This term, issue by issue · Health
Health: National and Labour lead with costed plans; nobody says how to fund demand from an older population
National and Labour build modestly on the 2050 position: earlier detection and cheaper primary care can slow costly hospital demand, and both are costed.
What is at stake now and by 2050
This term
Emergency departments are crowded, GP clinics are closing their books and many people put off care because of cost. Staff shortages, waits for diagnosis and the price of a GP visit or a prescription are what voters feel this term.
Number to know
74.4% of emergency department patients were admitted, discharged or transferred within six hours in the quarter to March 2026, against a 95% target.
By 2050
An older population means health demand grows faster than the economy, so health takes a rising share of every tax dollar. On Treasury's unchanged-policy projections, health spending rises from about 6.9% of GDP to about 9.4% by 2050, which squeezes everything else unless taxes rise or care gets cheaper to deliver.
Number to know
Health spending about 6.9% of GDP now, about 9.4% by 2050 on Treasury's unchanged-policy projections.
Source: Treasury, He Tirohanga Mokopuna 2025 (Long-term Fiscal Statement)
Current settings
Health NZ is funded on Treasury's cost-pressure track (PREFU 2026), with a $5 prescription charge, GP fees set by practices and a 95% six-hour emergency department target that is not being met. Pharmac funding was lifted in recent Budgets; the Māori Health Authority was abolished in 2024.
The options on the table
| Option | Backed by |
|---|---|
| Free or cheaper primary care (GP visits, prescriptions, dental) |
|
| More money for medicines through Pharmac |
|
| Earlier detection: wider cancer screening |
|
| Let pharmacists treat more conditions |
|
| Prevention: tobacco, alcohol and diet |
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| Lock in a long-term funding path (share of GDP, ten-year plan) |
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| Māori-led health authority |
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| Treat drug use as a health issue, not a crime |
|
Where each party stands
Voter priorities out of 15 (the four core tests plus relief this term) and Readiness to 2050 out of 21 (the four core tests plus the three long-run tests). Current settings come first, as the bar to beat. Open a party for every test score, the rationale and the sources.
Current settings
- Voter priorities
- 7/15
- Readiness to 2050
- 10/21
Test scores, rationale and sources for Current settings
Test Score /3 Counts towards Diagnosis 1 Both scores Mechanism 1 Both scores Funding 2 Both scores Delivery 2 Both scores Relief 1 Voter priorities Future effect 1 Readiness to 2050 Durability 2 Readiness to 2050 Candour 1 Readiness to 2050 Rationale
Funds Health NZ on Treasury's cost-pressure track in Budget 2026, so the money and the agency exist, but the settings treat demand rather than its drivers and the six-hour ED target sits at 74.4% against 95%. No stated answer to age-driven cost growth.
Relief this term
Health NZ is funded on Treasury's cost-pressure track and the six-hour ED target stays at 95% while performance sits at 74.4%; current settings hold services rather than shorten waits or cut costs.
Sources
National
- Voter priorities
- 11/15
- Readiness to 2050
- 15/21
Fund Treasury's cost pressures and add targeted money for medicines and cancer screening.
- Health cost pressures funded on Treasury's track ($14.6b over four years)
- Pharmac budget up $604m over four years, paid for by a 10% cut to non-Pacific aid
- Bowel screening from age 50 by 2029 ($178m); free cervical screening 25 to 69 from March 2027; breast screening to 74
- Target of 5% of cancer patients treated in clinical trials within ten years; $8.5m for rural health workforce
Test scores, rationale and sources for National
Test Score /3 Counts towards Diagnosis 2 Both scores Mechanism 2 Both scores Funding 2 Both scores Delivery 3 Both scores Relief 2 Voter priorities Future effect 2 Readiness to 2050 Durability 2 Readiness to 2050 Candour 2 Readiness to 2050 Rationale
Costed in its fiscal plan: cost pressures ($14.6b), Pharmac $604m and bowel screening ($178m, Erasmus modelling) with dated targets. Names who pays for Pharmac (non-Pacific aid). Screening and earlier care are a modest build; cervical screening is also Labour policy, but the plan does not explain how health taking 61% of the allowance squeezes other pressures, so Candour is 2 not 3.
Relief this term
Free cervical screening for 25 to 69 from March 2027, Pharmac up $604m over four years for more medicines, and bowel screening from 50 by 2029; little that shortens ED or GP waits.
Sources
Labour
- Voter priorities
- 10/15
- Readiness to 2050
- 14/21
Free primary care for everyone, paid for by a capital gains tax on investment property.
- Three free GP visits a year through a Medicard from July 2028 ($393m rising to about $553m a year)
- Remove the $5 prescription charge ($74.5m a year); free referred maternity scans
- Job guarantee for about 2,400 NZ-trained graduate nurses and doubled recruitment subsidies ($525m)
- $4 an hour pay rise for 65,000 care and support workers from 2027
Test scores, rationale and sources for Labour
Test Score /3 Counts towards Diagnosis 2 Both scores Mechanism 2 Both scores Funding 2 Both scores Delivery 2 Both scores Relief 2 Voter priorities Future effect 2 Readiness to 2050 Durability 2 Readiness to 2050 Candour 2 Readiness to 2050 Rationale
Names cost as the barrier to primary care with evidence (155,000 people not collecting prescriptions) and funds free GP visits, prescriptions and nurse jobs in a fiscal plan reviewed by a firm Labour commissioned, so Funding is 2. Medicard vehicle and a July 2028 start; names property investors as payers through the capital gains tax. Free primary care is backed by the Greens and Te Pāti Māori, but its funding depends on a tax National would not keep.
Relief this term
Three free GP or nurse visits a year for everyone enrolled from July 2028 ($393m a year), removal of the $5 prescription charge and a graduate nurse job guarantee give dated, costed relief on the cost of care; no modelled effect on ED or GP waits, and the start leaves about 15 months before the election.
Sources
Greens
- Voter priorities
- 6/15
- Readiness to 2050
- 8/21
Work towards free primary and dental care, with more for mental health and a health-based approach to drugs.
- Work towards free public primary healthcare and dental care (uncosted)
- Fund pay equity for about 65,000 care workers ($1.1b a year) and set safe staffing levels
- Extend free mental health care to all communities; implement every suicide prevention recommendation
- Repeal and replace the Misuse of Drugs Act; regulate cannabis for personal use
Test scores, rationale and sources for Greens
Test Score /3 Counts towards Diagnosis 2 Both scores Mechanism 1 Both scores Funding 1 Both scores Delivery 1 Both scores Relief 1 Voter priorities Future effect 1 Readiness to 2050 Durability 1 Readiness to 2050 Candour 1 Readiness to 2050 Rationale
Names under-investment and cost barriers as drivers, but the core promise is to 'work towards' free GP and dental care with no cost or timeline; only care worker pay equity ($1.1b a year) sits in the party's costed table. Delivery is intent only.
Relief this term
The core promise is to 'work towards' free GP and dental care with no date or cost; care worker pay equity and safe staffing help the workforce but give no dated access gain for patients.
Sources
ACT
- Voter priorities
- 8/15
- Readiness to 2050
- 11/21
More medicines, more pharmacist care and a cancer centre, within a tight overall spending allowance.
- Lift Pharmac from 4.9% to over 10% of the health budget by 2033 (party estimate over $4b over seven years)
- About $2b capital contingency for two cancer centres built through public-private partnership
- Pharmacists treat more conditions; ease pharmacy ownership and location rules
- $400m over four years to raise GP pay and appointments
Test scores, rationale and sources for ACT
Test Score /3 Counts towards Diagnosis 2 Both scores Mechanism 2 Both scores Funding 1 Both scores Delivery 2 Both scores Relief 1 Voter priorities Future effect 1 Readiness to 2050 Durability 2 Readiness to 2050 Candour 1 Readiness to 2050 Rationale
Names the medicines gap with Australia and GP retirement data, and sets a measurable Pharmac target (over 10% of the health budget by 2033). The cancer centre contingency is in its fiscal plan, but the medicines and GP promises sit outside the costed table, and every health cost pressure must fit a $2b allowance, so Funding is 1 and Future effect 1. National also lifts Pharmac, giving partner support.
Relief this term
$400m over four years to raise GP pay and appointments and wider pharmacist prescribing would add access points, but neither has a start date and the GP money sits outside ACT's costed fiscal table; the Pharmac target runs to 2033 and the cancer centres land later.
Sources
NZ First
- Voter priorities
- 5/15
- Readiness to 2050
- 7/21
Shift health spending towards prevention, built around nutrition.
- Health coaches in general practice
- Independent review of dietary guidelines; nutrition taught from primary school to medical school
- Fund research on nutrient-based treatments, including intravenous vitamin C trials
- Cut regulatory burden on GPs and allow 'greater diversity of medical viewpoints' in professional standards
Test scores, rationale and sources for NZ First
Test Score /3 Counts towards Diagnosis 2 Both scores Mechanism 1 Both scores Funding 0 Both scores Delivery 1 Both scores Relief 1 Voter priorities Future effect 1 Readiness to 2050 Durability 1 Readiness to 2050 Candour 1 Readiness to 2050 Rationale
Names a driver (59% of spending on chronic illness, 1.75% on prevention), but the mechanism rests on health coaches, dietary review and intravenous vitamin C trials with no evidence path, no cost and no timeline. No trade-offs named.
Relief this term
Health coaches in general practice are the only service change; the dietary review and vitamin C research are reviews and research with no date.
Sources
Te Pāti Māori
- Voter priorities
- 6/15
- Readiness to 2050
- 7/21
Rebuild a Māori-led health authority and move the system towards prevention.
- Re-establish Te Aka Whai Ora, the Māori Health Authority
- Free primary healthcare and free dental care (uncosted)
- $500m a year for kaupapa Māori mental health and $1b a year for the health workforce, not in its tax package
- Make services accessible, culturally safe and accountable to Māori
Test scores, rationale and sources for Te Pāti Māori
Test Score /3 Counts towards Diagnosis 2 Both scores Mechanism 1 Both scores Funding 1 Both scores Delivery 1 Both scores Relief 1 Voter priorities Future effect 1 Readiness to 2050 Durability 0 Readiness to 2050 Candour 1 Readiness to 2050 Rationale
Names a driver (a system not accountable to Māori) and proposes re-creating the Māori Health Authority, but gives no evidence or timeline on its own pages. The $1.5b a year figure comes from party papers this report relied on and could not be re-verified; free GP and dental care carry no cost. The authority was abolished in 2024, so it is likely to be reversed again.
Relief this term
Re-creating the Māori Health Authority is a structural change, and free primary and dental care and the $1.5b a year for mental health and workforce carry no date.
Sources
Opportunity
- Voter priorities
- 8/15
- Readiness to 2050
- 11/21
A ten-year cross-party health plan with funding set as a share of GDP.
- Lift health funding from 7.4% to 9% of GDP over ten years (party-costed at about $1.3b a year)
- Raise primary care from 5.7% to 10% of Health NZ spending
- Renewed Smokefree programme, denicotinised tobacco, tougher rules on alcohol and unhealthy food
- Decriminalise drug possession (not supply) with a health-led response
Test scores, rationale and sources for Opportunity
Test Score /3 Counts towards Diagnosis 3 Both scores Mechanism 2 Both scores Funding 1 Both scores Delivery 1 Both scores Relief 1 Voter priorities Future effect 1 Readiness to 2050 Durability 2 Readiness to 2050 Candour 1 Readiness to 2050 Rationale
Strongest diagnosis: links instability and low prevention spending to health loss (tobacco, alcohol and diet cause about a quarter of healthy years lost) and sets measurable targets (9% of GDP, primary care to 10%). The $1.3b a year is costed but sits outside its balanced tax package, and the ten-year plan needs other parties to agree; it is a coalition bottom line.
Relief this term
Health funding rises from 7.4% to 9% of GDP over ten years and primary care's share rises gradually, so most of the effect lands after 2029.
Sources
Place yourself
Agreeing sometimes means change and sometimes keeping current settings. Take the quiz to compare across every issue.
| Statement | National | Labour | Greens | ACT | NZ First | Te Pāti Māori | Opportunity |
|---|---|---|---|---|---|---|---|
| Health above forecast. Health spending should grow faster than Treasury forecasts. | Mixed | Agrees | Agrees | Mixed | No stated position | Agrees | Agrees |
| Free GP visits. Everyone should get three free GP visits a year. | No stated position | Agrees | Agrees | No stated position | No stated position | Agrees | No stated position |
| Pharmac share. Pharmac's budget should rise to over 10% of health spending by 2033. | Mixed | No stated position | Mixed | Agrees | No stated position | No stated position | No stated position |
| Drug possession offence. Possessing drugs for personal use should remain a criminal offence. | No stated position | No stated position | Disagrees | No stated position | No stated position | No stated position | Disagrees |
✓ Agrees, ○ Mixed, ✗ Disagrees, · No stated position. Silence is a finding.
Why each statement matters
Health above forecast Health spending should grow faster than Treasury forecasts.
- What it means
- Health NZ is now funded on Treasury's track of rising costs. Agreeing means spending above that track; disagreeing means staying on it.
- The case for
- Crowded emergency departments and GPs closing their books show the current track does not meet demand.
- The case against
- Extra spending needs higher taxes, cuts elsewhere or more debt, while health costs already outgrow the economy.
- The trade-off
- Better care now versus health taking more than its forecast rise from 6.9% to 9.4% of GDP by 2050.
Free GP visits Everyone should get three free GP visits a year.
- What it means
- Each practice sets its own GP fees now, and many people put off care because of cost. This would give everyone three free GP visits a year (one costing: $393m a year, rising to $553m).
- The case for
- Seeing a GP early is cheaper than treating problems later in hospital.
- The case against
- The money could go to staff, medicines or screening; free visits do not add GPs.
- The trade-off
- Cheaper access for all versus other health priorities as demand climbs.
Pharmac share Pharmac's budget should rise to over 10% of health spending by 2033.
- What it means
- Pharmac is the agency that decides which medicines the public health system pays for. Its budget is about 4.9% of health spending now; this would lift it to over 10% by 2033.
- The case for
- More funding would close the gap with Australia on access to modern medicines.
- The case against
- Doubling the medicines share leaves less for hospitals, staff and GPs unless total spending grows.
- The trade-off
- More funded medicines versus other services competing for the same budget.
Drug possession offence Possessing drugs for personal use should remain a criminal offence.
- What it means
- Possessing drugs for personal use is a crime under the Misuse of Drugs Act now. Agreeing keeps that; disagreeing treats personal use as a health issue instead.
- The case for
- A clear criminal penalty deters drug use and gives police a tool against harm in communities.
- The case against
- A criminal record damages jobs and lives, while a health response gets more people into treatment.
- The trade-off
- Deterrence through criminal penalties versus treatment through the health system.
The 2050 test
National and Labour build modestly on the 2050 position: earlier detection and cheaper primary care can slow costly hospital demand, and both are costed. Opportunity names the long-run problem most clearly, but its 9% of GDP target adds cost that its own tax package does not cover, and ACT's medicines push sits beside an allowance that does not fund demand growth. No party says how a health budget heading for about 9.4% of GDP will be paid for, or which care will be rationed if it is not.
| Party | Effect to 2050 | The policy that drives it | Would it last? |
|---|---|---|---|
| National | Builds | Funded cost pressures plus earlier cancer detection. Screening finds cancers when treatment is cheaper and more successful, inside a costed plan that keeps debt below 40% of GDP. Source | Partly |
| Labour | Builds | Free GP visits and prescriptions funded by a capital gains tax. Earlier primary care can reduce avoidable hospital use, and a new tax base pays for it rather than borrowing. Source | Partly |
| Greens | Neutral | Work towards free primary and dental care. Prevention intent is sound but the main promises are uncosted, so the net fiscal effect is unclear. Source | No |
| ACT | Neutral | Pharmac to over 10% of the health budget inside a $2b total allowance. Better medicines access can cut hospital costs, but holding all cost pressures to $2b leaves demand growth unfunded. Source | Partly |
| NZ First | Neutral | Nutrition-led prevention. Targets chronic disease, but with no cost, scale or evidence path the fiscal effect is unclear. Source | No |
| Te Pāti Māori | Neutral | Re-created Māori Health Authority and prevention focus. Could lift Māori health outcomes, but uncosted free GP and dental care and a likely reversal leave the long-run effect unclear. Source | No |
| Opportunity | Neutral | Health funding to 9% of GDP with a shift to prevention and primary care. Prevention and stable planning help, but the extra $1.3b a year sits outside its funded tax package, so it adds to the gap as much as it eases it. Source | Partly |
All sources for this grouping are listed on the sources page.