Northland-based PSA organiser Theresa Nelson (inset) says Hokianga Hauora workers, including those at Rawene Hospital, are stretched and going backwards financially.
Healthcare workers in Hokianga are burning out, working unpaid overtime and stressing about their future due to a restructure and lack of funding.
The workers’ unions called on Health New Zealand Te Whatu Ora to adequately fund Hauora Hokianga, which posted a $2.3 million loss in the year to June 2025.
Hauora Hokianga, which runs Rawene Hospital and 10 clinics, was trying to stop the losses after a $2.8m profit in 2023.
Measures included cheaper supplier contracts, a restructure in October 2025 and telling unions there was no money for pay rises.
Te Tai Tokerau Public Service Association organiser Theresa Nelson said staff morale at Hauora Hokianga was very low because of ongoing uncertainty about the service’s future.
“Despite this, staff continue to show up every day and carry on the mahi because this is their community, their people and their whakapapa.”
The restructure’s impact was significant and ongoing, with three redundancies and several staff having hours reduced, Nelson said.
“Reducing staff numbers has not reduced the workload ... This has forced staff to change how they work – cutting corners where possible, working beyond their contracted hours or carrying unsustainable loads."
The PSA was also concerned about the lack of funds for pay rises, meaning staff were going backwards as the cost of living continued to rise.
Nelson said unless Health NZ gave meaningful support, there was a risk of worker burnout, disengagement and the loss of highly skilled workers embedded in the Hokianga community.
“The PSA is clear: Te Whatu Ora must step up and fully fund remote and rural services like Hauora Hokianga appropriately.
“The solution cannot be to cut services, reduce staffing or shift costs on to already disadvantaged communities.”
Nelson said the Hokianga’s mainly Māori communities deserved fully resourced healthcare close to home.
“Equity means recognising that delivering healthcare in remote rural settings costs more, not less.”
Nelson’s comments were echoed by E Tū and the New Zealand Nurses’ Organisation, which also represent Hauora Hokianga workers and said the financial challenges were not unique.
Health NZ said it was working with Hauora Hokianga to identify and understand its financial sustainability challenges, with continuation of health services in the area a key consideration.
Margareth Broodkoorn, chief executive of Hauora Hokianga, said the response was frustratingly slow.
“Notwithstanding the work we have done to leverage off Health NZ’s supply contracts and reviewing smaller contracts, the request for financial stabilisation has been glacial.”
The key issue was that meeting clinical, safety and quality standards in a remote rural setting costs more than in an urban area, and funding from Health NZ did not cover the full costs, Broodkoorn said.
“This is not a story about overspending. It is about a structural gap between what we are funded to do and what it actually costs to safely deliver those services in a remote rural community.”
Broodkoorn said the organisation was working with Health NZ to confirm the services needed in the community based on health need, showing they could not simply be reduced.
For the current financial year, an expected $1.4m deficit was reduced to $500,000 and capital expenditure was also reduced as a short-term way to support cashflow, Broodkoorn said.
The most important message to the community was that Hauora Hokianga was not closing or reducing services, and its 24/7 after-hours care had been restored, she said.
Broodkoorn said while Hauora Hokianga pushed hard to improve worker pay, staff were still paid materially less than many Health NZ counterparts, making recruitment and retention harder in an already tight market.
She noted that Health NZ staff were striking over pay and conditions, highlighting significant workforce issues across the sector.
Jensen Webber, chief executive of primary health organisation Mahitahi Hauora, said Hauora Hokianga’s fees-free model was important to maintain because of the community’s high and complex health needs.
“Although it is unique in Northland, it is an essential response to the needs of Hokianga whānau and plays a critical role in reducing barriers to care,” he said.
“My concern is that financial constraints risk having the greatest impact on those who can least afford it.”
Webber had been meeting fortnightly with Hauora Hokianga and Health NZ to see if he could provide support.
Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.