ACT has moved the primary care debate onto firmer ground. Its $400 million plan to retain more doctors and incentivise more GP appointments is pitched directly against Labour’s promise of three free GP visits a year. The detail of how ACT will deliver the money still needs scrutiny. But the diagnosis is right. You cannot subsidise your way out of a shortage of people.
For employers, this is not a niche health argument. It decides whether a sick worker sees a doctor this week or in three, and whether a manageable problem becomes a longer absence or a trip to the emergency department.
Making a scarce thing free makes it scarcer
Labour’s 2025 offer implied roughly 12.5 million appointments across about 4.2 million New Zealanders aged 14 and over, much of it new demand landing on clinics already turning patients away. Labour’s health spokesperson Dr Ayesha Verrall said in 2025 the party had “worked with general practice providers to come up with a credible plan for releasing five million more visits”, leaning on phone triage and AI tools.
The doctors were not convinced. Dr Luke Bradford, Royal NZ College of GPs president at the time, said: “Currently we can’t meet the demand that’s already there”. He noted AI note-taking saved about two minutes a consultation, enough to “barely free up sufficient time for additional appointments”.
That is the core economic flaw. Dropping the price to zero does not add a single clinician-hour. It just changes who wins the race for the slots that already exist.
The workforce is shrinking from both ends
The numbers from the profession are stark. In 2025, General Practitioners Aotearoa chair Dr Buzz Burrell put the sector at roughly 500 GPs short. Late that year the College’s medical director, Dr Prabani Wood, warned that access, not cost, was the biggest barrier, with two-to-three week waits common, and that 34% of the GP workforce was due to retire within five years.
Those still working were stretched. The average GP week rose to 38.1 hours from 35.9 in 2022, while consultations made up only 56.4% of GPs’ time, with non-contact clinical work swallowing much of the rest. That is a productivity problem as much as a headcount one. Every hour of paperwork stripped out is an hour of patient time created.
The government’s own analysis in 2024 pointed the same way. A Cabinet paper found more than one million people reported unmet GP need due to wait times, and that the workforce would need to grow 25.5% above anticipated growth just to hold ratios for over-60s steady.
Closed books are the real waiting list
A 2025 study found practices were still capping enrolments, with no overall improvement in closed books and the worst effects in Northland, the lower North Island and the lower South Island. Rural and lower-income patients were hit hardest. A free visit is cold comfort if your nearest practice will not take you on.
The industry has said for years that supply comes first. General Practice NZ argued in 2024 that practices must be resourced to build a stable, multidisciplinary workforce before demand-side measures could work. ACT’s framing echoes that more closely than Labour’s does.
Why the bill lands on business
General practice is the system’s load-bearing wall. Health officials reported in 2025 that GP teams delivered 24 million patient encounters a year against 1.4 million ED visits. Push even a small share of that volume into hospitals and costs climb fast, while workers sit at home waiting for treatment. The same factsheet recorded 25.7% of adults unable to see a GP in a timely way. For a business, that translates into longer sick leave, more presenteeism and rising pressure to fund private cover as a staff perk.
What ACT still has to prove
The right diagnosis is not the same as the right prescription. ACT needs to show how $400 million translates into retained doctors and extra appointments, not just topped-up practice margins. Pay alone will not fix a job Dr Wood described as poorly sized, nor the admin load eating into clinical time.
Still, the election choice is now clearer. One approach spends to make a scarce service cheaper. The other spends to make it less scarce. Business should back whichever party can prove it adds appointment capacity, and so far the weight of evidence sits with the parties talking about doctors rather than discounts.
Sources
- NZ Herald: Election 2026: Act to spend $400m to retain more doctors, incentivise more appts (2026-10-17)
- NZ Herald: Labour’s free GP visit policy: Doctors sceptical but party confident there is enough capacity to meet demand (2025-10-28)
- RNZ: Success of Labour’s capital gains tax plan rests on expanded primary health workforce – GPs boss (2025-10-29)
- RNZ: Group supports capital gains tax, warns of strain on clinics (2025-10-29)
- The Post: Labour’s free GP policy will fail without more doctors, college warns (2025-11-28)
- Ministry of Health: Transforming primary care – first steps (Cabinet paper) (2024-12-09)
- Ministry of Health: Factsheet – Primary Care Funding Boost (2025-03-01)
- General Practice NZ: Securing sustainable general practice in Aotearoa (2024)
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