Māori health providers have scaled back targeted Covid-19 testing of Māori, amidst fears some will fall through the cracks.
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Cabinet is considering its next testing strategy, with Prime Minister Jacinda Ardern confirming yesterday New Zealand could move to level 1 as early as next week.
She signalled today that would mean far fewer restrictions, with no requirement for social distancing, but maintaining strong border controls.
Dozens of community-based assessment centres (CBACs) and mobile clinics have closed down around the country and people with Covid-19 symptoms are increasingly being directed to their GPs for testing.
Tui Ora clinical director Bernard Leuthart said the Taranaki health provider had stopped its mobile clinic, which had increased testing rates in the area.
Considering Māori already had less access to healthcare, he was concerned that limiting testing to GPs would be a barrier for some.
"I don't think that it is fair or equitable in these times," he said.
"Where people - whoever they are, and particularly Māori - where they need a Covid test they should be able to present to a DHB-provided service and get that."
Director-General of Health Dr Ashley Bloomfield said today the country was at the tail end of asymptomatic testing and as winter approached, the focus would shift to testing people with respiratory symptoms.
Covid-19 testing remains free wherever it was conducted, he said.
Leuthart said some GPs would however not be set up to do testing, and could still charge people for the consultation to determine if a test was required.
"They might front up to a GP, get charged, and then find the fact that they can't get that there and they need to go somewhere else.
"That would be my worry."
Scaling back mobile clinics
Whakawhiti Ora Pai chief executive Errol Murray said his service was no longer running its mobile clinic, which had increased Māori testing rates in the Far North.
"I'm quite comfortable with that - if they need to be tested, our population up here know that they can get tested," he said.
"We haven't had any cases for a while now... so I think fewer people are feeling anxious, they're feeling less fearful."
Mobile clinics around the country have been credited with boosting Māori testing and improving equity at level 4.
Murray said they were an effective tool for reaching Māori communities and should be funded to provide further health services.
"The proof has been in the pudding. Prior they (DHB) had nothing up this way, they contacted our organisation and we were able to get the numbers.
"They would be foolish not to use us in the future because it has worked so well to date."
Bernard Leuthart agreed mobile services had the potential to improve access to healthcare for Māori in the future.
"We are looking at, again, how we take what we have got and get it out there to where we are needed, because that has been one of the exciting learnings from this time," he said.
"People are very responsive to that, it is respectful, it is always an incredible privilege to go into peoples' houses and to serve them there.
"It is really about again trying in every way that we deliver our healthcare services - trying to find that equity of outcome and we just need to be a little more agile and responsive to particular groups."
Equity remains a priority for Ministry of Health
One of the Ministry of Health's four key objectives is ensuring that access to testing is equitable for Māori and Pacific people and other priority groups, as well as across the country.
In the month of May, the Māori testing rate increased from 24 to 56 per 1000 people, compared to only 50 per 1000 for Pākehā.
"There needs to be a focus on actively protecting the health and wellbeing of whānau, hapū, iwi and Māori communities from risk of increased infection, and ensuring equitable health outcomes," the ministry said.
"Māori, Pacific people, and people in communities with high deprivation, crowded housing, and barriers to access to healthcare should be prioritised."
Details of the government's next testing plan should be made public by mid-June.
