Source: Royal New Zealand College of General Practitioners
8 October 2026
Almost half of specialist GPs’ work takes place outside funded face-to-face consultations. This work is essential to safe patient care, but the health system often relies on GPs and practices to absorb the cost or recover it from patients, creating further barriers to equitable access. The College is calling on the next government to fund the full range of clinical work that is required to provide safe, equitable, culturally safe and continuous care, and to meet its obligations under Te Tiriti o Waitangi.
The College is calling for the next government to:
- Fund the full range of clinical work, including work outside consultations.
- Address GP remuneration and working conditions compared with hospital-based specialties.
- Measure general practice need and use, including inequities for Māori, Pacific peoples, rural and underserved communities.
- Plan and adequately fund the workforce required to meet that need.
General practice is the entry point to the health system for most New Zealanders, with 90 percent of health conditions being managed in primary care. Specialist GPs provide early intervention, manage long-term conditions and help prevent illness from becoming serious enough to require hospital or emergency care. The demand is growing as the population ages and patients’ health needs become more complex.
Aotearoa New Zealand currently invests a low proportion of Vote Health funding in primary care, an average of about 6 percent.
However, the public funding model does not adequately fund the breadth of work carried out by GPs in the provision of culturally safe and clinically excellent patient care, including the time needed to respond to patients’ cultural, social and clinical needs. The College’s Your Work Counts project found that 44 percent of specialist GP work happens outside funded face-to-face consultations. This includes reviewing and acting on test results, writing and managing referrals, coordinating care with other services, and completing clinical follow-up.
Patients may never see this work, but their safety depends on it.
Expecting specialist GPs to provide this work without sufficient funding is not sustainable. It contributes to burnout, reduces the number of patients GPs can see and makes it harder to retain experienced specialist GPs. Patients experience longer waits, reduced continuity and greater difficulty receiving timely care. Pressure then shifts to hospital emergency departments and after-hours services.
Recruiting more GPs is important, but recruitment alone will not address the shortfalls of current primary care funding models. New Zealand must adequately fund those clinicians delivering primary care in a way that covers the breadth of their work. Clear career pathways in clinical leadership, teaching, supervision and practice ownership can support specialist GPs to maintain long-term careers in the communities they serve.
General practices also carry the costs of employing staff, maintaining premises and infrastructure, supporting training and sustaining services for their communities. Underinvestment can make practices financially fragile, particularly in rural and underserved communities where recruitment is already difficult and loss of local services can deepen inequities in access and continuity. Funding should support sustainable, culturally responsive models of care that reflect community need. If a practice reduces services or becomes unviable, patients lose access and continuity while demand moves to more expensive parts of the health system such as the hospital Emergency Department.
Policies intended to give more people access to care cannot succeed if general practice does not have the funded workforce capacity to deliver them. Training, teaching, clinical governance, patient follow-up and non-contact clinical time must be treated, and funded, as core components of care, rather than assuming this work will simply be absorbed into existing primary care workloads.
Properly funding this work will give specialist GPs more time for patients, support workforce retention and enable practices to plan for future demand. It can also support culturally safe care, Māori health equity, specialist GP clinical leadership and sustainable rural services. For the people of Aotearoa New Zealand, the benefit is straightforward: safer follow-up, better and more equitable access and more consistent care from a general practice team that can remain in the heart of their community.
This paper is part of a series of advocacy White Papers that set out our priorities for strengthening Aotearoa New Zealand’s health system through a sustainable general practice workforce. These papers will be released in the lead-up to the 2026 general election and outline the evidence, value and investment required to ensure the specialisms of general practice and rural hospital medicine can continue to deliver accessible, equitable care for all New Zealanders. Keep informed of our Budget and election advocacy on our website.