The proposed arm would use multidisciplinary teams, employing specialist GPs alongside resident doctors training as GPs.
Three Rivers Medical general manager Michelle Te Kira said she supported exploring a Health New Zealand primary care arm, but did not want it to create further barriers for patients.
“We don’t want another arm thinking they know what’s best for our patients.
“You know, we’re the ones who know what to do with our 21,000 patients. So if we have to then go to another referral process outside of here, it’s just putting up more barriers.”
“If you fragment the stages, they’re not going to engage. Because they barely engage with us.”
Te Kira said Three Rivers had about 3500 disengaged patients three years ago and carried out a re-engagement programme by phoning them.
The latest data showed about 1800 patients remained on the disengagement list.
“Why aren’t they coming to us? Why aren’t they seeking access? Some may not need it. Some just can’t afford it, can’t get here.
“Food comes first, money for petrol, getting to work.”
Te Kira said opening another arm would involve working in partnership with existing primary health organisations, not in competition.
“Not setting up duplicated services that we’re already providing, because that just leads to confusion and patients getting hōhā [annoyed].”
Three Rivers Medical has a three-to-four-week wait to see a GP.
“Access is the biggest issue facing all of us”
Te Kira said the practice would like more health improvement practitioners, accessible counselling services, and a social worker.
She said they also need four more GPs.
“How do we get a disengaged population into general practice, when, you know, if you ring to get an appointment, it’s weeks out.”
“It’s who these patients know, it’s who they feel comfortable with, it’s their trusted provider and we need to gain back their trust a bit.”
City Medical general practitioner and co-director Jun Camero said the proposed model could help relieve pressure, but he did not believe it should be a long-term solution.
Instead, he said primary care should be better funded and given a better reputation as a preferred specialty for medical students.
“That’s the only way we can rebuild the workforce of the future.”
Camero said there had been a “chronic underestimation of the value of primary care”.
He said the proposed primary care arms may not have the same level of expertise, efficiency and capacity as fully staffed expert-level GPs, such as City Medical, which employs six GPs who co-own the practice.
City Medical has a one-to-two-week wait to see a GP and leaves room for acute patients.
Much of primary health care involved prevention and educating patients, he said.
“Those are largely invisible activities that we do, but the value [is in] the amount of people that we save [from] going to hospital.”
New Zealand Resident Doctors Association secretary Dr Deborah Powell said the more options available to the GP workforce, the more likely doctors were to be retained.
The proposal also aimed to ease pressure on emergency departments, where many people not enrolled with a GP accessed care because they could not afford co-payments.
She said the 320,338 could move into the proposed community arm.
“As we say in the report, this isn’t a one-size-fits-all. Primary care has all sorts of models operating these days,” Powell said.
The Health NZ arm would not have a primary health organisation representing them, reducing the cost.
Powell said the proposed arm would work alongside existing primary care providers and offer extended hours, with some regions operating for up to 24 hours and others for 16 hours.
“I do find it ironic. The nine-to-five sort of business model in a healthcare system is somewhat outdated.
“We’ve got a horrendously underserved population of people who need care.”
Powell said other benefits of having a community arm would be bringing other allied health professionals into the team.
“The ability to have a physio, social worker, psychologist, pharmacist as part of the team.”
“Many of our general practices struggle to do that because they can’t afford one of each of those.”
In a statement, Health New Zealand said while it delivers some primary care services, it has no policy or plans to extend primary care.
When asked what Health NZ’s alternative solutions were, it said it was working towards a more focused approach to monitoring performance and access through the primary target.
This came into effect on July 1 and states “more than 80% of people will be able to access an appointment with a general practice provider within one week”.
Results will be aggregated and published in late 2026, providing the first national view of access to primary care appointments.
“Health NZ continues to develop and invest in alternative ways for people to access primary care when they are unable to see their usual general practice. This includes virtual services such as Ka Ora in rural areas and Online GP Care, which is a service that is available 24/7.”