half to set us up with a two-way relationship. That whakawhanaungatanga, treating people like family, is exactly what we do at Manu Ora.”
Kaiāwhina Haumanu Hauora Mikayla Charlton says the kaupapa Māori approach has helped patients re-engage with healthcare.
“We’re helping so many who didn’t want to connect with previous doctors. They come here and then all of a sudden they’re going to appointments, they’re getting all the checks that they need, making that change for their health.”
Patients say the practice feels welcoming and accessible. One patient, Willie, says, “It’s got a good feeling when you walk in the door. It’s a welcoming feeling. I can get an appointment fairly quickly, and the staff are very caring.”
Another patient, Jahnay, says, “They’ve helped me in so many ways. I lost my mum two years ago, and they helped me through it so much. Even though I had lost someone so important to me, I had all of these amazing women by my side. They don’t just see you as another patient, you know, they see you as family.”
Mā te hurhuru e rere ai te manu
E 28% anake te nui o te pūtea e ahu mai nei i te pūkoro o te Kāwanatanga e rere ai a Manu Ora.
“One of the huge differences about Manu Ora is that we’re a non-profit service, and that means that we can provide care at low or no cost,” says Dr Simmons.
“Over 60% of our whānau pay nothing to come and see us. Without the support of the Rātā Foundation, we would be unable to provide the service.”
E ai ki te kaiwhakahaere i ngā mahi whakangao pūtea o Rātā ki a Kate Scaler, ko ngā moni nei e whakamānawa nei i te huarahi kei te takahia e Manu Ora ki te whakawhāiti i tēnei mea i te tautika kore.
“Manu Ora demonstrates how community-led solutions can transform healthcare delivery for people who need it most. Their kaupapa Māori model provides wraparound support that goes far beyond traditional general practice. By investing in supporting people early, the hope is that they can reduce people from developing more significant issues later.”
Kua whakawhiwhia tēnei whare hauora ki ngā tohu whakamānawa nui o te motu mō āna mahi whakaako i ngā nēhi me ngā tākuta o te iwi Māori, o ngā iwi o Te Moananui ā-Kiwa anō hoki.
Hei tā Tākuta Simmons, ko te pae tawhiti he whakakī i ngā whāruarua ki roto i ngā mahi hauora.
“We hope that the impact we have will, big picture, improve health outcomes and particularly trying to close the gap between the inequities that Māori experience in terms of health outcomes.”
