While access to health services is universal, there is clear evidence of barriers to access differentially affecting certain populations. The Health Quality & Safety Commission (HQSC) has developed the Atlas of Healthcare Variation which shows the variation in healthcare received by different geographical regions and population groups based on a survey of 79,000 people (Health Quality and Safety Commission NZ, 2021). The key findings relating to health service access included difficulties with cost, access, and the quality/type of care received:

• 15% of all respondents reporting a time when they wanted health care from a GP or nurse but couldn’t get it. More women (18%) than men (11%) reported this difficulty and there was a clear age gradient, and there was a clear age gradient with 23% of respondents aged 15-44 years having difficulty compared with <10% of those aged 65+. There was also a difference between regions, ranging from 8-27%.
• 17% reported not accessing healthcare in the last year because of cost, including the cost of the appointment, cost of taking time off work, and transport cost. Cost as a barrier was higher for younger patients and for Māori and Pacific (Table 24). Transport costs were higher for Māori and Pacific people (19%) compared to others (8%) and 29% of those aged <65 years compared with 5% aged 65+ reported the cost of taking time off work as a barrier.
• 8% of respondents reported not picking up a medication prescription because of cost, again much higher in Māori and Pacific people compared to other ethnicities (Table 25).

The Pacific population is experiencing unmet health needs and variations in the quality of health care. The three major barriers for Pacific are cost, transport, and language. Other barriers include family commitments, difficulty in meeting appointment times, difficulty in understanding the nature and necessity of an appointment, lack of access to after hour services, communication barriers, inflexible employment, and feeling cultural discomfort when discussing health issues with non-Pacific practitioners. Additionally, structural problems include long waiting times, lack of discussion time with doctor, crowded clinics, and the bringing and minding of children (Ministry of Health, 2019).

Table 24: Proportion of respondents reporting cost as a barrier to picking up a prescription by age and ethnicity (Health Quality & Safety Commission NZ, 2021)

Age group	Ethnicity (%)				Total
	Maori	Pacific people	Asian	Other
15-24	28	24	17	17	19
25-44	26	25	12	16	17
45-64	19	18	10	9	10
65+	6	8	5	2	3
Total	18	18	10	7	8

 

Table 25: Cost as a barrier to healthcare access by Age and Ethnicity (Health Quality & Safety Commission NZ, 2021)

Age group	Ethnicity				Total
	Maori	Pacific people	Asian	Other
15-24	43	35	22	37	37
25-44	38	32	25	34	33
45-64	22	20	18	18	19
65+	9	13	8	8	8
Total	25	25	20	16	17

 

References:

Health Quality & Safety Commission NZ. (2021). Health Service Access. Health Quality and Safety Commission website. Available from: https://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/projects/atlas-of-healthcare-variation/health-service-access/.

Ministry of Health. (2019). Visiting a doctor or nurse. Available from: https://www.health.govt.nz/your-health/services-and-support/health-care-services/visiting-doctor-or-nurse.