The first is to fund what works.
Funding matters, but what we fund matters just as much. We should put more investment into prevention, primary and community care where it delivers the greatest impact, while improving access to medicines.
We should fund what works and focus relentlessly on results. Childhood immunisation at 24 months rose from 77% to nearly 83% as greater focus was put on targets and performance. The Government deserves credit for that progress. Medicines access is improving too, with Pharmac continuing to widen access to funded treatments.
The next step is to keep backing interventions that deliver measurable results and shift funding towards areas where it can make the greatest difference. Mental health should be part of that, with earlier intervention, clearer pathways and stronger accountability for outcomes and value.
Just as importantly, we need to stop spending time and money on activity that adds little value. In just under three months, my team spent more than 220 hours in routine meetings with officials. We estimate at least half of that time was spent covering the same or substantially similar ground.
The Government should be using technology and AI to reduce that burden: fewer meetings, less duplication, less administration and faster decisions. Every hour and dollar saved should be redirected towards frontline care.
Ultimately, funding what works means demanding results. More investment should come with clear expectations about what it will deliver for patients, and the willingness to stop funding activity that does not.
The second priority is to make it easier to get healthcare.
For most people, the question is simple: can I get help when I need it? Health Minister Simeon Brown has brought a strong focus on access, wait times and accountability, including a new primary care access target. That direction should be sustained over the long term.
We need the same practical focus locally. Since our network expanded this year, National’s Nicola Grigg has been the first, and so far only, MP to reach out directly and ask what more could be done to improve access for her communities. That kind of engagement matters.
New Zealanders should be able to access same-day primary care when they are unwell, backed by stronger after-hours and urgent care options. We also need to use the full clinical workforce, with nurses, nurse practitioners, pharmacists, paramedics and allied health professionals working at the top of their scope so GPs can focus where their expertise is most needed.
Digital care must be treated as core healthcare infrastructure. Used well, it makes care faster, more accessible and more efficient, complementing rather than replacing face-to-face care.
We also need far greater urgency around our ageing population. The system must plan now for the next 10 to 15 years by strengthening primary, community, home-based, palliative and aged care so more people can remain well and supported outside hospital.
The third priority is that digital capability must be treated as essential health infrastructure.
The Government’s Health Digital Investment Plan is a positive step and points in the right direction. The challenge now is implementation, sustained investment and long-term bipartisan support.
Because in technology, complexity compounds quickly. More people building a giant Lego set does not necessarily make it better. Good systems are designed around simplicity, clear architecture and making sure the pieces actually work together. Health needs the same discipline.
Globally, digital capability is recognised as a game changer for health systems, yet in New Zealand too many clinicians still work across fragmented systems that do not reliably share information. That wastes clinical time and creates real patient safety risks.
Information should follow the patient wherever they receive care. We need fewer disconnected systems, funded adoption of national standards and genuine interoperability across health. Technology should reduce administration for clinicians today while building the foundation for AI, automation and better care tomorrow.
Health funding should follow results, not routine activity. (Image: Deposit Photos)
The fourth priority is to back our health workforce.
We need to make far better use of the workforce we already have, with clinicians working at the top of their scope and fewer unnecessary barriers in the way. That means safely expanding scopes of practice, making it easier for experienced clinicians to return to the workforce, providing them with the tools to do their jobs well, competing harder for international talent and cutting unnecessary compliance and administration.
Regulation also needs to be practical. If an internationally qualified GP is willing to work in a rural community but cannot access a local supervisor, remote, shared or cross-region supervision should be an option where clinically appropriate.
The fifth priority is to close the health equity gap.
This should be grounded in evidence and outcomes. It is a national shame that life expectancy still differs so significantly between Māori and Pākehā, and we should be transparent about where access and outcomes are worse for Māori, Pacific peoples, disabled people, rural communities and others facing persistent barriers.
That is why we should be cautious about defaulting to universal funding. Labour says around 650,000 New Zealanders cannot afford to see a GP or nurse practitioner when they need to. We should all support funding those people properly because delayed care leads to worse outcomes and higher costs elsewhere in the system.
When resources are finite, we should target investment according to demonstrated need, access barriers and outcomes, rather than spread funding so broadly that those facing the greatest barriers still miss out.
Build for the long term, not the next election
There are things we should start doing tomorrow: scale models already proven to work, reduce unnecessary administration and duplication, expand team-based and virtual care, improve transparency around outcomes and remove practical barriers that stop clinicians working to their full potential. At the same time, the bigger reforms need stability.
New Zealand cannot keep resetting health policy every three years. We need a 10-year bipartisan, cross-party health plan with a small number of enduring priorities.
And the test should be simple. Can New Zealanders get care when they need it? Are health outcomes improving? Are inequities reducing? Is the workforce thriving? Are we getting better health from every dollar we spend?
For too long, we have talked about our health system in terms of constraint. I think it is time we talk about possibilities. We have the scale, the talent and the resources. What we need now is greater ambition, clearer priorities and the discipline to stay the course.
There is no reason New Zealand cannot build a health system that is among the best in the world.
Cecilia Robinson is a founder and co-chief executive of digi-physical primary care provider Tend Health.
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