This study confirms gross underutilisation of and expenditure on primary medical care and related services to Maori and other New Zealanders in poor circumstances. It also confirms what has been known by general practitioners for a long time, that they are required to subsidise many Maori and poorer patients who face financial and other barriers in accessing their services. Practices servicing poorer populations cannot subsidise these patients from their fewer better off patients. The small advantage of the CSC is largely offset by the reduced subsidy from ACC. Poor access to and utilisation of primary care services is likely to be a significant factor in the high use of hospital inpatients services by the groups studied. A radical review is required of the current problems of financial access if health services are to have a better chance of improving the health status of disadvantaged New Zealanders.