Budget 2026 misses the opportunity to invest in a sustainable, accessible and affordable primary care

A sustainable health system starts with a sustainable general practice workforce and today’s Budget announcement does not go far enough to deliver it.

Despite commitment to improve access and strengthen frontline services, the significant investment into general practice that is required is yet to be delivered.

The Royal New Zealand College of General Practitioners’ President, Dr Luke Bradford, says increasing enrolments and access targets must be matched by workforce capacity.

“You cannot improve access to frontline health care without the workforce to deliver it. Announcements to provide 53,000 additional enrolments and expanded access are positive in their intent, but without enough GPs there is a real risk of shifting the pressure, rather than relieving it.

“General practice is the front door to the health system, but patients are struggling to afford to see their GP. At the same time, we are struggling to recruit enough junior doctors into this profession due to a lack of alignment in pay and working conditions compared to other specialities."

There are so many advantages to investing in general practice, and the College is concerned that the Budget continues to prioritise hospital and secondary care, despite the evidence that investing in primary care is the most cost-effective option for reducing pressure on the rest of the system and for improving health outcomes.

“Funding must reflect the full scope and value of general practice, including the complex, preventative and ongoing care we provide, as well as the essential work that happens outside of the patient consultation that keeps patients safe and well.”

College Medical Director Dr Prabani Wood says, "Funding must support GPs to build long-term therapeutic relationships with the communities that they serve. It is this continuity of care that enables general practice to deliver its full value to the health system."

“Retention of the current workforce is just as critical as recruitment. Today’s workforce is under significant pressure, and they are the ones who are also training the next generation,” says Dr Bradford.

A significant win for New Zealanders is the lowering of the bowel screening age to 56 years. However, to meaningfully address the documented health inequities, eligibility must be extended to age 50 for Māori and Pacific Peoples who are at greater risk.

College CE Toby Beaglehole says a reset in health funding priorities is urgently needed.

“Investment in general practice is not optional. It is the most affordable way to improve access, affordability and health outcomes. We won’t achieve those improvements while primary care in New Zealand receives on average 6% of the total health budget, compared with 14% internationally.

“If we want to have a sustainable health system that delivers early, affordable care close to home, we need a targeted shift in investment towards the specialism of general practice and the wider primary care workforce.”

The College acknowledges support and additional funding provided for general practice and rural medicine and is committed to working with the health minister to deliver sustainable, equitable and accessible care for all New Zealanders.

The College has developed a series of advocacy white papers that set out the priorities for strengthening New Zealand’s health system. Read the first paper in the series, The future and sustainability of general practice – Why this must be a Budget and election priority.

Read Dr Bradford’s pre-Budget opinion editorial published in NZ Doctor highlighting how meaningful change depends not just on policy intent, but on solutions that reflect the realities of frontline care.