Letter to Minister: Concerns with the 24/7 Digital Health Service
The government’s new 24/7 digital health service promises better access to healthcare but only for those who can get online. For the New Zealanders without affordable internet, digital skills or the right devices, this could prove a barrier to essential care. That’s why DECA has written to Minister Simeon Brown, urging the government to ensure this system doesn’t widen health inequities. Read our full letter below to see our concerns, offer of collaboration and request for a meeting.
20th March 2025
Hon. Simeon Brown
Minister of Health
S.Brown@ministers.govt.nz
Cc: Hon. Judith Collins, Minister for Digitising Government
Hon. Shane Reti, Minister for Science, Innovation and Technology
Subject: Concerns Regarding the 24/7 Digital Health Service and Its Impact on Digitally Excluded Communities
Tēnā koe Minister Brown,
As representatives of the Digital Equity Coalition Aotearoa (DECA), we advocate for a future where all people in Aotearoa have equitable access to digital tools, services and opportunities. We write to express serious concerns about the proposed 24/7 digital health service set to launch in July and offer our support to work collaboratively with you to ensure the service is accessible, inclusive and effective.
While the initiative aims to enhance healthcare accessibility, we are concerned that it could unintentionally further exclude those already on the margins of digital access. In this letter, we outline key issues that need to be addressed, including:
World Health Organisation findings that digital health services are not accessible to all.
Challenges healthcare providers face in integrating digital health solutions
Lessons from Scotland’s NHS failed digital service.
Successful hybrid initiatives piloted by the Ministry of Health in collaboration with communities that did not receive continued investment.
DECA urges you to take this research and lived experience into account as you advance plans for a 24/7 health service. We also recommend investing in community-based digital literacy and access, maintaining hybrid models of care, providing training for healthcare professionals, policies for safeguarding patient data and co-designing the service with communities so it will meet their needs.
Additionally, we recommend that the service be accessible via the governments Zero Data Portal to eliminate barriers caused by the cost of Wi-Fi or mobile data.
The Impact on Digitally Excluded Populations
The World Health Organization has highlighted that digital health services are not equally accessible to all, disproportionately affecting:
Older adults, who may lack digital literacy or access to necessary devices.
Low-income and rural communities, where broadband connectivity is unreliable or unaffordable.
Disabled individuals, for whom accessibility features in digital health platforms are often inadequate.
Research confirms that digital exclusion translates directly into healthcare exclusion, as those unable to navigate digital systems face increased barriers to care. The introduction of a digital-first system without adequate safeguards may unintentionally widen existing health inequalities rather than reduce them.
Challenges for Healthcare Providers
A study published in NPJ Digital Medicine highlights major barriers for healthcare professionals when integrating digital health solutions, including:
Insufficient training and resources to effectively use new digital platforms.
Limited interoperability between digital systems, leading to fragmented care.
Resistance due to concerns about data security and patient safety.
For a digital health service to succeed, it must be designed with and for the healthcare workforce, ensuring that new digital systems complement, rather than disrupt, existing models of care.
Lessons from Scotland’s NHS Digital Failure
The case of Scotland’s NHS digital health rollout serves as a warning. Promised as a “digital front door” for healthcare services, the app faced significant issues, including:
Limited functionality and poor integration with existing GP services.
Outdated infrastructure that made real-time access to health records difficult.
Data security concerns, including a reprimand from the UK’s Information Commissioner’s Office over a lack of transparency in personal data usage.
Scotland’s experience shows that a rushed and poorly integrated digital health service can create more harm than good. We urge the Government to take a cautious, evidence-based approach to ensure that Aotearoa does not repeat these mistakes.
Success of Previous Ministry of Health Initiatives
The Pokapū o te Taiwhenua Network exemplifies how hybrid delivery models can effectively serve rural communities. This initiative utilised Starlink satellite technology to provide reliable internet connections, enabling telehealth services for rural Māori patients. Healthcare professionals, including paramedics, facilitated in-home telehealth appointments, allowing real-time monitoring and consultations with hospital clinicians. This approach not only reduced missed appointments but also increased comfort and trust among patients receiving care in their own homes.
Similarly, on Matakana Island, the installation of Starlink satellites enabled community nurses to conduct telehealth appointments directly in patients’ homes, overcoming previous connectivity challenges. This initiative, part of the Tāpiri Mai project, demonstrated the effectiveness of combining digital technology with personalised care to improve health outcomes in remote areas.
Despite their success, such initiatives have faced funding challenges, limiting their sustainability and expansion. The discontinuation of support for these types of programmes underscores the need for consistent investment in hybrid healthcare delivery models that combine digital tools with on-the-ground support.
Key Recommendations for an Inclusive Digital Health System
To ensure the proposed 24/7 digital health service truly serves all New Zealanders, we recommend:
Investing in Digital Inclusion – Expanding community-based digital literacy and access programmes to equip people with the skills and devices needed to access digital healthcare.
Maintaining Hybrid Models of Care – Ensuring that in-person healthcare options are more readily available, especially for those who cannot engage digitally.
Supporting Healthcare Professionals – Providing comprehensive training and ensuring digital systems are designed with clinicians’ needs in mind.
Ensuring Data Security & Transparency – Implementing clear policies on how patient data is used and safeguarded.
Co-Designing with Communities – Engaging directly with Māori, Pasifika, disabled communities, and low-income households to design a system that meets their needs.
Zero Data Access – Ensuring the digital health service can be accessed via the Zero Data Portal, eliminating barriers caused by the cost of Wi-Fi or mobile data
As a country committed to equity in healthcare, we must ensure that digital advancements enhance access rather than create new barriers.
Meeting Request
DECA would welcome the opportunity to discuss these issues further and to collaborate on solutions that ensure Aotearoa’s digital health future is truly inclusive.
Nāku noa, nā
Victoria MacLennan and Kris Dempster-Rivett
DECA Ngā Kaiurungi | Co-Chairs
On behalf of Digital Equity Coalition Aotearoa (DECA)
kiaora@digitalequity.nz
www.digitalequity.nz
References
Health Informatics New Zealand (HINZ). (2024). National 24/7 telehealth service to launch in July. Retrieved from https://www.hinz.org.nz/news/695118/National-247-telehealth-service-to-launch-in-July.htm
NZ Herald. (2024). Funding boost for health: ‘Game-changing’ 24/7 digital appointment service to make it easier to see GP. Retrieved from https://www.nzherald.co.nz/nz/politics/funding-boost-for-health-game-changing-247-digital-appointment-service-to-make-it-easier-to-see-gp/JEWQQPGYX5E4BMDE4INKOXPXD4/
van Kessel, R., Wong, B. L. H., Clemens, T., Brand, H., & Mossialos, E. (2024). Digital health not accessible by everyone equally: A new study finds. World Health Organization Europe. Retrieved from https://www.who.int/europe/news/item/21-12-2022-digital-health-not-accessible-by-everyone-equally-new-study-finds
Sciencedirect.com. (2024). Barriers to digital health adoption and its impact on health inequalities. Retrieved from https://www.sciencedirect.com/science/article/pii/S0168851024001325
National Center for Biotechnology Information (NCBI). (2024). Infrastructure, digital literacy, and financial constraints limiting digital health adoption. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10507089
ASCO Journals. (2023). The impact of digital health on access to care: Lessons from recent studies. Retrieved from https://ascopubs.org/doi/10.1200/OP.2023.19.11_suppl.203
Health Informatics New Zealand (HINZ). (2023). Starlink connects rural Māori to health services. Retrieved from https://www.hinz.org.nz/news/634559/Starlink-connects-rural-Mori-to-health-services.htm
Western Bay of Plenty Primary Health Organisation (WBOP PHO). (2023). Telehealth on Matakana Island gets a boost. Retrieved fromhttps://wboppho.org.nz/telehealth-on-matakana-island-gets-a-boost/