About
Hauora Taiwhenua
Rural Health Network
Hauora Taiwhenua Rural Health Network is the collective voice of rural health in Aotearoa spanning general practice, rural hospitals, nursing, midwifery, allied health, research, students, communities and Whānau Whānui.
As New Zealand approaches the 2026 General Election, we call on all political parties to commit to the six priorities outlined in this manifesto. These commitments are drawn from the Aotearoa New Zealand Declaration on Rural Health 2026, which was developed through national and international collaboration at the 21st WONCA World Rural Health Conference. They represent a direction that has been endorsed by Government and now require action, investment, and accountability to deliver better health outcomes for rural communities.
Te Tiriti o Waitangi underpins all six commitments. Rural Māori experience some of the poorest health outcomes in Aotearoa, and each commitment set out below must be delivered through genuine partnership with rural Māori communities, providers and iwi in a way that upholds Te Tiriti and advances equity.
Dr Fiona Bolden
Chair
Dr Grant Davidson, Phd
Chief Executive
The next Government must deliver for rural communities
One in five New Zealanders - 908,034 people - live rurally, across 91% of the country’s land area. Rural communities drive the primary industries that generate more than 80% of export earnings, yet they carry a disproportionate burden of ill-health and face the greatest barriers to care.
People in remote communities live up to four years less than those in urban centres. Rural Māori, who represent one in four Māori nationwide, have 7% higher all-cause mortality rates than urban Māori, while those under 30 are twice as likely to die from a preventable cause.
Rural practices and hospitals are underfunded; many are understaffed. An estimated 130 additional GPs are needed to support safe patient-to-doctor ratios, yet we do not have a comprehensive national plan to grow and sustain the rural health workforce.
These gaps in health and access to care are serious, measurable, and preventable. Rural communities, iwi, and health providers are already leading solutions that work. What is needed now is the policy support, investment, and political commitment to sustain and expand them.
Six commitments every Political Party can make to rural New Zealand
1. Ensure rural voices shape health policy and system change
Why it matters
Health policy, planning, and funding decisions are too often made without meaningful engagement with rural communities, resulting in services and investments that do not reflect rural realities. Although important foundations have been established through the Pae Ora (Healthy Futures) Act 2022 and the Rural Health Strategy, progress in improving access to care and health outcomes for rural communities has been limited.
Rural areas are disproportionately exposed to extreme weather and natural disasters, yet rural health services are largely absent from emergency management planning.
We call on all parties to commit to
- Rural proofing all health policy and investment decisions to ensure the voices and realities of rural communities are considered from the outset.
- Making rural health visible in national reporting by showing health results separately for rural and urban communities, and by ethnicity.
- Strengthening partnerships with rural Māori communities, providers and iwi to improve access to services and health outcomes through targeted action and accountability.
- Establishing a Rural Health Services Framework that clearly sets out what health services rural communities should be able to access close to home.
- Emergency planning that works for rural and remote communities with rural health and disability expertise embedded in National Emergency and Civil Defence decision making processes.
What this means for rural communities
Rural communities have a genuine voice in health decisions, resulting in services, funding, and policies that better reflect their needs and improves access to care closer to home.
2. Grow and sustain the rural health workforce
Why it matters
The rural health workforce is significantly depleted, with no cohesive long-term strategy to attract, educate, train and retain health professionals. Rural students remain far less likely to enter health careers than their urban peers, and rural health services depend heavily on locums and internationally qualified professionals.
We call on all parties to commit to
- A comprehensive Rural Health Workforce Plan informed by reliable workforce data and supported by a funded action plan to attract, train, recruit, and retain rural health professionals.
- Four regional rural training hubs rural-proofed and appropriately funded, building on existing community-led initiatives that already support rural learners across all health professions.
What this means for rural communities
Rural communities have access to a skilled, sustainable health workforce, supported by a long-term plan to attract, train, recruit, and retain rural health professionals.
3. Recognise the broad clinical skills needed to provide care in rural communities
Why it matters
Rural health professionals need a broad range of clinical skills to provide comprehensive care close to home. In a single week, they may provide maternity care, manage a cardiac emergency, and treat a serious farm injury. Yet regulatory, credentialing, and funding settings do not consistently support clinicians to work to the full scope of their training, limiting access to care for rural communities.
We call on all parties to commit to
A nationally coordinated framework that recognises and supports the broad clinical skills needed in rural communities that connects training, career pathways and professional support across the health workforce.
What this means for rural communities
Rural communities can rely on highly skilled local health professionals to provide comprehensive care close to home, reducing the need to travel for services that can safely be delivered locally.
4. Fund the higher costs of delivering health care in rural communities
Why it matters
Rural communities regularly design and deliver innovative and collaborative ways of delivering health care, but limited support, protected time and appropriate resourcing constrain their ability to sustain them.
We call on all parties to commit to
- Funding that reflects the real cost of providing rural health care that ensures rural general practices and rural hospitals are funded adequately to meet the needs of the communities they serve.
- A fair National Travel Assistance Scheme that enables rural people to access essential specialist services without facing untenable costs and financial hardship.
What this means for rural communities
Rural communities have access to reliable health services close to home and realistic support to travel when their care is provided elsewhere.
5. Harness digital technology to strengthen rural health services
Why it matters
Video consultations, remote monitoring and digital and AI tools can shrink the distance between rural patients and the care they need but to do this, they must have reliable and affordable internet connections, suitable devices, and clinicians who are supported to use them.
We call on all parties to commit to
- A rural share of digital health investment so that at least 20% of Health NZ's digital health funding supports rural communities to benefit from new technology and ways of delivering care.
- Fund the implementation of the Rural Digital Health Workplan so that rural communities have reliable and affordable internet connections, up to date equipment, and the skills to use them.
What this means for rural communities
Rural communities know that where you live is not a barrier to benefiting from modern health technology, with rural communities fully connected to the digital health opportunities available across New Zealand.
6. Invest in rural health knowledge and research
Why it matters
Improving rural health depends on strong evidence about the challenges rural communities face and the solutions that work. Yet only a small share of New Zealand's health research funding is dedicated to rural health.
Funding intended for rural health education faces a similar problem: a significant portion is retained by metropolitan institutions before it reaches rural programmes, undermining their viability and the benefit they could deliver to the communities they are designed to serve.
We call on all parties to commit to
- A fair share of research funding so that at least 20% of Health Research funding dedicated to rural health research.
- Rural health education funding spent rurally ensuring that at least 95% of funding intended for rural health training is spent in the rural communities where training takes place.
What this means for rural communities
Rural health services are based on evidence, supported by local training opportunities and a strong pipeline of future health professionals.
OUR ASK OF EVERY
PARTY AND THEIR
CANDIDATES
This election, we call on every political
party to adopt the six commitments in
this manifesto, and we ask every rural
candidate to champion them.
Sources: Aotearoa New Zealand Declaration on Rural Health 2026; Hauora Taiwhenua Strategic Plan 2026–2029; Rural Health Snapshot 2026; RuralFest 2026 Calls to Action; Rural General Practice Stocktake Survey 2024.