The big issues of 2025:
Of course, a quick triage confirms (again) that the fundamental issue of funding, related workforce shortages, and compounding needs require immediate action to simply ensure people can access care and GP doors stay open.
The funding gap: with rising costs fast outpacing government funding, and a still-broken funding model, many practices are being left with little choice: raise their fees, reduce their services, or close their doors. Individual patient affordability and access is a key concern, as are the much larger future costs to the system from deferred care.
Workforce shortages: Even with a shot in the arm of more nurses and doctors or plans for expanded training capacity, funding and the realities of time mean healthcare will continue to suffer from too few workers in the short to medium term.
Ageing populations: An increasing number of elderly patients and a greater prevalence of chronic conditions present growing challenges for primary care. Our ageing population requires better prevention strategies, earlier detection, and more patient education, as well as added capacity for GPs who need to help manage multiple conditions and medications, coordinate with specialists, and support end-of-life care.
Emerging health issues for our younger New Zealanders, such as vaping, also need greater focus.
Outbreaks: We’re on borrowed time for the next big outbreak. We’ve already entered the new year with whooping cough, and it’s only a matter of time before measles rears its head again. Increasing vaccination rates is key. This isn’t about fear-mongering, but a reminder to ensure we are prepared and resilient.
Climate change the next healthcare crisis: Our practices have seen some of the impacts of climate change first-hand through the destruction of the Auckland Anniversary floods and Cyclone Gabrielle. The toll on physical and psychological health can be immense – people being displaced from their homes, basic amenities being interrupted, and the subsequent rise in mental health issues including anxiety, stress and PTSD.
At first read, this is an overwhelming list of negatives, but there is significant scope in how we address these problems, and even make them opportunities.
Fixing the fundamentals such as funding and workforce is essential, but we can also meet these challenges with optimism, seeking emerging solutions that will help craft the future of Aotearoa’s primary healthcare sector in the process.
Collaboration: Practices are moving swiftly to ensure everyone in their team is working to the top of their scope, working with nearby clinics, and adding capability through roles such as nurse practitioners, health coaches and more. Primary healthcare organisations such as ProCare are also finding ways to support more professionals through training to become GPs and primary care nurses.
Outcomes, equity and prevention: With Health NZ introducing public reporting of key primary healthcare measures and performance just before Christmas, there will be increased pressure to show how we are helping achieve positive and equitable health outcomes for patient populations. It’s an approach we welcome alongside a shift towards more proactive and preventive care, investing in processes and responses to potentially stop life-threatening and costly conditions before they start.
Digital health: Phone and online healthcare continue to transform how primary care is delivered. In addition to the mahi our GPs undertake in this space on a daily basis, our CareHQ team is seeing more than 50,000 patients each year. Ensuring equitable access to technology and addressing digital literacy gaps will be key.
In a world that’s increasingly connected, real-time monitoring of patients, especially those with chronic conditions, could also drastically reduce hospital visits. In fact, wearable technologies are expected to reduce 16% of hospital costs by 2027, and by 2037, it could save $200 billion with its remote patient monitoring devicesi.
ArtificiaI Intelligence: The rise of AI-powered tools offers huge opportunities in primary care, from early diagnosis, treatment planning, and workflow optimisation. AI-driven tools are already helping with administrative tasks in practices across the country, and will only continue to enhance efficiency and patient outcomes. Of course, it is essential that systems are ethically designed and deployed, but the long-term benefits will far outweigh the costs if done properly.
In the years ahead, the only constant will be change, and it can’t come quickly enough.
Bindi Norwell is the group chief executive at ProCare. She is chairwoman of Fresh Minds and a board member of Care HQ. Previous board roles have included the EMA, deputy chair of the Auckland branch of the Institute of Directors, Marketing Association, Whakarongorau Aotearoa, and The Warehouse Group.
