Home and Community Health Association

04/06/2026

Budget Day always offers such hope and excitement and the public are right to state their agreement that health deserves to be the biggest winner 🏆
Hospitals infrastructure needs funding and everyone agrees with that, yet there appears to be a distinct lack of planning & dedicated funding for preventative primary and community based care - that doesn't make fiscal sense (for primary care every $1 gives $13 return).

Frustratingly digging into the details and looking further under the hood can be a bit of a downer. This report by Professor Paula Lorgelly helps to shine a light on the oil leaks.

As with most things materials, equipment and costs increase over time and the rising cost of healthcare delivery is moving at the pace of a Tsunami so the record investment in health appears in reality to only manage to meet Baseline Funding, to keep the lights on. An inconvenient truth indeed and it seems that if the projected funding was provided to meet the real need it would have to increase by $1.4billion.

So as the report points out the next government should focus funding where it delivers the greatest benefits, upstream in preventive interventions and primary healthcare or it will lead to a loop of doom.

Budget 2026 increases health spending but falls short of what is needed to address years of underfunding, with insufficient investment in prevention and primary care to improve access, equity and long-term health system performance.

04/06/2026

A Reflection from HCHA CEO Lisa Foster:

This substack piece by Dr Jane George really resonated with me. This names the fact that the system is doing exactly what it was designed to do. Built to compete to separate out into funding pools and limit.

We talk collaboration and fund competition.

We aspire to integrated, whānau-centred care, closer to home, and then wonder why it feels so hard to achieve. Jane's insight is that this friction isn't personal or inevitable; it's architectural. And once you can see the architecture, you can choose to act differently within it.

I believe many organisations are already doing exactly that. Rural providers of home and community health, alongside their kaiāwhina workforce, bring this grounded philosophy to life every single day, choosing cohesion in a system that rewards competition.

Most of us want care that is practical, responsive and funded effectively to keep us well at home so we can remain in our own space with our loved ones. This should not be in conflict with hospital level care needs that will only ever increase, but a sensible cost effective measure for happier, stronger, and productive community. That surely leads to growth in an integrated model that removes the silos?

So what would it mean to design for intergenerational wellbeing and genuine collaboration from the ground up? To build the architecture around hauora rather than around the budget line?
It's as old a question as it is urgent.

Budget day in Aotearoa is theatre. And as the curtain is raised, it reveals a lot.

28/05/2026

Great to be prudent in uncertain times yet are health cost savings now going to cost us all dearly later?

That’s the question we need the public to ask any Government to ponder and to make sure that we learn from our cousins across the Tasmin not replicate their mistakes. The post below shows dire 1 yr + waiting lists for home care and workforce crisis!

With a New Zealand budget appearing to focus on building more hospitals - where is the focus on prevention, on care closer to home with Home and Community support sector aligned with primary care partnerships- that’s the fiscal common sense pathway but when will we take it?

https://www.facebook.com/share/v/1NiZBtGtAD/

26/05/2026

A time for more transparency of the financial value for the Home and Community Health sector and its role as the heartbeat of health. Keeping whanau well closer to home offers more than just cost savings it makes peoples lives more colourful and offers whanau choice to remain in their own communities.

With Budget Day almost upon us, today's news of a $400 million health underspend, largely attributed to lower than forecast payments for community and residential support services, is worth pausing on.

Interesting timing. Interesting category.

The confusion about where exactly this underspend occurred reflects something we have long been calling out: we lack the budget transparency needed to properly analyse what we are spending on home care versus hospital or residential care, and crucially, what we are getting for it.
Because when we do have the numbers, they are impossible to ignore. Health NZ's own Sapere data shows that basic home and community support costs around $7,400 per person per year. A subsidised rest home place cost $65,000 at the same point in time. Nearly nine times more. With room for innovation and the right funding settings, expanding home care and investing in prevention and integrated care models is a clear winner. Whether that opportunity is taken, or whether the focus narrows to short term cost savings, is one of the more important questions sitting behind this Budget.

The international picture reinforces it. In the United States, supporting someone at home costs USD $70,000 per year (around NZD $118,000). In a state institution, that rises to more than USD $395,000 (around NZD $667,000), a fivefold difference. And for every dollar invested in home and community-based care, the broader economy returned $2.50.
Underfunding this model does not reduce costs. It shifts them, to emergency departments, rest homes, and family members who leave the workforce to fill the gaps. The savings are illusory. The harm is real.
Our kaiāwhina (community health assistants) workforce and family carers make this model work. It is, quite simply, a sound investment.

If we are ageing in place here in Aotearoa, and most of hopefully will be; this is one worth caring about.

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25/05/2026

On 21 May our CEO attended Rural Fest 2026 as a new member of Hauora Taiwhenua, and it was a day that reinforced the need for visibility and value for the care our kaiāwhina provide in rural and remote communities. Lisa attended carrying the voices of our members, with key messages shaped by their experiences on the ground: that kaupapa Māori home and community support is relational, not transactional, and that the trust kaiāwhina build in isolated communities is an equity intervention in itself that cannot be measured in activity volumes alone. Whānau trust is not incidental to these services. It is the service. Rural Aotearoa represents the second largest city in the country, and home and community support sits at its heart. Lisa will be sharing more detail with HCHA members, along with the advocacy priorities that emerged from the day.

Kia ora koutou. I'm Lisa Foster, Chief Executive of the Home and Community Health Association (HCHA), the peak body and national voice for home and community health and support providers across Aotearoa. HCHA represents varied organisations that enable people to live at home and within their communities: kaumātua, tāngata whaikaha, people recovering from acute illness, and those managing long-term conditions, often in rural areas.

I'm thrilled to join Hauora Taiwhenua because rural care is strongest when we are focused on the needs of our communities, with GP practice, homecare providers, community health professionals and the kaiāwhina workforce working in alignment. That connection is at the heart of what I hope to explore here. Where this alignment already exists in rural locations, the outcomes are noticeably better for it.

With the Rural Health Strategy setting a clear direction toward integrated, preventative care closer to home, the home and community health sector is a natural part of that picture. These priorities resonate deeply with home and community providers, and advocating together for their realisation makes every kind of sense. The effects of getting this right ripple outward: healthier whānau, more empowered communities, and reduced pressure on acute and residential services. Those benefits are not always easy to measure, but they are profound and they are real.

The rural dimension of home and community health remains genuinely underserved in national policy conversations, and that is the other reason I am so glad to be part of Hauora Taiwhenua. Too often, policy for our sector is shaped around urban service patterns, leaving rural and remote communities to absorb the consequences, with compounding factors of workforce shortages, inequitable funding, and the quiet weight of geographical distance from decision-making. These are the challenges we share, and they sit squarely at the intersection of what HCHA advocates for and what this network truly understands. I'm here to learn, to connect, and where I can, to contribute.

Learn more about Lisa here: https://zurl.co/xrj4F

24/05/2026

There is a short time for submissions on impactful changes for disability so please spread the word.

Submissions are open for the Disability Support Services Bill, announced last week by the Government. If you are a disabled person, a family carer, or a watchful citizen of New Zealand, we encourage you to read the Bill (there is an Easy Read version on the submissions page) and make a submission. There are only 19 more days to make a submission - an absurdly short amount of time for such an important Bill. We will be releasing information along the way. Shame on the New Zealand National Party, the NZ First Party, and the ACT Party for this cynical surprise legislation so close to a general election. And the very very short submissions timeframe which makes it difficult for the most stressed and vulnerable people to participate in what should be a fair democratic process. However, we have no option but to participate in the submissions process as best we can. Have a look. https://www3.parliament.nz/en/pb/sc/make-a-submission/document/54SCSSC_SCF_E6D8596D-C177-486B-CCF2-08DEB47E5457/disability-support-services-bill

23/05/2026

HCHA supports and stands together with NZDSN in the request for adequate and authentic engagement to occur for this Disability Support Bill.

“We’re calling on the Government to urgently extend the Select Committee process for the Disability Support Services Bill so disabled people, whānau and the wider disability sector have a genuine and accessible opportunity to participate,” said NZDSN CEO Debbie Hughes.
Read our statement: https://nzdsn.org.nz/disability-support-services-bill-select-committee-process-not-accessible-for-disabled-people/

21/05/2026

If rural Aotearoa were a single city, it would be our second-largest, serving almost 20% of our population.

A fantastic day on Wednesday at Parliament, part of an annual event run by Hauora Taiwhenua Rural Health Network;. The day brought real clarity to key Ministers and MPs across the parties on the healthcare challenges impacting rural healthcare.

The passion, dedication, and compassion in the rural health sector is clear. And there was sharing of simple (and strategic) ways to improve rural healthcare with moderate investment or reshaping - the key point overall is that rural just needs 'a fair go' for those working in these communities!

Funding is required for training, for NGO hospitals to align with HNZ run hospitals, among other needs. Another point that stood out for me is the fact that behind healthcare there is a massive integrated workforce, and we need to be able to quantify this better. GP's, nurses, allied health professionals, medical lab scientists, and this includes the 27,000 kaiāwhina/community healthcare assistants.

How do we ensure we keep them and care for them = Realistic funding.

This links to the Declaration on Rural Health https://lnkd.in/eq8z7xex

19/05/2026

Homecare is the invisible heartbeat of health and we can take it for granted until it stops! In Australia adequate realistic funding is still falling way short and causing chaos for the 200,000+ seniors who need it.
Aotearoa can learn from this and hopefully the recommendations that eventuate from the Ministerial Advisory Group on Aged Care can offer the roadmap and the means to achieve that!
Investment in prevention is always better choice than the alternative.

Ageing Australia is alarmed at the lack of Support at Home packages announced in tonight’s Federal Budget.

19/05/2026

The Disability Support Services Bill is welcomed for offering clearer frameworks for disabled people. However, if these frameworks lead to reduced access for those with impairments and health needs, that is not acceptable. That will just lead to more acute needs, more hospital admissions and people falling between the cracks. That would also be a disaster for the 300,000 people living with a Rare Disorders NZ
Consultation with key groups prior to this Bill being announced would have been a sensible action. There was an opportunity to include the voices of disabled people, carers, and providers in the Bill's development. As it stands, we all need time to understand what this means in practical terms for disabled people, carers, and our provider members who deliver respite care, employ family carers or act as hosts of Individualised Funding.
The Select Committee process offers an important opportunity to raise realistic implementation concerns and ensure the Bill strengthens rather than constrains support for disabled New Zealanders and those who care for them.
There is now a consultation period and it is vital to have your input as providers, carers, and kaiāwhina. Please share your thoughts and concerns so we can represent your voices effectively in the Select Committee process.

Disabled people in Aotearoa have become fluent in government language and we know that when ministers start talking about sustainability, clarity, fairness, and stability, it is worth paying close attention to what is happening behind those carefully chosen words.