Free GP visits are a promise clinics say they cannot staff

Days out from the election, the people who would deliver Labour’s flagship health promise have given their verdict. A GenPro survey of 132 general practice owners found only 14% support Labour’s policy of three free GP appointments per patient per year. GenPro chair Dr Angus Chambers said owners liked the idea of better access but feared “some significant risks that we’ll be even more over-burdened than we are.”

That is not a political objection. It is an operational one, and business owners will recognise it straight away. If you cut the price to zero and leave supply where it is, the queue gets longer.

GP owners like the tools but not the order

The survey shows owners are not rejecting Labour outright. In the same survey, Labour’s telehealth funding review drew 77% support, its digital innovation fund 71% and its low-interest loans for younger doctors buying into practices 66%. The policies owners rated highest were all about supply. The Opportunity Party’s plan to lift primary care’s share of Health NZ funding scored 93%, ACT’s extra $100 million a year for general practice 86%, and faster registration for overseas-trained doctors 71%.

So the message is clear enough. Fund the practices and staff them, then widen access. Labour’s health spokesperson Ayesha Verrall argues the party’s plan does this, pointing to independent pricing based on the actual cost of running a practice and measures to free up time for 4.5 million appointments. GP owners have heard that pitch for a year and still do not believe the numbers add up.

Price cuts don’t create doctors

The scepticism goes back to the policy’s launch. In 2025, Labour estimated the pledge would generate around two million extra visits a year. It would be funded by a 28% capital gains tax on property, with free visits starting in July 2028. At the time New Zealand was 485 GPs short on official 2024 figures, and more than a third of GPs intended to retire by 2027.

The then-president of the College of GPs, Dr Luke Bradford, backed the funding mechanism but put the problem plainly in 2025: “Currently we can’t meet the demand that’s already there.” He called the 4.5 million freed-up appointments “ambitious”, noting AI scribes save about two minutes per consultation.

Tend Health co-chief executive Cecilia Robinson gave the clearest economic version in a November 2025 column. “When you remove price but don’t increase supply, demand surges and something has to give. In healthcare, that ‘something’ is wait time,” she wrote. She also pointed out that one in five clinics had already stopped enrolling new patients.

A workforce already running hot

The College’s 2025 figures show a profession with no room to spare. Medical director Dr Prabani Wood said the average GP week had risen to 38.1 hours from 35.9 in 2022. She also said 34% of the workforce was set to retire within five years, and only 56.4% of GPs’ time went on consultations, with much of the remaining work unfunded. Cost, Wood argued, was not the main barrier for patients. Two-to-three-week waits were.

In October the College formalised that view in a white paper, warning that access promises, Labour’s included, cannot succeed without a funded workforce.

These are also small businesses with thin margins. Back in 2024, GenPro found 89% of practice owners were raising fees, 70% were worse off than a year earlier and 83% were worried about viability. Around half of practice revenue comes from patient fees. Swapping that revenue for a government-set price is a bet on the price being right, and general practice has spent years arguing capitation never has been.

Rural practices would feel it first

The pressure would show fastest outside the cities. A new Hauora Taiwhenua survey of 141 rural practices found the country short 151 rural doctors, with 48% of practices carrying a GP vacancy and 46% saying their facilities are no longer fit for purpose. The 2024 stocktake found about 90% of rural practices already above recommended patient-to-GP ratios. A single-GP town with a seasonal tourist surge cannot absorb a free-visit spike.

For employers in the regions, this has a direct cost. Longer waits mean more sick days, more presenteeism and more pressure on emergency departments.

Fix supply first, then cut the price

None of this makes universal free care a bad goal. It makes it the last step, not the first. Owners have told every party what they would back. They want funding that covers real costs, faster pathways for overseas doctors, less compliance and a career young doctors want to buy into.

Whoever forms the next government will inherit the same 151-doctor rural gap and the same retirement wave. Labour’s promise has a July 2028 start date. The real test is whether enough GPs can be recruited and kept before then. If they cannot, patients will get free appointments on paper and longer waits in practice.

Sources

• RNZ: Only 14% of GP owners support Labour’s three free appointments policy – survey (2026-11-04)
• The Post: GP visit pledge welcomed with a dose of workforce scepticism (2025-10-28)
• RNZ: Royal New Zealand College of GPs backs funding for doctors from Labour’s capital gains tax (2025-10-28)
• NZ Herald: Free GP visits – Good intentions, fragile foundations (2025-11-01)
• The Post: Labour’s universal free GP policy faces workforce warning (2025-11-28)
• NZ Doctor: Election policy to date falls short of meeting needs – RNZCGP white paper (2026-10-09)
• GenPro: Concerned about going broke, general practices hike fees and reduce services (2024-09-02)
• Hauora Taiwhenua: Rural General Practice Stocktake Survey 2024 (2025-01)