Budget 2025 offers limited relief for primary care

Justin Butcher, Chief Executive, Pinnacle 

Following the pre-Budget announcement on rural and after-hours care, and the plethora of wide ranging workforce initiatives announced several months ago, Budget 2025 has fallen somewhat short for primary care. While we hoped for more, this year’s ‘fiscally restrained’ budget, is aptly named.

The Budget announcements today include some additional funding to account for population growth and acknowledge the flow-on costs of policy changes, for example, enabling some patients to collect 12 months of prescriptions rather than three. There’s also recognition that, as police withdraw from responding to mental health-related 111 calls, investment will be needed to build a viable alternative system.

There is welcome investment in rural and after-hours care, as outlined in the pre-Budget announcement, and funding to support transitions from hospital to aged residential care. Earlier announcements referenced again today include 25 additional medical students shared between Otago and Auckland, the opportunity for 50 New Zealand medical graduates to spend an extra 8 months in primary care during training along with up to 100 international medical graduates new to NZ, and funding for new graduate nurses and nurse practitioners.

These are all positive initiatives, but at this scale, they will have limited impact on bringing more people into the primary care workforce.

We remain concerned about the impact today’s announcements will have on patient co-payments in general practice. It does feel like the writing is on the wall and that we will see a similar situation to last year – where patients bear the burden of underinvestment and practices feel morally conflicted. However, we welcome the investment in extended prescriptions as it lessens the financial burden on those who suffer some of the greatest inequities, and while there are practicalities which need to be worked through, and only a minority of patients will be suitable, it will make a difference to those with long term conditions, and their whānau.

There’s no specific reference to the long-anticipated third medical school in Waikato, but we remain hopeful there will be progress and are committed to ongoing advocacy for its development. Investment in health infrastructure, particularly hospitals is a bitter pill to swallow – if it’s been at the expense of further investment in primary care. 

While today hasn’t delivered what we hoped for, or desperately need, general practice and primary care must keep pushing forward, together. Burgeoning workloads, a strained workforce, and ongoing underfunding must be addressed, and while it appears incremental investment is what’s on the table currently, all eyes are firmly fixed on what might come next year and the intervening time. Here’s hoping it’s less ‘fiscally restrained’ and offers further, overdue investment.