Preventative Healthcare

Covid-19 has really handed it to us this year. If we didn’t appreciate how important it is to be a healthy nation before Covid-19, we certainly do now. TOP has always had an excellent health policy that emphasises sickness prevention, and this year we’ve updated it with a few things we know you feel are important too.

TOP will:

  • Strengthen public health
  • Tax sugar and junk food
  • Create an accessible fruit and veggie scheme
  • Make primary care affordable
  • Increase investment in mental health prevention
  • Improve access to dental care - free dental care for 1 in 5 Kiwis (needs based)
  • Investigate the best way to address period poverty
  • Reinstall the independent Public Health Commission

The Covid-19 pandemic has shown us and the world that an ounce of prevention is worth a pound of cure. To shore up our defences and prepare for the next one, public health experts have called for the reinstallation of the independent Public Health Commission - TOP will make this happen! This commission will also have other crucial functions, such as fighting our many local epidemics like rheumatic fever, measles and diabetes.

To support the Public Health Commission's work TOP will also target one of the biggest causes of health issues - unhealthy food. Even our most vulnerable children are asking the government to take a stand on unhealthy food to help support them and their families. TOP will tax sugar and other junk food. We would also include a ban on all junk food marketing to kids and ensure local communities have a greater say on the availability of junk food outlets in their area.

A 20% tax on all junk food would raise approximately $1 billion. TOP will reinvest the money to ensure improved access to:

  • Nutritious Food - Every community has access to an affordable, at cost fruit and veg box scheme. We will do this by expanding existing fruit and veg co-ops.
  • Primary Care - Boost funding of primary health care through introducing a risk-adjusted capitation model (much like we are doing for schools). This would ensure that the practices dealing with at-risk clients get more money to invest in prevention. The goal is to keep GP visits below $10 and make nurse or nutritionist visits free. Covid-19 has shown that primary care is foundational to our health system function.
  • Dental Care - Ensure free dental care for under 18s and introduce free dental care for our most deprived people (around 20% of the population).

Given that prevention and early intervention are four times more effective than paying for more operations, we need to shift our focus to these initiatives. We can’t keep relying on the ambulance at the bottom of the cliff - we must put a fence at the top.

As part of this TOP supports an increased investment in mental health prevention made by this government. However, we believe the best way to prevent mental health problems is by ensuring people have a strong identity and sense of belonging in communities. TOP would see greater funding of community groups as a way to reduce mental health problems. To fund this, TOP stands by our 2017 policy of increasing the excise on alcohol.

In pre-Covid-19 New Zealand, demands on our healthcare system were already outstripping capacity, and those demands are still set to climb.

Add to this:

  • An equity gap - Health outcomes are worse across population groups, especially for Māori and Pacific Peoples.
  • An ageing population - 1 in 5 New Zealanders will be aged 65+ by 2032.
  • Growing costs - Healthcare costs are predicted to increase by 40%, from 6c in every dollar to 10c by 2060.

NZ cannot afford this reality. Our government has a moral and financial responsibility to ensure this doesn’t happen. TOP will address this through a proactive, evidence-based, patient-focused healthcare system. The fact that the system is not like this now is unacceptable to us.

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Page last updated on 2-Oct 2020


When it comes to obesity and diabetes, studies show that exercise is about 20% of the problem. Diet is more like 80%. In fact most people offset exercise with 'treat' food so it ends up having zero benefit for our waistlines. 
You can read more on this issue here.

Our health system bears the costs when poor diet makes us unwell, so the taxpayer has skin in this game. Charging extra on unhealthy food can help pay for those costs, and offering rebates on healthy food makes it easier for people to make healthy eating choices. It's good for our health, as well as our national health budget.

That is up to Pharmac. Currently Pharmac makes funding decisions independently based on the health returns that different drugs provide. Pharmac works better when politicians don't interfere and try and tell them what to do, and we want to keep it like that. In fact, we want that model broadened over our whole health system so that we can be certain we are getting the best return on each dollar invested. 

The future of healthcare isn't more hospitals, it is more prevention. Every dollar we spend on prevention gets four times the benefits we get from a dollar spent on hospitals. We need to care for people in their communities, and keep them out of hospital. 

No matter how much money Labour and National throw at the health system in coming years, we will not be able to meet the demand. In fact there is rationing in the health system already, and this will only grow in the future with an ageing population, increased demand for treatment, chronic disease and new technology. Every health system in the world is struggling, and ours is no exception. 

What we can do to have better health outcomes - live longer healthier lives - is to invest more of our health budget in prevention. That is a much more effective use of our health budget, and it will give us better outcomes than increasing the amount of money we put in. 
At the same time we have to have a conversation about what we can realistically expect from our health system now and in the future. For example should we be investing more in invasive operations that keep people alive for a matter of weeks, or end of life care? TOP proposes citizens' assemblies to investigate these questions.

TOP will sit down with a panel of nutrition experts and improve the current front of pack labelling scheme so that we have a clear definition of junk food. Junk food will be labelled with a "red" traffic light style sticker, and for these foods advertising to children will be prohibited.

We will tax the junk food so that there is an average price rise of 20%. The revenue will be used to fund free dental for the poorest 20% of society, reducing GP visits to $10, and fruit and veg box schemes to provide affordable high quality foods.