As featured in The New Zealand Herald, Saturday 31 October 2026
Every election, politicians promise more funding, more doctors and shorter waiting times. Yet too many New Zealanders still struggle to get the care they need.
With just five million people, New Zealand could build a world-class health system that attracts great clinicians, prioritises prevention and delivers accessible care. But that requires more than money. We must strengthen our workforce, tackle inequities and fund outcomes, not activity.
As Co-CEO of a primary care network serving more than 550,000 enrolled patients, I see firsthand what works and where the challenges lie.
Ahead of the 7 November election, I’ve assessed the major parties’ health policies against six tests: workforce, access, equity, sustainable funding, accountability and value for money. Importantly, I’ve judged them on what they would mean for patients.
Parties are presented alphabetically. Workforce is the binding constraint in our health system, so I’ve weighted capacity most heavily. A promise that can’t be staffed can’t be delivered.
ACT – General practice, medicines and cancer care
Score: 7/10
ACT’s $400 million GP package, $100 million a year on top of normal capitation increases, recognises something fundamental: improving access starts with increasing capacity. Retaining experienced doctors and attracting more from overseas are important priorities.
ACT’s commitment to lift medicines funding towards Australia’s share of health spending would help close the gap in access to modern treatments. It proposes increasing medicines’ share of the health budget by one percentage point annually, funded through future budget increases. But that money has to come from somewhere. How would ACT prioritise the remaining funding across hospitals, primary care and other stretched services?
A national cancer centre could transform cancer care, research and clinical trials. ACT has earmarked around $2 billion, but questions remain about ongoing operating costs and delivery.
What I’d like to see: ACT explain the trade-offs required to fund its medicines commitment and how its GP investment will deliver more appointments where access is hardest.
The Greens – Free care needs more clinicians
Score: 3/10
The Greens propose broader publicly funded primary and dental care, alongside greater investment in prevention. Dental care remains unaffordable for too many New Zealanders, and prevention is the right long-term focus.
But free healthcare doesn’t create capacity. Without more clinicians, removing fees could increase demand and lengthen waiting times, disadvantaging those who need care most. Universal access doesn’t necessarily mean equitable access.
The Greens propose funding their commitments through higher taxes on wealth and high incomes. Whether those measures would survive coalition negotiations is uncertain.
What I’d like to see: The Greens show how they would fund and deliver these commitments if their proposed tax increases don’t survive coalition talks, and how expanded access would reach those with the greatest health needs.
Labour – Affordable healthcare, but can it be delivered?
Score: 4/10
Labour promises three free GP visits a year from July 2028, free prescriptions and guaranteed jobs for graduate nurses, funded through a capital gains tax.
Affordability matters, and nobody should miss out on healthcare because of cost. But making visits free doesn’t create the capacity to deliver them.
Labour estimates that technology, clinical triage and other changes will free up 4.5 million GP appointments annually. Across our network of 550,000 enrolled patients, that equates to roughly 10,000 additional appointment equivalents every week. We simply cannot deliver that capacity.
Our practices already use these approaches to improve productivity, and the efficiencies are already being directed into patient care. But technology doesn’t replace clinicians, and clinical triage still requires healthcare professionals. There’s a fundamental difference between appointments theoretically freed up through efficiency and additional appointments actually available to patients. With half of general practices reporting GP vacancies, it’s difficult to see how these changes alone could deliver the millions of additional appointments Labour is forecasting.
There’s also an equity question. Universal free visits could increase demand and lengthen waiting times, making access harder for those with the greatest health needs and adding pressure to emergency departments.
Labour’s medicines policy also lacks detail. While it supports increasing Pharmac funding over time, it has made no specific funding commitment or set a timeframe for improving access to modern medicines.
What I’d like to see: Labour demonstrate how its proposed efficiencies will translate into genuinely available GP appointments, prioritise those with the greatest health needs and set out a clear, funded commitment to improving access to medicines.
National – Medicines, cancer prevention and workforce
Score: 7/10
National is promising a further $604 million for Pharmac, expanded cancer screening and continued investment in the health workforce.
This builds on 66 new medicines, including 33 cancer treatments, alongside plans for clinical trials and locally developed CAR-T therapy. Expanded screening, new medical training places and easier pathways for overseas-trained doctors could improve access and capacity over time.
National has also invested in after-hours care, digital GP services, primary care nursing and elective surgery. Its renewed focus on transparent health targets, including 80% of patients accessing primary care within a week by 2030, is welcome.
The challenge is bringing these initiatives together. Despite some positive steps, primary care still needs a more comprehensive plan to address workforce shortages, affordability and sustainable funding. Without that, pressure on hospitals will continue.
Delivery matters too. Training doctors takes years, while expanded screening requires sufficient diagnostic and treatment capacity. Funding much of the Pharmac uplift through reductions in foreign aid also raises questions about long-term sustainability.
What I’d like to see: National set out how its investments will strengthen primary care, deliver timely access and translate into measurable improvements in health outcomes.
NZ First – Prevention, metabolic health and informed consent
Score: 5/10
NZ First’s 15-point health plan prioritises prevention, metabolic health and informed consent.
Reducing chronic conditions such as diabetes and cardiovascular disease could improve lives while easing hospital pressure. Proposals to reduce GP administration and introduce health coaches also have merit.
But the plan is light on costings and measurable targets, making delivery difficult to assess.
Given NZ First’s longstanding focus on older New Zealanders, I’d also expected more attention on our ageing population. Over the next 20 years, ageing will fundamentally reshape healthcare demand, making aged care, dementia, frailty and healthy ageing increasingly important.
What I’d like to see: NZ First build on its prevention agenda with a long-term strategy for an ageing New Zealand and commit to measurable improvements.
Te Pāti Māori – Tackling inequity
Score: 4/10
Te Pāti Māori proposes restoring the Māori Health Authority, directing a significant share of health and ACC funding to Māori-led systems and making health and dental care free. It also commits $1 billion annually to workforce development.
Equity is this platform’s greatest strength. Māori-led approaches can improve access and engagement, while targeting resources towards communities with the poorest outcomes is something I’d advocate more broadly. Its substantial workforce commitment also deserves recognition.
But rebuilding a separate authority means further structural change in an already repeatedly restructured system. Shifting that much funding would be a major undertaking without a clear transition plan. New structures and free services alone won’t improve outcomes without more frontline clinicians.
What I’d like to see: Te Pāti Māori explain how its workforce investment will produce more Māori doctors, nurses and health professionals, and the measurable health improvements that will follow.
The Opportunity Party – Will evidence survive the negotiating table?
Score: 5/10
Opportunity proposes a cross-party ten-year health plan, increasing health funding from 7.4% to 9% of GDP and investing more in primary care and prevention.
Long-term planning makes sense. You cannot train doctors or transform healthcare within a three-year electoral cycle. Political consensus could also help end constant restructuring.
But increasing spending doesn’t guarantee better outcomes. Opportunity needs to show who pays and how additional funding would improve access, workforce capacity and productivity.
Its evidence-based approach faces a bigger test at the coalition negotiating table. When compromises are being made, will Opportunity challenge policies that don’t stack up, even when proposed by potential coalition partners?
What I’d like to see: Opportunity stand by its evidence-based principles when political compromise is on the table and ensure additional spending delivers measurable results.
The verdict: it’s all about delivery
There are good ideas across the political spectrum. Some parties promise free healthcare. Others want to invest more in clinicians, medicines, infrastructure or prevention. All have merit, and all involve trade-offs.
Those trade-offs deserve more scrutiny. Every party should answer the same questions: How many more people will get care? Who will deliver it? What will it cost, and who pays? Will it reach those who need it most? And how will we measure success?
Judge them on delivery, not promises. The best healthcare policy isn’t necessarily the most generous, expensive or politically popular. It’s the one that makes the greatest measurable difference to the health of New Zealanders. That’s the standard I want every party to meet.
