Source: Rata Foundation
Marlborough’s only kaupapa Māori general practice, Manu Ora is focused on addressing healthcare inequity through prevention and early intervention, resulting in positive results both for its patients and the wider healthcare system.
The practice, established by Dr Sara Simmons (Ngāi Tahu) and Dr Rachel Inder in partnership with Te Piki Oranga, focuses on Māori and Pasifika and patients with complex medical needs. Despite high patient complexity, including trauma histories, homelessness, mental health challenges and addiction issues, the practice achieves comparable or lower emergency and urgent care presentations, and higher engagement with health services.
“Prevention and early intervention have a profound impact on positive health outcomes,” says Dr Inder. “By serving our Māori and vulnerable members of society well, it reduces the cost and ‘burden’ on whānau and the strain on the wider health system minimising the need for more expensive downstream health interventions. If we don’t deliver complex medical care in the community like this, you can guarantee it’s going to cost the health system an enormous amount more in the long run.”
An independent evaluation by Sapere (2022) reported: “Stakeholders identify to us that these high needs vulnerable whānau likely would not have [otherwise] connected with general practice or would not have received an appropriate level of service, and only occasionally would have been seen by the DHB in its hospital, usually in a crisis situation.”
The Manu Ora approach differs significantly from traditional general practice models. The practice maintains a dramatically lower patient-to-GP ratio of 1:900, compared to the national average of 1:1,700. This enables longer appointment times and quicker access to care. The practice also offers initial enrolment appointments that are at least 90 minutes and involve kōrero and pātai to understand a person’s holistic needs. Nearly 50% of the practice’s patient roll is Māori, compared to 13% at other Blenheim practices; over 50% of staff, and 80% of the Board, whakapapa Māori.
“In Marlborough, many of the other practices are a three-week minimum wait, but some are out to four months, so to be able to offer appointments within a couple of days and same-day acute care is so important,” says Dr Simmons. “Everyone in their first consult will see the team for an hour and a half to set us up with a two-way relationship. That whakawhanaungatanga, treating people like family, is exactly what we do at Manu Ora.”
Kaiāwhina Haumanu Hauora (Healthcare Assistant) Mikayla Charlton (Ngāti Rangiwewehi me Ngāti Kahungunu) says: “We’re helping so many who didn’t want to connect with previous doctors. They come here and then all of a sudden they’re going to appointments, they’re getting all the checks that they need, making that change for their health.”
Patient Willie says: “It’s got a good feeling when you walk in the door. It’s a welcoming feeling. I can get an appointment fairly quickly and the staff are very caring.”
Another patient, Jahnay, says: “They’ve helped me in so many ways. I lost my mum two years ago and they helped me through it so much. Even though I had lost someone so important to me, I had all of these amazing women by my side. They don’t just see you as another patient, you know, they see you as family.”
Rātā Foundation has awarded $165,000 to Manu Ora over three years addressing a critical gap as the not-for-profit faces the challenge of raising 72% of its operational costs annually, with only 28% provided through government funding. “One of the huge differences about Manu Ora is that we’re a non-profit service and that means that we can provide care at low or no cost,” says Dr Simmons. “Over 60% of our whānau pay nothing to come and see us. Without the support of the Rātā Foundation, we would be unable to provide the service.”
Rātā Foundation Head of Community Investment Kate Sclater says the funding recognises Manu Ora’s innovative approach to addressing healthcare inequity. “Manu Ora demonstrates how community-led solutions can transform healthcare delivery for people who need it most. Their kaupapa Māori model provides wraparound support that goes far beyond traditional general practice. By investing in supporting people early, the hope is that they can reduce people developing more significant issues later.”
Manu Ora has received significant recognition for its work. In 2025 Dr Simmons and Dr Inder were awarded the Royal New Zealand College of General Practitioners’ Community Service Medal, one of the profession’s highest honours, and the team as a whole was awarded the “GenPro General Practice of the Year” in the New Zealand Primary Healthcare Awards 2025.
Ms Charlton also recently received top honours as the ‘Emerging Practitioner’ at the Top of the South and Te Waipounamu ‘Allied Health Scientific & Technical (AHST) Awards’ – and was later awarded ‘runner-up’ nationally in the same category. Shianne Casey (Kaitautoko Hapori / Health Coach) was also recognised as a finalist at the Te Tau Ihu AHST Awards in the Mana Taurite (equity) category.
The practice also operates as an active teaching practice, engaging with school students, and hosting and supporting trainee interns – particularly Māori and Pasifika, Rural Medical Immersion Programme students, nursing students, and GP registrars to engage them in a kaupapa Māori model of care.
Dr Simmons says this approach is aimed at helping address chronic underrepresentation of Māori in healthcare settings while inspiring youth to consider healthcare careers. “We hope that the impact we have will, big picture, improve health outcomes and particularly trying to close the gap between the inequities that Māori experience in terms of health outcomes.”
About Rātā Foundation: Rātā Foundation is the South Island’s most significant community investment fund, managing a pūtea (fund) of around $700 million. This enables Rātā to invest around $25 million per annum into its funding regions of Canterbury, Nelson, Marlborough and the Chatham Islands. Since its inception in 1988, Rātā has invested over $600 million through community investment programmes to empower people to thrive.
