As Budget 2026 approaches, questions remain over what the Government’s health spending plans will mean for Māori communities following the disestablishment of Te Aka Whai Ora.
“Kāre anō kia āwhina tēnei pūtea hei tautoko i ngā mahi i roto te hapori,” says Dr Rawiri Jansen, a former board member of Te Aka Whai Ora.
Dr Jansen now works as a community GP and says the pressure and lack of resources are being felt on the ground.
“Kei te pīrangi tonu tēnei whānau te kuhu mai, mā te whare hauora rātau e tiaki engari, te roa o te tatari ka raru, te utu tētahi o ngā raru, te tokoiti nei e mahi nei i roto i ngā whare hauora, he raru.”
Last year, the Government disestablished Te Aka Whai Ora, returning its functions to Health New Zealand and the wider public health system.
Dr Jansen says community health centres and Māori health initiatives need more funding in the upcoming Budget.
“Ka whakapau pūtea ki roto i te hapori, koinā te wāhi tino pai, te oranga ka puta mō ngā whānau.”
‘Me whai wāhi ngā take Tiriti’
The coalition government is also moving to change or remove Treaty of Waitangi clauses across 19 different laws, including legislation relating to health.
“He raru tērā mō ngā kaupapa hauora, mō ngā kaupapa mātauranga, mō ngā kaupapa katoa,” Dr Jansen says.
Public health services must currently give effect to Te Tiriti o Waitangi, but Prime Minister Christopher Luxon says the Treaty clauses are inconsistent and unclear.
“Having open-ended Treaty clauses that say ‘give effect’, ‘honour’... you know, a whole mish-mash of things that have been built up over 30 to 40 years, it doesn’t make sense to us,” Luxon says.
Basics focus of Tahua 2026
Finance Minister Nicola Willis says Budget 2026 will focus on core services such as health, education, and law and order, while maintaining tight spending.
The Government has already signalled health initiatives including expanded urgent and after-hours care, improved GP access, continued funding for Pharmac and cancer treatments, mental health support, longer prescriptions where appropriate, and a $35 million boost for ambulance services over four years.
Māori health advocates say it is still unclear how much of this funding will directly reach Māori-led providers.
Pharmac has proposed widening access to key diabetes medicines while removing Māori and Pacific ethnicity-based eligibility pathways. Associate Health Minister David Seymour and Health Minister Simeon Brown say the changes ensure treatment is based on “clinical need, not race” and could expand access.
“Ethnicity shouldn’t decide what funded options you can access to manage type 2 diabetes,” Seymour says.
However, Māori health leaders, clinicians, and iwi organisations oppose the proposal, warning it would remove an important equity measure that has helped address higher rates of diabetes, complications, and earlier deaths among Māori and Pacific peoples.
Te Tiratū co-chair Glen Tupuhi says, “Māori are diagnosed younger, become sicker earlier, and die sooner from preventable chronic illnesses.”
Budget 2025 also faced criticism after the Government disestablished Te Aka Whai Ora and did not introduce major Māori-specific health funding. The Government said this would reduce bureaucracy and create a single health system under Health New Zealand and the Ministry of Health, while critics argue it reduced Māori decision-making power and weakened accountability for Māori health outcomes.
Kei hea he moni mō ngā nēhi Māori
Dean Cowles, Kaiārahi Hauora Māori at Southern Cross Health, says Māori nurses continue to face longstanding inequities within healthcare.
“There’s a lot of challenges that Māori nurses face within healthcare, particularly associated with historical discourse, and you know, healthcare inequities with Māori.”
Members of the public say mental health support and access to care remain key concerns.
One person said, “I’d definitely like to see more put into mental health issues, definitely around the justice system - there needs to be more resources.”
Another rangatahi said accessibility to healthcare services remained an issue.
“Even going to the doctor, people have that mindset of, oh no, I’ll be right, I’ll be sweet - but not actually knowing their true problems.”
Another said delays accessing care were affecting people’s ability to work and recover quickly.
“When you’re unwell, you wanna be able to see a practitioner as soon as possible and calling a doctor and seeing that you can’t get an appointment for a week to 10 days.”
The Government will announce its Budget on May 28.
