New Zealand’s primary healthcare system is facing mounting pressure from an ageing population, growing demand and persistent workforce shortages, with one of the country’s leading general practitioners warning that long-term reform is needed to ensure patients continue receiving timely, high-quality care.
Speaking with Radio Waatea’s Matthew Tukaki, Dr Bryan Betty, a specialist GP with more than 35 years of experience, said general practice remains the foundation of New Zealand’s health system but is under increasing strain as patient needs become more complex.
Dr Betty’s career has spanned frontline general practice, Pharmac, the Royal New Zealand College of General Practitioners, GPNZ and the Government’s COVID-19 response. He is also preparing to join the Health New Zealand Board, bringing decades of experience in clinical leadership and health policy.
The discussion explored several major challenges facing healthcare, including the potential funding of new weight-loss medicines, advances in medical technology and the future sustainability of primary care.
Dr Betty said New Zealand’s population is living longer and experiencing more chronic and complex health conditions than ever before. General practices are managing increasing numbers of patients with diabetes, cardiovascular disease, cancer, mental health conditions and multiple long-term illnesses, placing significant pressure on already stretched services.
At the same time, many communities continue to struggle with GP shortages, particularly in rural areas and regions serving high-needs populations. Workforce recruitment and retention remain major concerns, with practices reporting increasing difficulty attracting doctors, nurses and other primary healthcare professionals.
Dr Betty believes one of the biggest challenges is the continued separation between hospital services and community-based healthcare.
He argues patients experience the health system as one journey, yet primary care and hospitals are often funded, planned and managed separately. Better integration between the two would improve communication, reduce unnecessary delays and provide smoother transitions for patients moving between general practice, specialist care and hospital treatment.
Strengthening multidisciplinary models of care is also seen as critical to the future of healthcare.
Dr Betty says modern general practice increasingly relies on teams that include nurses, pharmacists, nurse practitioners, physiotherapists, health coaches and other allied health professionals working alongside GPs. Expanding these collaborative approaches could improve access while allowing patients to receive the right care from the right professional at the right time.
For Māori and Pacific communities, culturally responsive primary healthcare remains a key priority.
Māori continue to experience significant inequities across many health indicators, including lower life expectancy, higher rates of chronic disease and barriers to accessing timely healthcare. Dr Betty says improving health outcomes will require greater investment in community-based services that are designed around the needs of whānau and delivered in partnership with Māori providers.
The conversation also examined advances in medical technology, including emerging weight-loss medicines that are changing the treatment of obesity and related conditions internationally.
While these therapies are showing promising results, Dr Betty says any future funding decisions will need to balance clinical effectiveness, affordability and equity, ensuring access is guided by evidence and patient need.
As he prepares to take up his new governance role at Health New Zealand, Dr Betty says success should be measured by whether patients can access care earlier, whether health inequities are narrowing and whether general practice remains sustainable for future generations.
With demand for healthcare continuing to grow, he believes strengthening primary care is one of the most important investments New Zealand can make to improve health outcomes while reducing pressure on hospitals.
For Dr Betty, the future lies in a health system that is connected, collaborative and centred on patients and whānau—one where strong primary care forms the cornerstone of healthier communities across Aotearoa.
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