What is general practice and the health service like in New Zealand?

With a number of GPs struggling to find enough work in the UK, many are considering working abroad, with New Zealand high on the list. It is also an attractive destination for those in work too. In the first part of a five-part series based on a new guide by Pulse, Rachel Carter provides an overview of the health system in New Zealand

Similar to the UK’s NHS, the health system of Aotearoa New Zealand (the Māori-language name for New Zealand) was founded on the principle of equitable access for all, regardless of ability to pay. It is primarily funded through general taxation and provides universal health coverage to the population. Core public hospital services, including inpatient and outpatient, maternity and mental health care, are all free to patients.

One significant difference is that patients aged 14 and over are required to pay a co-payment for GP visits at the point of care, and for many of the services provided by nurses within GP practices. The Government has generally not set limits on the fees GPs can charge, but co-payments can be capped at lower levels, often around NZ$20, for eligible populations.

Around a third of New Zealanders also have some form of private insurance, which is mostly used to cover cost-sharing requirements, elective surgery in private hospitals, and private outpatient specialist consultations. Most private health insurance is sold on an individual basis.

The Government sets an annual health budget, which is managed and distributed by Health New Zealand, or ‘Te Whatu Ora’, which means ‘the weaving together of wellness’ in te reo Māori, the language of the country’s indigenous Māori population. The body was established in July 2022 as a Crown Agent, meaning it must implement government health policy.

Health New Zealand contracts 30 Primary Health Organisations (PHOs), which are mostly not-for-profit networks of practices, to provide primary care services within geographical areas. PHOs distribute population-based funding and provide support programs for general practice.

Reducing health inequities experienced by Māori and Pacific Peoples is central to the country’s health policy. Te Tiriti o Waitangi (the Treaty of Waitangi) is the founding document of New Zealand, signed in 1840, and places a responsibility on the Government to protect Māori health, improve equity, and enhance long-term outcomes. Separately, the Government published its first-ever legislated Pacific Health Strategy in 2023, Te Mana Ola, which sets out the long-term priorities for improving health outcomes for Pacific communities over a 10-year period.

General practice in New Zealand

General practice in New Zealand offers a variety of opportunities for UK GPs depending on the type of practice you would like to work in, the location, and population you choose to serve.

‘One of the things we talk to doctors about early on is that the system will feel familiar in many ways, but the context is different,’ says Moana Bywater, director of recruitment consultants Good Together, who are supporting this guide. ‘Understanding that context is key to feeling confident and settled in practice.’

Just like in the UK, GPs are the front door to the health service and the day-to-day tasks of diagnosing, treating and referring patients to specialists are the same. However, the scope of practice is broader in New Zealand. This can include minor surgery, such as skin cancer excisions, low-risk fracture management, joint injections and ADHD prescribing for adults.

Continuity of care is the core component of general practice in New Zealand. The standard appointment length is 15 minutes, and most practices operate with a named GP model, where patients are enrolled with a ‘usual GP’ at their practice. ‘That relationship-based model of being able to look after patients over a long period of time, which a lot of us got into general practice for in the first place, is still very much findable out here,’ says Dr Luke Bradford, president of the Royal New Zealand College of GPs (RNZCGP), who moved over from the UK in 2010.

GPs refer directly to specialists in the public and private systems. ‘The public system is quick enough for cancer and children, but non-urgent cases can be fairly delayed,’ Dr Bradford says. They can also make referrals via the Accident Compensation Corporation (ACC), the country’s ‘no fault’ personal injury scheme, with many orthopaedic cases going through this route.

Practices are typically privately owned by either individual GPs or corporates. There are also some Iwi-owned (tribe-owned) practices and Kaupapa Māori clinics, which are led by the Māori community and deliver wraparound primary care including GP consultations. Most GPs are employed in salaried roles or work as independent contractors on a self-employed basis. Home visits are markedly less common in New Zealand, Dr Bradford says, and are usually used for palliative care.

Specialist areas of practice

For doctors with specific professional interests, there are opportunities to specialise. Some common areas include skin cancer medicine, women’s health, and rural medicine. GPs are in particularly high demand in rural areas, and this work often involves a broader scope, greater autonomy and responsibility, and a closer connection with the local community. There are 25 rural hospitals in New Zealand, 14 in the North Island and 11 in the South Island, according to Health New Zealand.

Urgent care, which sits between general practice and hospital emergency departments, is also a specialty in its own right in New Zealand, with a separate medical college and fellowship. Many GPs choose to work in this area, and it often appeals to those with an interest in emergency medicine. Separately, practices in rural towns offer after-hours services, however this is no longer a contractual obligation for all practices across the country.

Key health and social challenges

It is important to understand that general practice in New Zealand sits within the broader context of some complex health and social challenges. The country has high rates of psychological distress among young people and GPs may encounter a significant burden of mental health presentations, including suicide risk and crisis care. Issues such as family violence and substance misuse are also common and can have a profound impact on patients’ lives.

New Zealand also has well-recognised health inequities, particularly for Māori and Pacific communities. Māori and Pacific peoples experience a higher burden of chronic disease, earlier onset of illness, and, in some areas, reduced access to care compared to other population groups. Addressing these inequities is a priority across the health system.

For GPs, this means developing an understanding of the wider social and cultural context of health in New Zealand, alongside a commitment to culturally safe and equitable care. While this can be a new and sometimes challenging aspect of practice for international doctors, many find it to be one of the most meaningful and rewarding parts of working in New Zealand.

Working conditions and job satisfaction

The outdoors lifestyle New Zealand offers is frequently cited by UK GPs as a major factor in why they relocated and has led to improvements in job satisfaction and quality of life. GPs in New Zealand typically work a 34-hour week on average, while 30% work less than 30 hours a week. Some practices also offer flexibility around the hours you work.

New Zealand GPs do report similar levels of burnout to their UK counterparts. Over a third (38%) of New Zealand GPs responding to a 2025 Commonwealth Fund survey said they were experiencing burnout, compared with 34% of UK GPs. Dissatisfaction with time spent on administrative work was also high among GPs in both countries, at 92% and 89% respectively.

However, the survey showed GPs in New Zealand were much less likely to associate burnout with having too little time to spend with their patients. Only 6% reported this, compared with 54% in the UK. ‘Most GPs come out here and can’t get over the luxury of seemingly spending at least twice as long with patients as they were used to in the UK,’ Dr Buzz Burrell, chair of the GP advocacy organisation, General Practitioners Aotearoa, says.

Dr Burrell says that the ‘user pays’ model is often the biggest culture shock for UK GPs, but many doctors quickly adapt: ‘I think quite a lot of people enjoy it and genuinely feel valued by it.’

The existence of the Accident Compensation Corporation in New Zealand’s medicolegal environment means that patients cannot sue their doctors for personal injury caused by medical error. This makes it ‘much easier to breathe’, Dr Burrell says.

Considering New Zealand is famous for its outdoor living, this applies both metaphorically and literally.

The next part of the series will focus on what UK GPs who have made the move say about New Zealand. You can download the full report here.