Ask 150 chief executives and chairs what they want from the next government and you might expect grand talk about productivity, tax and growth. The Mood of the Boardroom 2026 survey suggests something more grounded. Alongside compulsory KiwiSaver at 12% (scored 3.99 out of 5), the best-rated policies are about getting someone out of the way: qualified engineers signing off building work without a council inspection (3.87), consent-free rooftop solar (3.85) and a specialist national consent authority for large commercial buildings (3.78).
Business is not asking Wellington for a vision. It is asking for permission. Act’s Pharmacy First policy is the same species of idea, applied to health, and it tells you exactly what boards want.
The coalition business has already picked
The same survey found 53% of respondents think National has the best overall policy mix for business and 30% pick Act. Labour and NZ First managed 3% each. That is a near-total concentration of confidence in the two parties most likely to govern together.
It is not uncritical support. One mining CEO complained that “every party is playing to its perceived base at the expense of a cohesive policy suite”. Mainfreight’s Don Braid warned the supermarket and banking “fiascos” had raised questions about where National stands for business. Boards want dependable, practical policy, and they are rewarding the specific over the rhetorical.
Pharmacists already have the shopfront
Act leader David Seymour launched Pharmacy First in August with a line that could sit on any deregulation manifesto: “Pharmacists have the capacity, the need, and the proximity. All that’s missing is permission.”
The plan lets pharmacists treat sore throats, tonsillitis, school sores, gout, thrush and period pain, order blood tests, and run self-swab testing for chlamydia and gonorrhoea. Pharmacists could also manage stable hypertension, type 2 diabetes and high cholesterol within limits set by GPs. Act would scrap the five-pharmacy ownership cap and proximity rules, and allow 24-hour prescription collection from secure lockers, as Pharmacy Today reported.
The employer logic is obvious. One in four adults report difficulty getting a GP appointment, and a staff member losing half a day to a routine consult is a cost every business absorbs. The 2023 minor health conditions pilot saw more than 120,000 people use it, with 88% having their needs fully met at the pharmacy.
The bureaucracy is already halfway there
This is not the radical leap critics claim. Pharmac consulted in April on letting pharmacies supply funded medicines without a prescription for scabies, head lice, uncomplicated UTIs and the emergency contraceptive pill. Health NZ confirmed decisions in May and September and counts more than 1,070 community pharmacies nationally. The direction is settled. The argument is about pace and scope.
GPs have a point worth hearing
General Practitioners Aotearoa chair Dr Buzz Burrell calls it a “shadow system”, costing up to $100 million a year that he argues should fund general practice. “Skipping the GP is a dangerous gamble with patient safety,” he said.
Some of that is turf. Not all of it. A missed serious diagnosis carries real human and economic cost, and underfunded primary care does not become well funded because work shifts down the street. But the status quo is not risk-free either. Patients who cannot get an appointment for weeks are also missing critical windows.
Permission is not the same as capacity
The harder problem is workforce. A 2025 Ministry of Health briefing found that in 2024 only 99 pharmacists held prescribing authority, and none were known to be prescribing in a community pharmacy, despite those pharmacies employing 76% of the workforce. Training costs and a rule barring owner-pharmacists from prescribing kept uptake low. The Pharmacy Council’s 2024 report showed intern numbers had fallen 26% even as registrations rose.
A 2023 evaluation of extended pharmacist roles concluded there was no single fix, pointing to funding, training time and accreditation support as the real enablers. Removing red tape opens the door. Someone still has to walk through it.
Act’s wider pledge to lift Pharmac’s share of health spending from 4.9% to 12% by 2033 signals it understands money matters. In 2025, Pharmac reported a $1.689 billion medicines budget for 2024/25, so the scale of that ambition is considerable.
What boards should watch next
The boardroom instinct is sound. Engineers signing off buildings, solar without consents and pharmacists treating sore throats are all bets that trained professionals can be trusted to do their jobs without a gatekeeper. If National and Act form the next government, the pharmacy plan will be an early test of whether that philosophy can be delivered, not just announced. Watch the prescriber training pipeline, the ownership rules and the funding model. Those, not the slogan, will decide whether your staff spend less time in waiting rooms.
Sources
- NZ Herald: New Zealand business leaders rate the election policies (2026-10-23)
- RNZ: ACT wants to expand pharmacists’ power and make it easier to open new pharmacies (2026-08-06)
- PharmaDispatch: New Zealand’s ACT announces plan for pharmacies to do a lot more, but also ownership and location reform (2026-08-10)
- Pharmacy Today: ACT Party unveils ‘pharmacy first’ election policy (2026-08-06)
- Pharmac: Proposal to expand pharmacy services (2026-04-15)
- RNZ: GPs oppose ACT’s proposal to extend pharmacists’ power (2026-08-11)
- Ministry of Health: Briefing decision, current settings and opportunities for pharmacists (2025-08-12)
- Pharmacy Council of New Zealand: Annual Report 2024 (2024-10)
- Research in Social and Administrative Pharmacy: A realist evaluation of the development of extended pharmacist roles and services in community pharmacies (2023-12-01)
- RNZ: Health policy guide (2026-10-20)
- Pharmac: Annual Report 2024-25 (2025-10-31)
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