Pacific health leaders are standing firm on their challenge to Aotearoa's new health authority to ensure it is not a one-size-fits all system.

They said the pandemic has proven it does not work and a bespoke approach, cutting out all the bureaucracy, is needed to provide equity.

Preparations are underway for Health New Zealand to take over the current health system and replace the 20 District Health Boards.

The move comes at a time when change is clearly needed especially within Pacific communities where decades of entrenched health inequities have been exacerbated by Covid-19.

"I take it quite seriously, someone like me needs to continue to advocate and hold the new health system to account."

Dr Api Talemaitoga is not only a front-line worker dealing with serious health needs in his community as a GP in Auckland, he is also the chair of the Pasifika GP Network, was in the Immunisation Implementation Advisory Group and the Roche-Simpson border response group.

Now Health New Zealand is on his radar, with preparations underway to inform the new authority about the needs of Pasifika.

"I think there is a willingness to do it better but it is very easy to default back to the one size fits all model because that's easy, that's what we've all done. But we need to be smarter and people like me need to keep reminding the system," Talemaitoga said.

Talemaitoga said bureaucracy has caused major setbacks throughout the pandemic. One example of this was that Pacific health leaders had advocated very strongly for the Pacific vaccination age range to be lower from the get-go.

"That would have really worked well right from the beginning but that advice was not taken up and it caused a lot of the delay in getting these vulnerable people immunised," he said.

Pacific community members have had relentlessly high hospitalisation rates throughout the Delta and Omicron outbreaks with more than 100,000 Pasifika cases in these two outbreaks alone.

"It feels, certainly for our partners and ourselves, like we have barely been able to take a breath for the last two years," Pasifika Medical Association CEO Debbie Sorensen said.

The Pasifika Medical Association has been frustrated at the speed at which Covid-19 funding has been rolled out.

"I think we could have avoided the large case numbers for Pacific if we had acted faster in providing ethnic-specific vaccination drives and incentives alongside those drives to get people in," Sorensen said.

"We knew what worked, we knew how to do it, our providers really just needed to be given the resources to do the job they do so well."

There are two separate issues facing Pasifika regarding healthcare in Aotearoa. The need for sustained funding for Pacific health providers in the community and the current healthcare system is getting a shake-up and transitioning to Health New Zealand.

Pacific health care provider The Fono revealed that $US68 million ($NZ200 million) was needed in Auckland alone to bolster the community response to Covid-19, on top of funding that has already been provided to grassroots initiatives.

The Ministry of Health's Pacific Health Director, Gerardine Clifford-Lidstone said she has heard the call from providers for more funding.

She said the challenge now is how to secure funding on an ongoing basis to leverage what providers have already achieved.

"This is what the health reforms are meant to be achieving, I think that it would be naive to think this is just a response to Pacific health, this is a major systemic dilemma that needs to be addressed," she said.

"I am confident we are aware of what the issues are, the challenge now is how to respond in a way that will address the inequities that exist within the system," Clifford-Lidstone said.

Talemaitoga said some changes had been made by the government already, proof that authorities were moving forward.

"I'm so pleased that this year because we are going into the flu season the ministry has taken that on board and improved access to lower age groups for Māori and Pacific as was advocated two years ago for Māori and Pacific," he said.

But he said more drastic changes were needed to save lives. He hopes those at the top formulating Health New Zealand will deliver regarding Pacific communities. But he remains cautiously optimistic.

Covid-19 has been and a horrible experience, particularly for Pacific communities, he said.

Clifford-Lidstone said she was confident the Ministry was aware of the issues and inequities that exist within the system.

She was all for communities mobilising and having their voices heard. She said traditionally, "well we haven't been heard".

Talemaitoga said this time Pasifika will be heard as consultation on Pacific healthcare within the new health authority opens soon.

He said a draft Pacific health plan is being worked on and preparations are underway to capture the voices of Aotearoa's Pacific clinical health teams to inform decision makers at Health New Zealand.