Venkat Raman
Auckland, July 1, 2025
The provision of robust and accessible healthcare remains a perennial challenge for nations across the globe, and New Zealand is no exception. Despite its reputation as a progressive and well-developed country, its public health system has grappled with a complex array of issues that have at times, strained its capacity to deliver optimal care to all its citizens.
Recognising these deep-seated problems, the New Zealand government unveiled on July 1, 2025, a significant new initiative, signalling a concerted effort to reshape the landscape of primary healthcare and address long-standing systemic deficiencies.
Healthcare Challenges
For many years, the New Zealand public health system has contended with a series of interconnected challenges. Perhaps most prominent among these has been a sustained period of low investment. Decades of underfunding have led to an infrastructure that, in parts, struggles to meet contemporary demands, with facilities requiring upgrades and technology lagging behind the pace of innovation. This historical underinvestment has created a cumulative burden, making it difficult for the system to adapt and expand in line with population growth and evolving health needs.
Compounding the issue of funding has been the perception of less-than-optimal management within the public health system. Critics have often pointed to inefficiencies, bureaucratic hurdles, and a fragmented approach to service delivery that has, at times, hindered seamless patient pathways and effective resource allocation. While dedicated professionals work tirelessly within the system, structural and organisational challenges have frequently impeded their efforts, leading to frustrations for both healthcare providers and patients alike.
However, arguably the most pressing and widely acknowledged challenge is the acute shortage of doctors, nurses, and other medical professionals. This workforce crisis is multifaceted, stemming from a combination of factors including an ageing healthcare workforce, insufficient domestic training pipelines, and the global competition for skilled medical personnel. General practitioners, in particular, have faced immense pressure, with many practices struggling to take on new patients, leading to extended waiting times for appointments and a reliance on overstretched emergency departments for non-urgent care. The scarcity of specialist nurses, allied health professionals, and rural practitioners further exacerbates these pressures, creating significant disparities in access to care, particularly in remote and underserved communities.
Addressing the Foundations
In response to these pervasive challenges, the New Zealand government has been engaged in a broader series of efforts aimed at shoring up the healthcare system. These initiatives have encompassed a range of strategies, from reviewing funding models to streamlining administrative processes and fostering greater integration across different levels of care.
A crucial component of this remedial action has been a proactive approach to addressing the workforce shortage, particularly through strategic changes to immigration rules. Recognising the immediate need for skilled professionals, the government has moved to make it easier for overseas-trained doctors, nurses, and other medical specialists to gain residency and practice in New Zealand.
These changes aim to attract a steady influx of talent, providing a much-needed boost to the healthcare workforce and helping to alleviate the severe staffing pressures faced by hospitals and primary care providers alike. While these efforts represent a vital step, the scale of the challenge necessitates ongoing commitment and innovative solutions.
24/7 Primary Healthcare
Building on these foundational efforts, the government has just announced a transformative new initiative designed to significantly enhance access to primary healthcare across the country: Kiwis can now access 24/7 primary healthcare from anywhere in New Zealand. This ambitious programme seeks to dismantle geographical and temporal barriers to care, ensuring that medical advice and support are available whenever and wherever they are needed.
The implications of this round-the-clock service are profound and address several common scenarios that have historically presented significant hurdles for New Zealanders seeking care. Consider a mother with a sick child in the middle of the night, worried about a fever or an unexplained cough, with no after-hours clinic nearby. Or someone waking up with a sudden rash on a public holiday, uncertain whether it warrants an emergency visit. For a farmer in rural New Zealand, often many hours from the nearest medical centre, needing help after hours for a minor injury or sudden illness, this service offers a lifeline. Even for a family on holiday in a different part of the country, away from their usual general practitioner, or someone not enrolled with a local GP, this new 24/7 access provides a crucial point of contact for medical guidance and initial assessment. This initiative promises to offer peace of mind and timely intervention, potentially preventing minor ailments from escalating into more serious conditions requiring hospitalisation.
A Holistic Approach
This substantial investment in 24/7 primary healthcare is not an isolated measure but forms an integral part of the Government’s comprehensive primary care package, which was announced earlier this year. This broader package reflects a holistic strategy to strengthen the entire primary care ecosystem, addressing both immediate access needs and the long-term sustainability of the healthcare workforce.
Key components of this comprehensive package include increased access to urgent and after-hours care, complementing the 24/7 service by ensuring that when in-person care is required, it is more readily available. Crucially, the package also focuses heavily on workforce development and retention. It includes provisions for 100 clinical placements for overseas-trained doctors, providing them with the necessary experience and pathways to integrate into the New Zealand system. To bolster the nursing workforce, recruitment incentives for up to 400 graduate nurses annually for five years have been introduced, aiming to attract and retain new talent in the profession.
Furthermore, the government is investing in the future pipeline of medical professionals with 100 additional doctor training places over the course of this Government’s term. A specific focus on primary care is evident with up to 50 graduate doctors training in primary care annually, ensuring that more new doctors choose general practice as their specialisation. Recognising the vital role of advanced nursing, up to 120 training places for nurse practitioners in primary care have been allocated, empowering these highly skilled nurses to take on expanded roles. Finally, accelerated tertiary education for up to 120 primary care nurses will help upskill and retain experienced nurses within the primary care sector.
The Providers
To deliver this ambitious 24/7 primary healthcare service, Health New Zealand has so far contracted eight providers, leveraging existing and emerging telehealth and online consultation platforms. These providers include Bettr Online, CareHQ, Emergency Consult, The Doctors Online, MedOnline, Pocket Lab, Tend, and Practice Plus. The selection of these diverse providers indicates a strategic approach to ensure broad coverage, technological robustness, and varied service models to meet the needs of a diverse population. Their involvement underscores the shift towards digital health solutions as a critical component of modern healthcare delivery.
A vital aspect of this new initiative is its commitment to equitable access. The service is subsidised for eligible groups, ensuring that financial barriers do not prevent those most in need from accessing care. This includes children under 14, who will receive free access, reflecting a commitment to early intervention and child health. Community Services Card holders, who often face significant financial constraints, will also benefit from subsidised consultations, as will some young people, recognising the importance of accessible healthcare during formative years. This tiered approach to funding ensures that the benefits of this enhanced access are extended to vulnerable populations, aligning with the broader goal of reducing health inequities.
A transformative Journey
The challenges facing New Zealand’s healthcare system are significant and deeply entrenched, born from years of underinvestment, management complexities, and a persistent workforce crisis.
However, the government’s comprehensive primary care package, spearheaded by the groundbreaking 24/7 primary healthcare access initiative, represents a determined and strategic response. By addressing immediate access needs through digital solutions while simultaneously investing in the long-term growth and retention of its medical workforce, New Zealand is embarking on a transformative journey. This initiative holds the promise of a more responsive, accessible, and equitable healthcare system for all Kiwis, offering a beacon of hope for a healthier future.
