“The welfare system is a necessity for us”: providers’ perspectives on the barriers to accessing welfare supports for people living with work-limiting conditions and disability in Aotearoa New Zealand

AIMS: Income is a key determinant of health and health equity. This paper outlines the current welfare supports for people with longterm conditions and reviews the issues associated with accessing those supports, particularly during health system engagement. METHODS: Weaving a Kaupapa Māori methodology, the He Pikinga Waiora framework and a qualitative approach, our team spoke to 130 healthcare providers across the Waikato Region in face-to-face and virtual engagements about system-level issues associated with accessing welfare support. Notes taken during these engagements were analysed using inductive thematic analysis, systems thinking and a Kaupapa Māori lens. RESULTS: Because of the way health and welfare systems operate and limited access to advocacy, computerised resources and information about welfare and other supports, key informants observed that patients experienced many difficulties accessing the right type and level of welfare support, with likely consequent impact on health outcomes. These realities were exacerbated because providers were not enabled to help patients navigate the welfare system. CONCLUSION: The health and welfare systems are not designed to enable access to welfare support. Providers could have a more meaningful role ensuring equitable access to welfare and other supports but are underfunded, understaffed and unsupported. A more integrated approach and cross-sectoral action are needed.