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A story about the use and accessibility of health services for small urban, remote and rural communities


Uninhibited, fair access to health and disability services underpin the livability of communities as ‘health’ is a fundamental component of wellbeing. The Ministry of Health states that comprehensive, quality services for people living in rural areas is a priority for the Government.

Community narrative gathered for the purposes of this study, indicate a strong sense of disconnect and neglect by national health services, both primary and secondary. Within a New Zealand context, primary healthcare refers to the first point of contact for most health services i.e. GP’s, dentists, midwives and pharmacists; while secondary healthcare refers to more specialist level care, and is often based in a hospital or private specialist setting.

One particularly inhibiting factor is that the District is split between two District Health Boards; the Waikato DHB and the Whanganui DHB; with a proportion of the District choosing to access other DHB’s due to their proximity, these include the Taranaki DHB (New Plymouth) and the Mid-Central DHB (Palmerston North).

Other notable factors inhibiting the health of many Ruapehu residents include environmental factors such as poor housing and a cold climate. The most consistent narratives expressed by all participants across the district were, “long wait times to access primary healthcare”, and “financial barriers and inadequate public transport prohibiting access secondary heath care”. In addition to this, the main centers of the Ruapehu District score high on the deprivation index.

Key themes

  • Wait times to access local primary health care
  • Accessibility* issues
    • Lack of fit for purpose public transport to access secondary health care
  • Costs associated with travel to secondary services
    • Lack of knowledge about the National Travel Assistance Scheme
  • Effects of poor housing quality
  • Mental health services – what are they, where are they, when are they available and to whom
  • Confusion over DHB boundaries

*Accessibility is defined as accessible within one hours travel

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