New Zealand’s 32 hospices are cutting the number of dying patients they can care for, with sector leaders saying funding has fallen so far behind costs that some services are now dipping into cash reserves just to keep their doors open.
The country’s largest hospice, Tōtara Hospice in south Auckland, has reduced the number of people on its books from between 420 and 450 a month down to around 320 to 330. Chief executive Tina McCafferty told RNZ the hospice could not in good conscience accept more patients than it was funded to support.
“We are so desperately sorry for the unavoidable suffering and distress that this will cause,” McCafferty said.
She said the choice was a brutal one for an organisation built around caring for people in the final weeks and months of life. “At the end of the day, we can only provide the care that is affordable.”
The decision to scale back, she told 1News, would push more dying patients into the public hospital system at a time when emergency departments are already under strain.
“To have to add 100-plus patients to Middlemore Hospital or the South Auckland GP network is a burden that we didn’t want to give partners, but those people need care, and we cannot provide that under current funding,” McCafferty said.
“To provide on that scale is becoming more and more of a challenge with an absolutely tangible lack of investment from consecutive governments.”
Hospice New Zealand, the umbrella body representing the country’s 32 community-based hospices, says the sector needs between 80 million and 100 million dollars in additional government funding each year to remain financially sustainable. Without it, more services around the country will be forced to follow Tōtara’s lead and cap or cut patient numbers.
The funding mix varies from hospice to hospice but the pattern is the same everywhere. Hospices receive a contract payment from Health New Zealand that covers part of their running costs, and they raise the rest through community donations, op shops, sponsored events and bequests from supporters. As costs have climbed, particularly clinical wages, the gap between the contract payment and the actual cost of care has widened.
At Mary Potter Hospice in Wellington, chief executive Tony Paine said about half of the organisation’s funding comes from the Government, with the rest raised in the community. The hospice was now dipping into cash reserves to keep operating because the funding had not kept pace with inflation and wage settlements.
“People are very generous to us even though we know times are tough,” Paine said.
The funding numbers in dispute are stark. Tōtara Hospice receives about 8.89 million dollars a year from the Government, but McCafferty says the clinical wage bill alone now sits at just over 12 million. She puts the government share of the hospice’s clinical costs at 56 percent.
Health Minister Simeon Brown disputes that figure and says the Government provides 84 percent of Tōtara’s funding. He says Health New Zealand increased hospice funding by 3 percent over the past year and has asked the agency and Hospice New Zealand to develop a more sustainable funding approach for the sector.
“Health New Zealand is working closely with Hospice New Zealand around what that looks like, and how we can continue to invest more to provide better access to palliative care services for patients who are dying and their families up and down our country,” Brown said.
The minister has called on Tōtara to explain how it could be reducing services despite the recent funding lift.
The dispute over the headline funding percentage points to a deeper problem the sector has been raising for years. Government contracts have not been indexed in any meaningful way to clinical wage growth, and as Health New Zealand has lifted pay for nurses and other staff through its own settlements, hospices that compete for the same workers have been left to fund matching pay rises out of charity income.
McCafferty has previously described the situation as a “disempowered and broken system” and called for structural reform of how Health New Zealand funds non-government palliative care providers.
The political fight matters because the practical consequences fall on patients and families. Hospice care is the part of the health system most New Zealanders only encounter once, usually when a parent, partner or grandparent is dying. The service covers in-home nursing, pain management, family support, counselling and bereavement care, all delivered free of charge to the family. When a hospice cannot take a patient, that care defaults to general practitioners, district nurses and hospital wards that are not designed for end-of-life support.
The sector argues that letting the hospice model collapse will end up costing taxpayers more, not less, because hospital beds are far more expensive than a community nursing visit. Hospice New Zealand has been campaigning under the banner “Fund Hospice Fairly” for several years, and the latest patient cuts at Tōtara have given that campaign fresh weight as the Government works through its 2026 health spending decisions.
For now, families looking for hospice support around the country may find their local service has tightened the criteria for admission, lengthened waiting times, or in the case of Tōtara, stopped accepting new patients beyond the reduced cap.
What do you think New Zealand’s hospice funding settlement should look like? Should the Government cover the full cost of palliative care, or is the mixed donation and contract model still the right one? Leave a comment below and share your view.
This article was written by AI, briefed to report the facts, hopefully without some of the bias people bring to the job 🙂
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