36% of general practices had 'closed books' and did not take new enrolments in 2024
Districts in the lower North Island, Northland, and parts of the South Island were the most affected
A key driver is workforce shortages
About 94% of the population is enrolled at a general practice
More general practices are closing their books, with over a third of New Zealand's GPs turning away new patients last year.
A Victoria University of Wellington study has found 36% of general practices were not taking new enrolments in 2024, with districts in the lower North Island, Northland, and parts of the South Island most affected.
The figure is a three percentage point increase from 2022, when Covid-19 was inflating demand for appointments and border closures kept overseas healthcare workers out.
One of the study's authors, Dr Jackie Cumming, said workforce shortages were a major reason GPs were turning people away.
"Many GPs, for example, are coming up to retirement age. It's been difficult to recruit in rural areas, it can be hard to recruit into general practices because there's pay inequities between hospital care and community-based care."
Meanwhile, the funding model for general practices had not changed significantly in two decades, Cumming said.
Gore waitlist since October
Enrolment problems were magnified in certain areas - the Canterbury, Southern and Northland regions had the highest number of closed books, but the Hutt Valley, Lakes and Wairarapa districts were most affected when looking proportionally at how many practices operated in each region.
Gore Health Centre has been running a waitlist since October, when one of its doctors resigned. Practice manager Christine Miller said when a spot did become available, the clinic only took on people who were not enrolled anywhere else in the region.
"We are not enrolling people in the Southland district who currently have a general practitioner," she said.
"Even if they're living [in Gore] or they've moved to Gore and they still have a doctor in Invercargill we just politely ask them if they could just stay with their GP ... basically it's until we can get another doctor."
The clinic's doctors each cared for as many as 1500 patients, Miller said, and taking on more could lead to burnout.
However, convincing doctors to move to the regions could be challenging.
"I mean Gore's always had a bad rap you know, it's like 'Oh, who wants to live in Gore' type thing," she said.
"I come from the Bay of Plenty which is, you know, a beautiful area but I've never been happier being here. There's great people, so much to do outside of work - and you've just got to get people to come here and experience that."
The Victoria University researchers warned unenrolled patients were at risk of falling through the cracks or relying on emergency departments.
Cumming said the government had been focusing on hospital services, but primary care desperately needed attention.
"The government urgently needs to improve the funding going into the sector, improving working conditions in general practices as well - so, for example, by making sure that there's pay equity with hospital staff," she said.
"We need to be making sure that we can recruit and retain staff working in primary healthcare as well."
Numbers important - Health NZ
Health New Zealand/Te Whatu Ora director living well Martin Hefford said the agency monitored monthly whether general practices had closed their books.
"With regard to general practice clinic closed books, we do see this as important ... our most recent data as of January 2025 is that 33.1 % of practices are closed to enrolment," he said.
"Health NZ's data shows that the health system, including general practice, continues to experience high rates of patient enrolment. We recognise that primary care is managing workforce and resourcing constraints, resulting in some being unable to enrol new patients. However, despite these pressures, enrolment has remained at around 94 % of the NZ estimated population.
"General practice and wider primary care are the cornerstones of our health system and provide vital care to their patients and communities. Growing the health workforce - particularly our general practice workforce - is a key priority for Health New Zealand | Te Whatu Ora (Health NZ).
"All New Zealanders must have access to these vital services."
