Healthcare Providers Funding Immunisations Out Of Own Pockets, Health NZ Admits 'Work To Do'

Tuesday, 29 April 2025, 6:18 pm
Article: RNZ

Ruth Hill, Reporter

• Māori and Pacific immunisation providers say funding is too low to cover services, with many babies still at risk going into winter.
• One-year contracts and "piecemeal" arrangements are making it tough to build sustainable services.
• The Immunisation Advisory Centre says funding does not cover "hidden costs" for hard-to-reach communities.
• Health NZ says a range of funding models are in place, but admits there's still work to do.

Some Māori and Pacific healthcare providers say they are losing money on vital immunisation services for high-need communities due to funding shortfalls.

In the Far North, Te Hiku Hauora Māori health service has pooled resources with a couple of smaller providers to take immunisations on the road.

Chief executive Maria Baker said they discovered Health NZ had an immunisation van in Auckland, which was "surplus to requirements".

"So we reached out to get that van, and we've been really lucky to hire it. So we lease a tailor-made immunisation van that we lovingly call 'the Moko Van'."

Since its first community event in Kaitaia last April, the immunisation outreach programme, Hapaitia Ngā Mokopuna, has "engaged" with more than a thousand whānau.

Baker said its focus was pēpi and tamariki - "since they are the most vulnerable" - but it immunises anyone who needs it, from rangatahi to kuia and kaumatua.

"For me, as CEO of the organisation, finances should not ever be a barrier for healthcare. So we pay for it."

The lead vaccinator, a registered nurse, often dealt with non-immunisation related health problems for patients who popped into the van, especially in rural areas where primary care was in short supply.

Hapaitia Ngā Mokopuna received some funding - but that fell well short of what it actually provided, Baker said.

"Even though we've been really lucky to lease the van that we're using from Health NZ, we've had to purchase the fridge, we've had to purchase the medications. We also support other people's training."

The organisation had chosen to invest in the service from its own resources because the need was so great.

"And it's been important for us to do that. But honestly, immunisation should be a regular, consistent part of any primary healthcare service in New Zealand, and they should not be funded via one-year contracts."

It was not enough to simply impose an external target when it came to immunisation in those "hard to reach" communities, she said, it had to be about "relationship".

"It's more than just a target, it's more than just putting a contract in a location. There's a whole range of different things that need to happen around it for it to be suitable for that community."

The government target is for 95 percent of two-year-olds to be fully-vaccinated by 2030.

In the three months to the end of December, coverage was 77 percent, and lower still for Māori (63.5 percent) and for Pacific babies (under 69 percent).

Midwives spend own money to keep immunisation service going

In Papatoetoe, Niu Life Midwives - a small collective of independent midwives - has spent more than $5000 since August last year renting space for its vaccination service.

That was when its two-year contract under the Counties Manukau Maternal and Immunisation programme came to an end, after the Covid-19 surplus funding ran out.

Niu Life's clinic (which topped the country for vaccinating pregnant Pacific women) was downgraded to two days a week, appointment only, 9am to 2:30pm.

Spokesperson Linda Burke is thrilled that as of last month, the clinic is back up to four days a week - and Health NZ has agreed to cover the cost, including rent.

"I'm just relieved it's done. It's trying to prevent something that's going to relieve the strain on the health system, which is already overburdened as it is."

The new contract was arranged after persistent lobbying by Niu LIfe.

"I was never prepared to let such a wonderful service come to a halt, especially as we continually topped New Zealand stats for immunisations. Every service needs to be accessible to the people in their communities, this was Te Whatu Ora's vision."

The Immunisation Advisory Centre's medical director, Nikki Turner, said funding for providers was adequate for "straight-forward" patients.

"But if you're giving a complex catch up programme or multiple vaccines all at once, the funding does not cover that. The time it takes to reach out to the families, to communicate, to support them through that, to vaccinate - there are a lot of hidden costs that are not covered by the current subsidy."

"More work to do" - Health NZ

The National Public Health Service's acting national director, Vince Barry, said Health New Zealand acknowledged "the incredible work" of its provider and primary care partners across the country, who were "working tirelessly to increase access and boost childhood immunisation rates".

"While there is more work to do, there are a range of funding models in place across provider types to support their efforts," he said.

The agency had increased the administration fee for childhood immunisations on the National Immunisation Schedule in July last year, from $36.05 to $41.20 per immunisation event.

As well as receiving funding for their enrolled patients, general practice could also claim "performance based funding".

In 2024, Health NZ also introduced additional one-off funding to support best practice pre-call and recall activities.

"This was also to acknowledge the extra work required, and to support capability and capacity building for the delivery of childhood immunisations."

For providers, Health NZ had invested $12.1 million in the 2023/24 financial year to boost capacity of Pacific providers to immunise.

A two-year $50 million package to resource Māori health providers to lift immunisation rates, particularly among children and older people, is set to end in December.

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