As ACT campaigns to scrap Māori and Pacific medical-school admission pathways, one of Aotearoa’s leading public-health experts says the bigger question is whether the country is prepared to build the diverse health workforce its communities actually need.
Professor Sir Collin Tukuitonga, Associate Dean Pacific at the University of Auckland’s Faculty of Medical and Health Sciences, has long advocated for a health workforce that better reflects the people of Aotearoa.
The debate has taken on new urgency after ACT confirmed it will campaign at Election 2026 to remove targeted Māori and Pacific admission pathways at the University of Auckland and University of Otago.
The Government has already commissioned a review of those programmes under the National-ACT coalition agreement. But despite political debate intensifying over their future, the findings of that review have still not been made public.
For Sir Collin, the issue goes well beyond who gets through the doors of medical school.
It reaches into the future of the health workforce, the shortage of doctors, persistent inequities experienced by Māori and Pacific communities and whether those communities can see themselves represented among the professionals delivering their care.
ACT wants ethnicity removed from the equation
ACT’s position is that medical-school admission should be determined by individual achievement rather than ethnicity.
The party argues preferential pathways based on ethnicity are inconsistent with equal treatment and wants the Māori and Pacific Admission Scheme, known as MAPAS, and equivalent targeted pathways removed.
Supporters of MAPAS see the issue very differently.
They argue that measuring every applicant by exactly the same criteria without recognising longstanding educational, economic and social barriers does not necessarily produce equality — particularly when Māori and Pacific people remain substantially underrepresented in medicine.
University of Auckland Dean of Medical and Health Sciences Professor Warwick Bagg says Māori currently account for only 5.8 percent of the medical workforce, while Pacific doctors account for just 2.8 percent.
Both remain well below their respective shares of the New Zealand population.
Those figures go to the heart of Sir Collin’s longstanding concern: if Aotearoa wants a health system capable of serving its entire population, who trains as a doctor matters.
Representation isn’t just about numbers
The argument for increasing Māori and Pacific representation in medicine is not simply that patients should see doctors who look like them.
It is about the wider relationship between workforce composition, cultural understanding, trust, access and the communities in which doctors ultimately choose to practise.
The University of Auckland says evidence shows Māori and Pacific doctors have approximately an 86 percent retention rate in the New Zealand health workforce 10 years after registration, slightly above the approximately 83 percent rate for Pākehā doctors.
It also says Māori and Pacific doctors are more likely to work in general practice and in regional and rural communities — precisely the areas where workforce shortages remain a major challenge.
That makes the debate particularly relevant to Māori communities outside the main centres.
A policy designed to increase Māori participation in medicine may ultimately affect not only who studies medicine, but where the resulting doctors work and which communities gain access to them.
Same doctor at the end of the degree
One of the most contentious aspects of the political debate is the suggestion that targeted admission somehow means lowering the standard required to become a doctor.
The University of Auckland rejects that proposition.
Regardless of how students enter medical school, all students must ultimately satisfy the same academic, clinical and professional standards required to graduate as doctors.
That distinction is important.
MAPAS changes the pathway through which eligible Māori and Pacific students can enter medical and health programmes. It does not create a separate medical qualification or a lower professional standard at graduation.
The university argues academic grades are important, but grades alone cannot determine who will ultimately become an effective health professional.
For Māori and Pacific communities, qualities such as communication, cultural understanding and the ability to build relationships can become particularly important when mistrust or previous experiences with the health system create barriers to accessing care.
A health system already struggling for doctors
There is also a danger that the political fight over Māori and Pacific admissions distracts from an even larger problem.
Aotearoa needs more doctors.
Medical-school places remain intensely competitive, while regional and rural communities continue to struggle to recruit and retain clinicians.
That raises a broader policy question for Election 2026.
Rather than concentrating only on how the existing medical-school places are divided, should the political debate also focus on dramatically increasing the country’s capacity to train doctors?
More training places, clinical placements and stronger pathways into general practice and underserved communities could expand the overall workforce while maintaining pathways designed to improve Māori, Pacific, rural and socioeconomic representation.
Scrapping one pathway does not, by itself, create another doctor.
The evidence is sitting behind closed doors
There is another uncomfortable issue hanging over the debate.
The Government has already reviewed these programmes.
The National-ACT coalition agreement specifically committed the Government to assessing targeted Māori and Pacific admission schemes, including MAPAS, to determine whether they were achieving their intended outcomes.
The University of Auckland says it has spent the past year supplying information for that independent Ministry of Health review and is now calling for the findings to be released.
That creates an obvious question.
Why should New Zealanders be asked to decide the future of Māori and Pacific medical pathways during an election campaign without being allowed to see the Government’s own evidence about whether they work?
If the review identifies significant problems, those findings should be open to scrutiny.
If it concludes the programmes are successfully increasing Māori and Pacific participation in medicine, voters should know that too.
Either way, evidence commissioned by the Government should be central to a debate now being put before the electorate.
MAPAS has changed the workforce
The University of Auckland maintains that MAPAS has contributed to a sustained increase in Māori and Pacific health professionals, including doctors.
It says the numbers of Māori and Pacific doctors have steadily increased since the programme was established.
Yet the fact that Māori comprise only 5.8 percent and Pacific peoples 2.8 percent of the medical workforce suggests representation has not caught up with population need.
That poses a challenge for those proposing to remove the pathways.
If MAPAS goes, what replaces it?
How will the country increase the number of Māori doctors?
How will it increase the Pacific medical workforce?
How will medical schools recruit talented rangatahi from communities historically underrepresented in medicine?
And how will the health system ensure those doctors ultimately reach rural, regional and high-needs communities?
Those questions require more than an argument about university admission rules.
They require a national health-workforce strategy.
For Māori, this is ultimately about hauora
For Māori, the debate cannot be separated from the persistent inequities already evident across the health system.
Whether the issue is cardiovascular disease, cancer, diabetes, mental health, access to primary care or life expectancy, Māori continue to experience health outcomes that demonstrate the system is not delivering equally for everybody.
Increasing the Māori health workforce will not solve every one of those problems.
But workforce representation is one component of building a system in which Māori knowledge, cultural competency, community relationships and clinical expertise operate together.
That is why the political debate surrounding MAPAS matters far beyond university campuses.
It is ultimately about the people who will be standing in clinics, hospitals and communities caring for whānau decades from now.
The question Election 2026 needs to answer
There is a legitimate political debate about how university admission should work.
ACT is entitled to argue that ethnicity should play no role in determining access.
Universities, Māori and Pacific health leaders and public-health experts are equally entitled to point to workforce shortages, underrepresentation and persistent inequity as reasons targeted pathways remain necessary.
But the debate cannot end with whether MAPAS survives.
The bigger question is what kind of health workforce Aotearoa wants to build.
If the country wants more doctors, more doctors in rural communities and a workforce capable of serving an increasingly diverse population, then it needs a plan for producing them.
And before politicians dismantle programmes specifically created to address underrepresentation, the public should at least be able to examine the evidence the Government has already commissioned about whether those programmes are working.
Because ultimately this isn’t simply about who gets into medical school.
It’s about who will be there to heal our whānau.
#SirCollinTukuitonga #CollinTukuitonga #MAPAS #ACTParty #MedicalSchool #MaoriDoctors #PacificDoctors #MaoriHealth #PacificHealth #HauoraMaori #HealthEquity #HealthWorkforce #MedicalWorkforce #DoctorShortage #RuralHealth #UniversityOfAuckland #UniversityOfOtago #MedicalEducation #RangatahiMaori #MaoriStudents #PacificStudents #Equity #TeTiriti #Whanau #Election2026 #Election26 #NZPolitics #MaoriPolitics #Aotearoa #TeAoMaori #MaoriNews #WaateaNews #RadioWaatea
