The Equity Argument: Why Distance is Not a Fair Reason to Go Without

For someone in an urban area, a visit to the GP can take an hour out of a working day. Appointments can be booked online and are generally available at short notice, with alternative providers accessible if the regular doctor is not. Attending an appointment between work commitments is, for most people, manageable.

This is what ready access to health care looks like.

For someone in the Northern Coromandel, that same GP visit can take an entire day.

Depending on their location within the region, the drive can be up to 80 minutes each way on a road that can become inaccessible due to weather events. Fuel costs are an additional financial burden. For residents aged 80 or over who remain reliant on private vehicles, the need for this travel can be regular. Those without transport rely on family and neighbours to access care and may defer appointments to avoid this demand, effectively prolonging time between  accessing care.

The gap between these two different access realities is what geographic inequity looks like in practice.

What the Numbers Actually Show

The Colville Statistical Area covers the full Northern Coromandel catchment and has a usually-resident population of 1,563 people (Census 2023). The median age is 52.9 years. More than one in four residents, 28.3 %, are aged 65 or over. Nationally, that figure is closer to 17%.

The median household income in the Northern Coromandel is $27,100. The national figure is $41,500. That is a gap of more than $14,400 per year, or approximately $277 per week.

The Northern Coromandel sits at deprivation decile 9 on the New Zealand Deprivation Index (where ‘1’ indicates the most well-off communities and ‘10’ indicates the least well-off) - one of the highest rankings in the Waikato region.

The standard deprivation index was designed primarily with urban communities in mind. Research published by the UK's Centre for Thriving Places (commissioned by the Department for Environment, Food and Rural Affairs) argues that urban metrics systematically undercount rural disadvantage because they measure access to services rather than quality of life relative to context. TCP's reading of this research is that the Northern Coromandel's actual disadvantage may be more acute than a single index score reflects. The physical absence of services, combined with the cost and difficulty of reaching them elsewhere, produces a picture the numbers alone do not fully capture.

Deprivation decile 9 does not define the Northern Coromandel. The community has 29 named volunteer and community organisations and the highest rate of volunteers per capita in New Zealand: approximately one in three residents, 30.8 percent, contribute their time. New Zealand's volunteering measurement frameworks were designed with urban communities in mind. In the Northern Coromandel, volunteering is not just civic participation. It fills the gaps left by services that were never funded to come, or that came and then left.

The Health Gap is Real

There is currently no resident health professional in the Northern Coromandel. A visiting GP service runs one day per week. All other primary care requires travel to Coromandel town or further.

The Colville Community Health Trust (CCHT) supported a local provider to run the Colville Community Health Clinic for 17 years. It purchased the equipment necessary to attract a provider and enable them to deliver services.  It enabled the training of three nurse practitioners and three community nurse providers. It enabled the establishment of the Colville First Response Unit (CFRU), the only volunteer ambulance station in New Zealand with an unbroken 24/7 shift record across 15 consecutive years.

Toward the end of 2023, the primary care provider that CCHT had long supported lost a significant amount of government funding and could no longer continue. A provider based in Coromandel town now runs a visiting service. All residents of the Northern Coromandel must travel to Coromandel Town for primary care outside these 8 hours a week, and further to Thames, Hamilton, or Auckland for anything more complex.

The Colville First Response Unit recorded 49, 52, and 50 emergency callouts across 2020, 2021, and 2022 respectively. These figures reflect local first-response volunteer dispatches only and do not capture all emergency events in the area. 

Drive times from Colville to Thames Hospital in good weather: 90 minutes from the township, 120 minutes from Port Charles, 130 minutes from Port Jackson. Thames Hospital is a secondary-level public hospital, offering emergency care, general medical/surgical services, maternity, and community health services. Many specialist clinics operate on scheduled visiting days only.  For anything more specialist, travel to  Waikato Hospital in Hamilton is required, an additional 100 minutes further.  Road conditions routinely add time.

CCHT has stated that the current primary care model in rural New Zealand is unsustainable and in need of change. This pattern is not unique to the Northern Coromandel. What is distinctive is where the Northern Coromandel sits: at the furthest point of a rural health system that was never designed to reach it.

The Social Services Providers Aotearoa Issues Paper on rural social services (2019) notes that rural community providers are often the only helping agency in their area, absorbing work that government has withdrawn from, frequently without adequate funding. TCP reads this as consistent with what has occurred in the Northern Coromandel, and with what the Wellbeing and Education Centre is designed to address.

An Ageing Community, Without the Infrastructure

The Office for Seniors' Better Later Life Action Plan (2021) identifies three things as most critical to healthy ageing:

1. Housing quality

2. Social connection

3. Health access.

All three are constrained in the Northern Coromandel.

The 2020 Age-Friendly Community Survey of Coromandel-Colville residents, conducted by CILT (Coromandel Independent Living Trust ), found that transport was the single most critical issue identified by respondents. Ninety-five percent of residents drive themselves because there is no alternative. Of those aged over 80, 82% are still driving out of necessity.

The top four requests from respondents were for: transport options, retirement and aged care facilities, improved health access, and community space.

Thames township crossed the hyper-ageing threshold, where 20 percent or more of the population is aged 65 or over, in the early 1990s.

It was among the first communities in New Zealand to do so. The Thames-Coromandel District has continued on that trajectory.

The Thames-Coromandel District Workforce Report (TCDC, April 2024) confirms the current picture. Thirty-five percent of district residents are now aged 65 or over, the highest proportion of any district in New Zealand. The dependency ratio for Thames-Coromandel sits at 93.7 percent, one of the highest in the country. That means roughly one working-age person for every person who is either under 15 or over 65. Aging populations require more from the communities around them: accessible health services, housing they can stay in as they age, and local places to remain connected. The 65-plus age group has been the fastest growing in the district for the past two decades. Population projections for Thames-Coromandel District estimate nearly half the district will be aged 65 or over by 2053.

The Northern Coromandel sits at the furthest end of this district, furthest from services and with the least infrastructure to respond to a demographic shift that has been in motion for thirty years.

The Helen Clark Foundation's Age-Proofing Aotearoa report (October 2025) uses a different measurement framework: it identifies 'hyper-ageing' regions as those projected to reach 30 percent aged 65 or over by 2048, naming the West Coast, Tasman, Nelson, and Marlborough as examples. Analysis of current Coromandel-Colville ward data shows 31.9 percent already aged 65 or over, with a median age of 55. On either measurement, this community has crossed the threshold. The report identifies infrastructure investment as central to quality of life in ageing communities.

[Note: The two percentage thresholds in this section, 20% and 30%, come from separate sources using different frameworks. This is not a contradiction. TCP note sthat the Northern Coromandel already exceeds the Helen Clarke Foundation's projected 2048 benchmark.]

Between 2019 and 2022, residents aged 65 or over consistently accounted for 48 to 55 percent of all clinical calls to the local GP service. Nationally, around 17 percent of the population is aged 65 or over. The concentration of clinical need in the Northern Coromandel is proportionally high, in a part of the district that is already the oldest in New Zealand.

The Funding Gap That Compounds the Access Gap

Dr Kate Armstrong, TCP Board Co-Chair, previously ran a five-day-a-week health service in the Northern Coromandel.

It could not be sustained.

Not because of a lack of commitment or clinical quality, but because the funding model applied was the same one applied to urban practices. Great Barrier Island, a community with comparable isolation reached by a four-hour sea crossing rather than a road, receives recognised differentiated funding. The Northern Coromandel, at the end of an 80-minute drive, does not.

Road access and service equity are not the same thing. When the roads are damaged, which they frequently are, travel times increase.  When the roads close, which they do, access disappears entirely.

The Hauraki Opportunity Wellbeing Baseline Report (June 2025), funded by Trust Waikato and based on 878 respondents across the Thames-Coromandel, Hauraki, and Matamata-Piako districts, found that healthcare access is the top priority barrier in the region.

Cost, distance, and wait times are the three main obstacles named. Physical health features as the key area needing improvement across all measurement groups. The report concludes that local targeted action and investment is required to form more cohesive communities.

A Comparable Community, and What It Built

Great Barrier Island shares many characteristics with the Northern Coromandel: around 1,200 year-round residents; peak seasonal population of 15,000; no reticulated sewerage, no high school, no rest home; weather-dependent, privately operated transport with no public alternatives. The Great Barrier Island Community Health Trust was the original inspiration for CCHT's work in Colville. It has delivered community health infrastructure for over 50 years, and has adapted through many changes to continue serving its community.

Great Barrier Island's connection to Auckland is by a four-hour ferry crossing or by plane.  The Northern Coromandel effectively functions as a land island in every practical sense: a destination region not a travel-through region, isolated by distance, without public transport, and reliant on community self-organisation for services that government has not sustained. A region where members are required to drive 80-minutes each way to the nearest town on a road that can close, carries a comparable weight of isolation.

The Great Barrier model demonstrates that a community of this scale and character can build and maintain its own health infrastructure. The Colville Project's Wellbeing and Education Centre is the equivalent vehicle for the Northern Coromandel.

The Scale Problem

Colville township has 174 permanent residents (Stats NZ, 2023 Census). A funder encountering that number in isolation might reasonably question whether the project is the right scale of investment.

The relevant figure is 1,563.

The Colville Statistical Area, which is the actual catchment for the Wellbeing and Education Centre, covers 543 square kilometres and holds 1,563 usually resident people (Census 2023). That population is large enough to justify a community facility. It is also small enough to have fallen outside every standard funding category that might otherwise have applied.

Rural health funds typically target communities with no road access or defined remote status - the Northern Coromandel has a road, even if it suffers regular damage and closures. Remote-community funds tend to require a population below a lower threshold, or a geographic classification the Northern Coromandel does not formally hold. On the flip-side, urban-fringe or community facility funds are calibrated to larger populations or suburban needs. The result is that a population of 1,563 people, in one of the most isolated parts of the Waikato, with documented high deprivation and the oldest demographic profile in New Zealand, sits just outside the reach of every category designed to help.

The summer population is the other dimension of this story.

The Northern Coromandel is one of New Zealand's highest-use holiday destinations. The TCDC Peak Population Study 2021, prepared by Infometrics, confirmed that the Thames-Coromandel district reaches more than 116,300 people on peak dates, against a normal resident population of around 32,000. That is a 2.02x multiplier across the district. The study notes that Northern and Eastern Coromandel settlements are likely to see higher occupancy ratios than the district average. This is because the Northern and Eastern Coromandel has a higher prevalence of holiday homes. Around 44 percent of dwellings in the Thames-Coromandel district are estimated to be unoccupied outside of peak periods. On peak days, occupancy across the district jumped from 1.5 to 3.3 persons per dwelling.

In addition, the Northern Coromandel is home to 8 camp grounds, including five under the umbrella of the Department of Conservation (DOC).  These DOC campsites (Waikawau Bay, Port Jackson, Fletcher Bay, Stony Bay and Fantail Bay), have a combined capacity of approximately 1,570 people. According to DOC's Summer Visitor Insights Report 2021/22, these sites generally run at 19-59% average occupancy, with Christmas and New Year periods at or near full capacity. ACC's Safer Coromandel programme (acc.co.nz, May 2024) describes the area as experiencing a four-to-five-times population increase over summer. 

Overall, data  suggests the Northern Coromandel's peak seasonal presence may range from 3,000 to 8,000 people. The TCDC study puts the elevated population period at approximately four weeks, from the week before Christmas to 16 January.

TCP's own experience suggests the numbers are much higher and elevated period extends into February, and through to Autumn.

For four weeks each year, a community already up to 130 minutes from the nearest hospital, with no public transport and no permanent health facility, absorbs that population.

The Wellbeing and Education Centre is designed for 1,563 people year-round, and for what happens every summer.

What the WEC Changes

The Wellbeing and Education Centre (WEC) is designed around a dedicated Health Wing: a dedicated ambulance drop-off,  acute presentation room, shared consult rooms, a clinic reception and staff office, and the space and infrastructure to attract and retain visiting health professionals on a regular basis. 

The short-term accommodation units on site make it practical for visiting health providers, specialists, students and allied health professionals to stay overnight and run scheduled clinics. This removes one of the main barriers to professional recruitment in rural communities: the cost and difficulty of travel for a single appointment. This is the model operating at Kāwhia, where a GP practice, mobile nursing, visiting podiatry, hearing services, and mental health clinics serve a comparable community with a comparable population. The same model, given the right infrastructure, can work for the Northern Coromandel, including its non-resident homeowners and the seasonal visitors who arrive every summer.

The WEC also includes spaces for community development and services (Colville Junction offices, meeting rooms, library, reuse shop, community technology access) and other more general community spaces ( a commercial kitchen and dining room, flexible meeting rooms, and event/workshop space).

Social connection, identified alongside housing and health as one of the three pillars of healthy aging, requires a place to happen. The Northern Coromandel's key community service organisations and programmes currently operate in dispersed, ageing, inadequate spaces. By design and intention, the WEC draws them together under one roof.

The social cohesion research from the Helen Clark Foundation (2025, authored by economist Shamubeel Eaqub), finds that New Zealand's social cohesion lags comparable countries and identifies infrastructure and place-making as key mechanisms for building it. A community with one shared facility, well-designed and community-owned, has a different foundation than one whose services are scattered across borrowed spaces.

The Argument, Simply Put

The evidence base for this project spans Census data, government policy reports, regional wellbeing surveys, primary local data, and sector research.

Across all of it, the picture is consistent:

• The Northern Coromandel is a community with documented, concentrated need.

• It has the highest volunteer rate in New Zealand. I

• t has no resident health professionals.

• It has an ageing population without the infrastructure that ageing requires.

• It sits at deprivation decile 9, with a median income $14,400 below the national figure.

• It is up to 130 minutes from a hospital and has no public transport.

The Wellbeing and Education Centre does not solve all of this but it does provide strong foundation for significant positive change.

It provides a Health Wing that makes visiting health services viable to deliver and viable to sustain. It creates a permanent home for the community services that hold this place together. The land is community-owned, secured above all known climate hazard zones, governed by a trust that has spent nearly a decade building the evidence, the relationships, and the governance to do this properly.

The community has already donated approximately $1.25 million of its own capital into this project before a single major funder has been fully committed, including raising the money to purchase the land.

The Colville Community Health Trust transferred its accumulated Building Fund reserves to TCP in 2024 which is tagged  for completion of the health professionals spaces. 

Every population has the right to access health services, community space, and the infrastructure for a decent life. Distance is not a fair reason to go without.

What this project needs is investment on those terms, as the essential infrastructure it is, for a population that has waited long enough.

The Colville Project is an investment in equity, not a request for charity.

The Colville Project Trust is a registered charity (CC56058) based in Colville in the Northern Coromandel.

The Wellbeing and Education Centre project is community-led , evidence-based, and designed in partnership with the people who will use it.