Population analysis

About our Māori workforce

Māori make up 8.5% of our health workforce overall, compared to 17.3% of the New Zealand population. While there are some workforces where this representation is increasing over time – such as medicine, with 16.5% of new 2023 graduates identifying as Māori – this growth is not consistent. Māori are expected to represent 21% of our population by 2043.

Māori are relatively underrepresented in Health NZ’s workforce:

We also know Māori make up a greater proportion of our rural communities – making rural Māori workforce particularly important.

Trends in Māori workforce

An increasing number of our training pipelines have improved representation for Māori – however, long-standing inequities mean these shifts will take a long time to result in a representative workforce overall.

Pathways for Māori out of schooling and into health careers are often inhibited by poor access to science learning in school, and by an inability for some tauira Māori to see themselves in health roles.

At the same time, Māori are more likely to report that they experience racism and discrimination at work, or that the cultural practices of their workplaces don’t make them feel safe. 

The opportunity

To achieve representation for Māori in our workforce by 2033, we would need 65% of new medical trainees and 67% of new nursing trainees to be Māori. This is not likely – so we will need to consider opportunities to grow representation more slowly as we strengthen our workforce overall.

Partnering with Iwi-Māori Partnership Boards (IMPBs) offers a significant opportunity to improve pathways for Māori into health careers. IMPBs can take local approaches to local workforce needs, and better connect whānau to fruitful careers in health. Approaches to training such as earn-as-you-learn pathways are also particularly likely to improve Māori access to health training.

Likewise, our Māori providers have become a strong source of Māori talent for our health system – and continued growth in the primary and community sector offers opportunities to strengthen their workforce development capacity, working in partnership.

What will it take?

In the short-term, our focus will be on:

• Supporting local Māori innovation. By ensuring IMPBs are supported to develop local workforce initiatives when they are ready, we can catalyse Māori innovation where this is the best approach to reach local communities and improve outcomes.
• Investing appropriately in targeted programmes. Building on our investments through our last Workforce Plan, we want to continue to review our investments in Māori workforce to ensure they result in improved access to care in ways we can’t achieve with ‘mainstream’ interventions.

Over the medium-term, we will work with IMPBs to shape our enduring approach to growing our Māori workforce.

About our Pacific workforce

Pacific peoples make up 4.9% of our health workforce overall, compared to 8.9% of the New Zealand population. Pacific peoples are expected to grow to be 11% of the New Zealand population by 2043.

Pacific peoples are relatively underrepresented in Health NZ’s workforce

Trends in Pacific workforce

While we have had good growth in the number of Pacific peoples participating in some training pathways – particularly medicine – this growth does not reflect the proportion of Pacific peoples in the population, and has not yet addressed long-term underrepresentation.

Because Pacific peoples are more represented in urban communities, particularly in Auckland, urban-based training is well-placed to grow our Pacific workforce at scale – though other barriers to training (such as full-time study requirements or unpaid practice requirements) limit growth in our Pacific workforces.

As with Māori, Pacific peoples are more likely to report discrimination at work, and that their workplaces are not culturally safe.

The opportunity

To achieve representation for Pacific peoples in our workforce by 2033, we would need 35% of new medical trainees and 29% of new nursing trainees to be Pacific peoples. As with Māori, we will not be able to achieve these levels of representation – so we will need to consider opportunities to grow representation more slowly as we strengthen our workforce overall.

Pacific providers are highly connected to Pacific communities, and will be vital partners in the growth of the Pacific workforce. By better connecting Pacific fanau and Pacific health providers to local training providers, we can ensure strong pathways for Pacific peoples into health careers.

What will it take?

Over the next three years, we want to focus on investing appropriately in targeted programmes. Building on our investments through our last Workforce Plan, we want to continue to review our investments in our Pacific health workforce workforce to ensure they result in improved access to care in ways we can’t achieve with ‘mainstream’ interventions

About our disabled | tāngata whaikaha | whānau haua workforce

Around 25% of New Zealanders have a disability of some kind. However, we know very little about the proportion of health workers who identify as part of the disabled community; we have no consistent data on rates of disability in our workforce.

What we do know is that disabled people are almost certainly underrepresented in our workforce. There are a range of possible reasons for this:

• Disabled people report high rates of discrimination and concern about disclosing their disability status, including due to assumptions from colleagues or patients about what they can and cannot do – which may not be accurate.
• Disabled people often find it difficult to access the supports they need to allow them to thrive in certain roles – for example, accessible technology or interpreters.
• Recruitment and employment processes can raise barriers for disabled people to apply or to be selected for roles – for example, where disability information is asked for inappropriately, disabled people may be discouraged from proceeding with an application.
• Training into health professions may be impeded by regulations requiring that people are able to do certain tasks without assistance (which in some cases precludes accessibility technology).
• In some cases, disability may make it difficult for people to do certain jobs with the technology we have available today – for example, people who are vision impaired may not be able to perform visual diagnostics.

The opportunity

Growing our disabled workforce represents an opportunity to ensure the large number of New Zealanders with disabilities receive care from a representative workforce, to grow our workforce overall, and to improve employment opportunities for a community with disproportionately high rates of unemployment and underemployment. This would be a benefit to all New Zealanders – as many of us will experience disability at some point in our lives.

What will it take?

Over the next three years, we plan to focus on:

• Improving disability status data. As a single national employer of around a third of the health workforce, Health NZ is well-placed to develop a consistent national measure of disability status for our staff – and to improve our disability status data over time, ensuring our people feel safe to disclose if they have a disability.
• Addressing exclusory barriers to participation. Targeting areas where our systems and processes exclude disabled people from the health workforce without good reason – for example, recruitment processes – is a relatively simple way to improve labour participation.
• Targeting professions for safe growth. Some professions are particularly well-suited to good representation of disabled people – for example, physiotherapy and occupational therapy, which can be safely inclusive and where the lived experiences of disabled people are invaluable. We want to focus on areas where other countries have strong disabled representation, and create specific pathways for disabled people into health careers.

Medium-term, we will need to pivot from specialised pathways to improving the accessibility of a wider range of health careers – though doing so will require investment in enabling technologies and changes to professional expectations, to ensure that people with a range of disabilities can practice safely in a wider range of areas.