Sign this petition to help bring National Health Reform in front of Parliament and create lasting change for healthcare in New Zealand.

Purpose: This policy announcement is issued in response to evidence of declining health indicators in New Zealand. It mandates a comprehensive reform of health policies to address our chronic disease and mental health epidemics, our increasing reliance on medications, and concerns about the focus and integrity of our health system. This government understands that if you keep doing the same thing, then you will inevitably get the same results. This is why we are dramatically shifting our health policy and investment. New Zealand will once again be a world leader in healthy and happy people. The Government of New Zealand commits to an urgent, evidence-based strategy to improve the health and wellbeing of all New Zealanders

Executive Summary: National Health Reform in New Zealand
New Zealand is in a health crisis, with rising rates of chronic disease, mental illness, and medication dependence, placing a growing burden on individuals, families, and the healthcare system. Obesity, type 2 diabetes, and heart disease are now at record levels, while mental health disorders and suicide rates—especially among young people—are an epidemic. Our healthcare model focuses too much on treating illness rather than preventing it, leading to increasing reliance on medication rather than addressing the root causes of poor health.

If we are to make any progress, then it is obvious we must reinvest and reorient our health care away from treatment at any cost, to one where prevention is cure.

This policy marks a fundamental shift towards prevention, early intervention, and lifestyle-based health solutions. We will prioritise nutrition, physical activity, and mental well-being, while ensuring greater transparency and scientific integrity in health policy. By redirecting health funding to prevention and expanding support for community-based health initiatives, we aim to increase life expectancy, reduce preventable diseases, and improve the quality of life for all New Zealanders.

Key initiatives include:

Investing in prevention: A minimum 15% of the health budget will be allocated to chronic disease prevention and 5% to mental health services.
Reforming food policy: Stronger nutrition labeling, reduced unhealthy food marketing, and ultraprocessed food tax measures.
Reducing medication reliance: Encouraging “social prescribing” so GPs can refer patients to exercise, nutrition support, and mental health therapy before medication.

Expanding public health workforce: Training more health coaches and lifestyle medicine experts to support behaviour change.
Ensuring accountability: A National Health Reform Taskforce with executive powers will monitor progress, report on key health indicators, and adjust strategies as needed.This policy represents a bold step towards a healthier future for New Zealand. By prioritising prevention over treatment, empowering communities, and ensuring stronger scientific oversight, we can create a nation where people live longer, healthier lives, free from preventable disease and chronic illness.

 

Chronic Disease and Mental Health: Our twin epidemics

Chronic Disease Burden
New Zealand is in an epidemic of chronic, non-communicable diseases. Conditions like obesity, type 2 diabetes, and cardiovascular disease have reached concerning levels and are trending upward. Over one in three New Zealand adults is classified as obese (BMI ≥30)​. The adult obesity rate has risen from about 29% in 2011/12 to roughly 32–34% in recent years​, placing New Zealand among the highest in the OECD for obesity prevalence (ranked around the 6th worst out of OECD countries)​ socialreport.msd.govt.nz. Childhood obesity is also troublingly common – approximately 12% of New Zealand children (aged 2–14) are obese, with about 21% overweight​. These figures have increased since the early 2000s and show no sign of significant improvement, threatening the health of the next generation.

Consequently, diet-related diseases like diabetes are on the rise. An estimated 5% of New Zealand’s population now has type 2 diabetes, and this is projected to climb to 7% by 2040 (around 430,000 people) if current trends continue​ bpac.org.nz. The burden of diabetes is increasingly affecting younger adults as well, not just older populations​. Cardiovascular disease remains New Zealand’s leading cause of death, accounting for almost 1 in every 3 deaths​. Heart attacks, strokes, and other cardiovascular events claim the lives of many New Zealanders every day – a New Zealander dies from heart disease roughly every 90 minutes​. Importantly, many of these deaths are considered premature or preventable with better health interventions​.

These chronic diseases do not occur in isolation – they are often interconnected and share common risk factors. The overall health loss attributable to non-communicable diseases (like cancer, cardiovascular, diabetes, and musculoskeletal conditions) constituted about 87% of total health loss in New Zealand by 2016​ cph.co.nz. Such diseases reduce not only length of life but also quality of life, as people live longer in ill health. The years lived in good health are not keeping pace with total life expectancy, meaning New Zealanders are spending more years living with disease and disability​.

This policy recognises the chronic disease burden as a national crisis that demands a shift toward prevention, early intervention, and better management to improve outcomes.

Mental Health Crisis
Alongside physical illnesses, New Zealand is grappling with a profound mental health and addiction crisis. It is estimated that around one in five New Zealanders will experience mental health or addiction challenges in any given year​ mentalhealth.inquiry.govt.nz. Over a lifetime, as many as half of all New Zealanders are likely to experience mental distress or addiction issues at some point​. These challenges range from depression and anxiety disorders to substance use disorders and more severe conditions.

Youth mental health is of particular concern. Tragically, New Zealand has one of the highest youth suicide rates among OECD countries​. Our adolescents and young adults (especially those aged 15–24) die by suicide at rates that are among the worst in the developed world. Māori youth are disproportionately affected – the suicide rate for young Māori is about 2.6 times higher than that of non-Māori in the same age group​, placing Māori youth at the forefront of this national crisis. This reflects broader inequities: recent statistics show Māori males dying by suicide at nearly double the rate of non-Māori males (and Māori females at about 1.8 times the rate of non-Māori females)​. These numbers represent lost young lives, devastated families, and communities in pain. They are unequivocally unacceptable.

Beyond suicide, indicators of mental wellbeing are troubling. The number of people accessing mental health and addiction services has grown by 73% over the past decade​  mentalhealth.inquiry.govt.nz, indicating far greater demand for support. Similarly, the volume of prescriptions for mental health–related medications (such as antidepressants and anti-anxiety drugs) increased by 50% in the last 10 years, growing around 5% each year​. This suggests that more New Zealanders are seeking help for psychological distress – a positive sign that stigma may be easing – but it also signals rising incidence or detection of mental health conditions in our society, especially anxiety and depression. Notably, even children are affected: about 4% of children and adolescents (ages 2–14) have been diagnosed with an “emotional or behavioural” condition according to past surveys​ liebertpub.com, and issues such as anxiety, depression, and ADHD among youth have become more commonly recognised.

Measures of psychological distress in young people aged 16-24 as measured in the NZ Health Survey since 2005 have shown alarming increases. In 2005 "severe psychological distress” was evident in just over 5% of this age group. By 2023 this was over 20%. Importantly, young women show much higher signs of severe psychological distress than young men. This remains unrecognised in NZ health policy. 

If left unaddressed, these mental health trends will continue to undermine our nation’s wellbeing and productivity. The annual economic cost of serious mental illness (including addiction) in New Zealand is estimated to be around $12 billion, about 5% of GDP ​mentalhealth.inquiry.govt.nz, due to healthcare costs, lost productivity, and social impacts. More importantly, the human cost – in suffering and lost potential – is incalculable. This Executive Order therefore elevates mental health alongside physical health as a pillar of our reform efforts. Improving access to care, early intervention, community support, and suicide prevention will be top priorities.

Medication Reliance: Treating Symptoms, Not Causes
The rising burden of chronic disease and mental health issues has been met with a corresponding increase in the use of prescription medications among New Zealanders – including children. While medications are often critical for managing illness, an over-reliance on pharmacological solutions can indicate that underlying causes are not being effectively addressed. This order acknowledges the need to re-balance our approach toward health promotion and disease prevention, so that medication becomes one tool among many rather than the default solution.

Data from PHARMAC (the Pharmaceutical Management Agency) and the Ministry of Health show sharp increases in prescriptions for chronic conditions and mental health conditions in recent years. For example, in 2018 about 400,000 people – 8.3% of New Zealand’s population – were dispensed an SSRI or similar antidepressant medication for depression or anxiety​ hqsc.govt.nz. About 5% of the population were taking these antidepressants regularly (indicating long-term use). This rate of antidepressant use has climbed steadily. Likewise, use of anti-anxiety sedatives (like benzodiazepines or zopiclone) is relatively common in older adults – over 11% of Kiwis aged 75+ were regularly taking such medication in 2018​ hqsc.govt.nz despite known risks in the elderly. In total, nearly one-quarter of New Zealanders over 75 were on some type of psychotropic medication (antidepressants, sedatives, antipsychotics, or stimulants) in that year​, highlighting how pervasive medication use is in our senior population.

Children and adolescents are also increasingly prescribed medications. Dispensing of medications for attention-deficit/hyperactivity disorder (ADHD) has surged – rising tenfold among adults and threefold among children from 2006 to 2022​ pubmed.ncbi.nlm.nih.gov. This reflects greater recognition of ADHD in adulthood and more frequent treatment in youth. In absolute terms, however, many with ADHD still remain untreated; one recent study estimated only 0.6% of New Zealanders were receiving medication for ADHD, even though roughly 2.6% are believed to have the condition​. The long waiting lists for ADHD assessment and the stigma around stimulant medications contribute to this treatment gap​. Nonetheless, the sharp increase in dispensing signals that a growing segment of our population – including young people – is dependent on daily medications to function.

Beyond mental health, medications for chronic physical ailments are also widespread. Thousands of New Zealanders use pharmaceuticals to manage blood pressure, cholesterol, diabetes, pain, and other long-term conditions. In our older population, polypharmacy (the use of multiple concurrent medications) is common. Over one-third (35%) of New Zealanders over 65 years old were prescribed five or more long-term medications in 2016​ bpac.org.nz, and about 4% of seniors were on eleven or more medications​. These figures have grown since. While sometimes clinically necessary, such heavy medication burdens increase the risk of adverse drug interactions, side effects, and challenges with adherence.

The prevalence of medication use in New Zealand raises critical questions: Are we doing enough to prevent illness and treat root causes, or have we become too quick to medicate symptoms? Are patients receiving adequate support for lifestyle changes and non-pharmacologic therapies that could reduce the need for drugs? This policy calls for a paradigm shift. Our health system must strive to reduce unnecessary medication dependence by emphasising preventive care, lifestyle interventions, and holistic support. Medications will always play an important role in healthcare, but they should be used judiciously and accompanied by real investment and action to improve the underlying health of patients. By empowering New Zealanders to live healthier lives, we can lower the burden of disease and, in turn, the volume of medicines needed.

Nutrition and Lifestyle Factors: Foundations of Health
At the heart of New Zealand’s health challenges are the everyday behaviours and environmental factors that drive our health outcomes. Decades of evidence point to poor diet, sedentary lifestyles, and harmful substance use as major contributors to chronic disease. Addressing these factors is essential to improving our nation’s health metrics.

Diet and Nutrition: The typical New Zealand diet is not meeting recommended nutritional standards. According to the latest New Zealand Health Survey, only about 1 in 10 adults (10.4%) eats the recommended daily intake of vegetables​ sugarnutritionresource.org. Fruit intake is somewhat better but still inadequate – only half of adults meet fruit intake recommendations​. This means a large majority of adults are not consuming the five-plus servings of vegetables and two servings of fruit per day that are recommended for good health. Children’s diets are also lacking in essential nutrition, with just 6.4% of children (2–14 years) eating enough vegetables​ and about 74% getting enough fruit​. In other words, nearly 94% of our kids are not eating the daily veggie portions they need​, which can impact their growth and long-term health. High consumption of processed foods high in sugar, starch, and unhealthy fats is an ongoing problem. These dietary patterns directly contribute to obesity, diabetes, heart disease, and even dental disease.

Physical Activity: Modern lifestyles have become increasingly sedentary. Only about 52% of New Zealand adults meet the physical activity guidelines (at least 2.5 hours of moderate activity per week)​ sugarnutritionresource.org. Meanwhile, roughly 13% of adults do little to no physical activity at all​, leading a largely sedentary life. The situation for children and youth is equally concerning: a recent Active NZ survey found that just 7% of 5–17-year-olds accumulate the recommended 60 minutes of moderate-to-vigorous physical activity per day journals.humankinetics.com. This means 93% of our young people are not getting sufficient daily exercise. Insufficient physical activity, combined with high-calorie diets, is a key driver of the obesity epidemic and contributes to other problems like poor cardiovascular fitness and mental health issues.

Other Lifestyle Factors: New Zealand has made progress in some areas – for example, smoking rates have declined significantly over the past decades. However, smoking still causes an estimated 5,000 deaths per year in New Zealand (about 12 deaths a day) through direct smoking or second-hand exposure​, remaining a leading preventable cause of death. Hazardous alcohol use is another persistent issue: about 18.8% of adults are considered hazardous drinkers​ sugarnutritionresource.org, a rate that has remained stubbornly high since 2015. Within this statistic, there are disparities – for instance, one-third of Māori adults (33%) report hazardous drinking patterns​, which is significantly higher than the overall rate. Excessive alcohol consumption contributes to injuries, liver disease, mental health problems, and social harm. Additionally, factors like inadequate sleep and high stress levels (for which national data indicate many New Zealanders feel high levels of stress in their daily lives) also influence health, including risk of mental illness and cardiovascular disease.

Environmental Contributors: The environments where New Zealanders live, work, and play affect their ability to make healthy choices. In many communities, high-calorie fast foods and sugary drinks are readily accessible – children in lower-income areas are more likely to consume fizzy drinks and fast food frequently​ cph.co.nz. Urban design that prioritises cars over walking or cycling can discourage physical activity. Access to fresh, healthy foods can be limited in some rural or high-deprivation areas. Environmental pollution and exposure to toxins can also impact health (for example, poor housing quality contributes to respiratory diseases). This policy acknowledges that individual lifestyle choices are shaped by broader social and environmental factors, and effective reform must address those factors as well.

In summary, the foundation of a healthy society lies in good nutrition and an active lifestyle. The data makes clear that we must do better in promoting healthy habits. By improving diets, increasing physical activity, and reducing harmful substance use, New Zealand can dramatically cut rates of chronic disease and improve mental wellbeing. These preventive approaches are far more cost-effective and beneficial long-term than treating diseases after they develop. This Order will initiate robust efforts to transform our food systems, encourage exercise, and create health-enabling environments across the country.

Healthcare System and Public Policy: From Managing Disease to Promoting Health
New Zealand is proud of its healthcare system, which provides universal coverage and high-quality acute care. We invest heavily in health – current health expenditure is about 10% of our GDP​, comparable to other developed nations. Approximately 85% of our healthcare is government-funded​ trade.gov, reflecting a strong public commitment. Yet despite this investment, our outcomes (life expectancy, chronic disease rates, mental health statistics) indicate that our system’s focus and priorities must be recalibrated. Too often, our health services are oriented toward managing diseases and treating illness rather than actively preventing disease and promoting wellness.

One key issue is the imbalance in resource allocation. Only a small fraction of health spending is directed towards public health, prevention, and health promotion. In fact, spending on prevention and public health in New Zealand is low and has decreased over the past decade​ cph.co.nz. Government budget data indicates that the share of Vote Health devoted to preventive programs has been shrinking, even as evidence mounts that prevention offers immense “value for money” in health gains​. This imbalance means we under-invest in interventions that keep people from getting sick in the first place (such as screening programs, immunisations, healthy lifestyle promotion, and addressing social determinants of health). The result is predictable: more New Zealanders develop advanced illnesses that require costly medical treatment and suffer avoidable harm.

Moreover, our healthcare delivery has historically been fragmented. Primary care (GPs and community services) has not always been fully empowered or resourced to coordinate preventive care and chronic disease management. Hospitals are often overburdened with patients whose conditions could have been mitigated with earlier care. Public health initiatives– like those to combat obesity or improve mental health literacy – have at times lacked sustained funding and political priority. This Executive Order intends to re-orient the health system toward proactive health management. We must integrate services, strengthen primary and community care, and ensure that keeping people healthy is as high a priority as treating them when they are ill.

Finally, transparency, scientific integrity, and safety in health policy have emerged as areas of concern. In recent years there have been calls to ensure that health guidelines and recommendations are based on solid, unbiased science and that any conflicts of interest (for example, ties to the food or pharmaceutical industry) are disclosed and managed. The public must have confidence that dietary advice, vaccination schedules, medication approvals, and other health directives are driven by evidence and the public interest, not by undue commercial influence. Restoring and protecting scientific integrity in health governance is essential. This includes reinforcing the independence and rigour of agencies like Medsafe (our drug safety regulator) and ensuring PHARMAC’s decisions on drug funding are transparent and evidence-based. It also means improving food safety and nutrition policies – for example, evaluating the safety of food additives, ensuring accurate food labelling, and updating nutritional guidelines to reflect the latest science (in areas like sugar intake, processed foods, and emerging dietary research). New Zealanders deserve clear, honest information about health risks and nutrition, free from confusion or misinformation.

By addressing these policy and system-level issues, New Zealand can move from a paradigm of reactive care – waiting for disease to happen and then responding – to one of preventive care and health promotion, where we actively create the conditions for people to thrive in good health. We can also rebuild trust where it may have eroded, by being transparent and accountable in all health-related decisions. Our goal is a healthcare system that is people-centred, prevention-oriented, scientifically sound, and equity-focused.

Call to Action: Building a Healthier Future for New Zealand
In light of the evidence presented –rising chronic physical and mental health conditions, heavy reliance on medications, and systemic issues in our health approach – immediate and comprehensive action is imperative. Through this policy, the Government of New Zealand commits to a series of policy reforms and initiatives designed to prevent chronic disease, improve nutrition and lifestyle factors, reduce unnecessary medication dependence, and restore scientific integrity in health policy. The following directives are hereby established:

Prioritise Prevention and Health Promotion: Health NZ and local health boards, shall significantly increase investment in preventive health programmes​. A “Health in All Policies” approach will be adopted across government agencies, ensuring that education, housing, transport, and other sectors collaborate to promote healthy environments. Our health system will be reoriented to proactively support health at every stage of life, with a special focus on early-life interventions and addressing determinants of health (like poverty, housing, and education) that contribute to disparities.

Combat Chronic Diseases at their Roots: We will launch a National Chronic Disease Prevention Strategy targeting obesity, diabetes, heart disease, and cancer. This strategy will set ambitious targets to reduce obesity rates and improve disease outcomes over the next decade. Initiatives will include: robust public education campaigns on nutrition and exercise; subsidised access to weight management and quit-smoking programs; and community health worker outreach in high-risk communities. By preventing disease or detecting it early, we aim to increase healthy life expectancy and reduce the years New Zealanders live in ill health. We commit to allocating at least 15% of the health budget to these activities.

Mental Health and Addiction Support: A Mental Health Emergency Action Plan will be implemented to address our mental health crisis. The plan will increase funding and resources for youth mental health services, suicide prevention programs, and school-based counselling. We will ensure accessible, affordable mental health care for all – moving towards funding universal talk therapy/counselling sessions and peer support options, so that medication is not the only avenue for care. We will allocate at least 5% of the overall health budget to these activities.
Improve Nutrition and Food Environments: In order to improve national nutrition, a comprehensive food policy reform is ordered. The Minister of Health, in conjunction with the Minister of Education and Minister for Food Safety, shall:

Revise dietary guidelines based on the latest scientific evidence, with full transparency of the scientific committee’s processes and any conflicts of interest. Guidelines will emphasise whole foods, fruits and vegetables, and limits on sugar, and ultra-processed foods.

Strengthen food labelling and marketing standards. We will cancel the existing star rating system and introduce clearer, credible front-of-pack nutrition labels to help consumers make informed choices at a glance. Advertising of unhealthy foods and sugary drinks to children will be further restricted. We will also explore fiscal measures (such as a tax on ultra-processed food) to reduce consumption of ultra-processed products and use the revenue to fund healthy eating initiatives.
Encourage Responsible and Rational Use of Medications: In line with reducing medication dependence, healthcare providers will be supported in pursuing “social prescribing” and non-pharmacological therapies. This means GPs and clinicians will have tools and referral pathways to prescribe exercise programs, nutritional counselling, mindfulness/stress reduction programs, and therapy sessions as complements or alternatives to medication where appropriate. The Ministry of Health will issue updated guidelines on responsible prescribing for conditions like mild depression, insomnia, and ADHD – emphasising careful diagnosis, regular review of medication necessity, and using the lowest effective doses for the shortest necessary duration. A nationwide deprescribing initiative will be launched for older adults, reviewing long medication lists to taper and discontinue drugs that may no longer be needed – improving safety and quality of life for seniors​. To support this, pharmacists and doctors will receive training on deprescribing best practices.

Strengthen Healthcare System Capacity and Capability: Health NZ is directed to bolster primary care and public health workforce capacity and capability especially in support for behaviour change and knowledge around the evidence and practice in lifestyle medicine. We will bolster the use of well-trained, industry-accredited health coaches, mental health coaches, and metabolic health coaches to support the primary care workforce. We recognise that significant improvements in medical and allied health education needs to occur during training and will be directing the tertiary sector to revise their curriculums to reflect a dramatic refocus. 

Monitoring and Accountability: An interagency National Health Reform Taskforce will be established to coordinate the implementation of this policy. This Taskforce will set specific, measurable targets (KPIs) for each initiative – for example, targets for reducing obesity prevalence, increasing life expectancy, lowering suicide rates, and reducing prescriptions of certain medications. It will report publicly on progress annually. We will leverage data from Stats NZ and the Ministry of Health to track improvements: life expectancy and healthy life expectancy will be key indicators, as will rates of chronic disease incidence, mental health outcomes, and survey measures of nutrition and activity. If strategies are not meeting targets, the Taskforce is empowered to recommend course corrections or additional actions. Regular updates will ensure the Government and the public stay informed about where progress is being made and where challenges remain.

Conclusion: This policy represents a bold commitment to change the trajectory of health in New Zealand. We recognise that simply doing more of the same is not enough. New Zealand must pivot from a disease-treatment model to a true health-centred model. By tackling the root causes of our declining health trends – poor diet, inactivity, inequity, and a lack of preventive focus – we aim to secure a healthier future for all citizens.

The Government calls upon health professionals, community leaders, iwi, academics, families, and individuals to join in this national effort. Improving health is not only the job of the healthcare sector; it requires a whole-of-society movement. Together, we will create a New Zealand where children grow up healthy and active, where our lifespan is matched by healthspan, where far fewer people suffer preventable diseases, and where mental wellbeing is nurtured alongside physical health. By implementing these reforms, New Zealand will set a course to increase life expectancy, reduce chronic illness, ease the burden of medication reliance, and uphold the highest standards of science and transparency in our health system. In doing so, we honour our responsibility to current and future generations to provide the opportunity for longer, healthier, and happier lives.

Signed this day, [Date], by the authority of the Government of New Zealand.

Prime Minister
[Name]

Minister of Health
[Name]

Minister for Sport and Recreation
[Name]