NZ’s health system suffers from chronic ailments only cross-party consensus can treat

With news of hospitals unable to provide safe care, workforce shortages and difficulties in accessing services, health is again a major voter concern leading up to next month’s general election.

Last month, Treasury’s Pre-election Economic and Fiscal Update (PREFU) highlighted rising health costs as a significant fiscal risk, and both major parties are promising to invest billions to maintain existing baseline services.

But neither party has a credible plan for addressing the system’s underlying problems caused by chronic underfunding and inadequate long-term planning.

The current government inherited a health system under pressure. Since then, concerns about access to services and the capacity to provide them have persisted.

To address these underlying issues, all political parties, ideally led by Labour and National, will need to build a long-term, consensus-based, cross-party plan.

Read more: Election Policy Tracker: your guide to what the parties are promising during the 2026 election campaign

What changed since the last election

In 2024, the government announced health targets to deliver faster access to cancer treatment, improve childhood immunisation rates, shorten stays in emergency departments and cut wait times for first specialist assessments and elective treatment by 2030. So far, it has failed to deliver.

Underfunding and a lack of long-term planning have made it particularly challenging to achieve shorter stays in emergency departments and faster access to first specialist assessments and elective services, falling between 19-29% short of the respective targets.

At the same time, political attention has increasingly shifted from health system structure to performance.

Since wider reforms in 2022, the overall health debate has shifted from the creation of Health New Zealand, intended to support coordinated national services and reduce bureaucracy, to whether patients can obtain timely care.

In the process, medical professionals have taken industrial action over pay demands, and have hit back at the implication they should improve service access and delivery without additional resourcing.

Meanwhile, the government has moved to bolstering the private sector through long-term contracting for publicly-funded elective procedures, such as opthalmology and orthopedics.

This essentially tilts the balance away from the public health system, without an overarching plan for how the public sector will be maintained.

Growing evidence of unmet healthcare needs has also sharpened the debate. Research highlights the rising percentage of patients assessed as needing specialist treatment but not able to get it because health services lack capacity.

The study shows regional disparities, with some areas severely underserved. Widespread impacts on patients and their families include poorer health outcomes and higher costs from multiple visits to the doctor while waiting for specialist treatment.

In short, the national discussion has moved away from how the system is organised towards whether it is meeting its fundamental purpose: providing access to care.

Challenges for the next government

The parties’ pre-election policies, such as National’s plan to fund more medicines and Labour’s pledge to provide three free GP visits are important. But the next government inherits several challenges no single initiative can solve.

Workforce shortages are ubiquitous across professions and services, driving staff dissatisfaction and safety concerns. Without investment in long-term planning, patient access and adequate care will remain difficult regardless of how much money is spent.

New Zealand’s population is ageing, with a rise in chronic conditions. These trends will continue to drive demand and need a response.

Funding remains a perennial challenge. Health expenditure has grown steadily over many years, but mostly only meeting inflation. Costs and demand have grown faster.

A new government may need to reallocate budget priorities to favour health, or look at increasing taxes specifically to fund health needs. Neither of these options is easy.

Major questions focus on public versus private provision of health services. Some parties see a greater role for private hospitals and providers as a way of reducing public waiting lists. Others argue public resources should be focused on strengthening the public system itself.

Perhaps the most difficult challenge, however, is political. Many initiatives require a time horizon of ten years or more. Yet governments operate within three-year electoral cycles which encourages short-term solutions.

What voters should look for

The election campaign will feature many promises to improve the health system. Voters should ask several questions.

First, does a party have a credible workforce strategy? Any proposal to increase services depends on having enough doctors, nurses and allied health professionals to deliver them.

Second, do policies address causes or symptoms? Reducing waiting lists is important but waiting lists are a consequence of wider problems such as access to primary care, specialist services and workforce availability.

Third, is there a commitment to prevention? Future healthcare demand cannot be managed through hospitals alone. Policies to improve prevention and early intervention may not generate immediate political rewards but are crucial for long-term sustainability.

Finally, voters should look for evidence of cross-party thinking. The health system’s challenges did not emerge, nor can they be resolved, in a single parliamentary term.

Frequent changes in organisational structures and policy priorities have been a recurring feature of New Zealand health policy. While reform can be necessary, constant change distracts from improving services.

New Zealand most needs agreement on long-term objectives: improving access, reducing unmet need, building workforce capacity, strengthening primary care and addressing persistent inequities in health outcomes.

Political parties have always disagreed on how these goals should be achieved. But unless some kind of cross-party consensus is achieved, the health system and its users will continue to suffer.

From the cost of living to how best to tackle climate change, the coming election involves some big choices.

This article is part of The Conversation’s Election 2026 series: expert analysis of the major policy debates and the big challenges New Zealand’s next government will face.