More Kiwis are too sick to work. What can be done?

Monday, 6 July 2026

Around 200,000 New Zealanders now claim a sickness or disability benefit, with increases driven by mental health claims.

The ACT Party wants Government-appointed doctors to take over medical assessments from GPs as a way of getting more people into work.

GPs say a second opinion system is useful, but question the merits and logistics of using designated doctors to check and recheck every health-related beneficiary.

The number of New Zealanders claiming a sickness or disability benefit is climbing every single year.

One of the main drivers is mental health claims, especially since the pandemic as more young people report psychological distress and services are stretched.

The ACT Party, in a rally in the weekend, identified what it saw as another key factor: GPs who are rubber-stamping the medical check-ups.

In a bid to get more beneficiaries into work, the party outlined a proposal on Sunday for Government-appointed doctors to completely take over this role.

So what's driving this increase in New Zealanders unable to work? And are overly sympathetic doctors to blame? Or something else? We wanted to take a look.

At the moment, a person who is sick, injured or disabled can apply for two benefits - Jobseeker Support (for temporary or short-term issues) or the Supported Living Payment (for permanent or severely limiting conditions).

They need to get a medical certificate to show that their illness or disability prevents them from working.

Once approved, they are regularly reassessed to ensure they still qualify.

The number of New Zealanders on a sickness or disability payment has risen from 141,465 to 194,157 in the last 10 years. That means around 5% of the working population is on one of these benefits - up from around 4% ten years ago.

The bill has grown to between $5b and $6b. Another $837m is spent a year on back-to-work schemes.

While it’s not easy to directly compare with other countries, New Zealand’s rate of sickness and disability benefits is roughly in the middle of the pack globally.

In the UK, for example, there has been a sharp increase in health-related benefits since 2019, more than any other comparable country, to around 10% of the working-age population.

Analysis of the UK situation shows that it is mainly driven by mental health claims, especially among young people. But there is also a more complicated factor. Non-health benefits are relatively low in the UK and difficult to survive on - meaning that in a cost of living crisis, more people are shifting towards the health benefit category.

There are also broader concerns in developed countries about the impact of sickness claims on productivity. Germany has banned workers from calling in sick, requiring them to instead see a doctor in person and get an exemption. Germans take an average of 15 days of sick leave a year.

In New Zealand, mental health conditions are also the main driver of benefit increases in the last five years.

Ministry of Health data shows an unprecedented 23% of young people meeting the clinical criteria for for high or very high levels of psychological distress - compared to 11% before the Covid-19 pandemic.

There are also other factors at playing including the so called the “flow-through” effect. Ministry of Social Development (MSD) research has found that in an economic downturn, workers with borderline or manageable health conditions were more likely to lose their jobs. In a weak job market, their health conditions deteriorated and they were more likely to want to shift onto a health-related benefit.

All that said, at the moment, GPs can ask for a second opinion from Government-appointed doctors when assessing whether a patient is able to work.

And under a law passed last week, MSD will be able to refer beneficiaries for a medical reassessment at any time.

ACT Party leader David Seymour says this does not go far enough. His party would require every person seeking a health or disability benefit to get approved by a Government-appointed doctor before going on welfare.

GPs would still have some input but there would also be “clear, objective criteria”, leaving less room for doctors’ discretion.

In interviews this week, Seymour identified what he saw as a factor in rising rates of health-related benefits.

“We’ve got GPs made to do this job, and if you’ve got someone who’s a bit abusive and saying ‘sign this so I can keep getting my benefit’, you know you’ve got a waiting room filled with people, are you going to say ‘hang on, you need to get back to work’ or are you going to sign it and clear your waiting room?,” he said on Newstalk ZB.

GPs agreed that there was some value in being able to refer a difficult patient for a second opinion.

“I think that there is a subset, a percentage who definitely would benefit from having a review taken away from the usual GP for independent eyes, and perhaps a little bit more in-depth support in getting them back to work,” said Royal NZ College of GPs president Dr Luke Bradford.

MSD had already offered this option, but Bradford said the service had gradually faltered.

When GPs ticked the form seeking a second opinion it now often went unanswered, he said.

And while second opinions were useful, Bradford was sceptical about whether every patient needed to be assessed by a MSD doctor and how this would be resourced.

“The majority of sickness benefit claims are accurate, are necessary,” he believes. “People at that point in their lives are not well enough to be in work because of cancers or operations, all of these things.

“So when you then do it for everyone, that is a lot of work and presumably a large expense. And I'm interested, where are all of these doctors going to come from to do this?”

MSD already has a pool of 65 doctors. Asked about resourcing for its policy, an ACT spokesperson said this would be determined by MSD and that the standards the doctors applied would be more important than the headcount.

ACT’s policy is not a new idea. The former National-led Government had designated doctors to assess patients for the old sickness and invalid benefits in the 1990s, though it was not as tough.

The measure was scrapped by the Helen-Clark led Labour Government in the 2000s.

A major review of the welfare system in 2019 recommended that adversarial medical testing should be scrapped.

The review recommended that MSD should change its model to trusting an applicant’s GP or specialist, given they were in a far better position to gauge their capacity for work than a MSD-appointed doctor.

Dr Ben Gray, a senior lecturer in General Practice, said MSD doctors, unlike GPs, would not have a deep, trusting relationship with the patient and were less likely to pick up on issues such as past trauma or social issues which could genuinely affect a person’s ability to work.

Stuff asked the ACT Party about why its policy would work when it had previously been considered ineffective.

The spokesperson said the MSD-appointed clinicians would not be “simply a second doctor”.

“ACT’s policy means that a designated doctor applies clear, objective criteria based on medical history and supporting evidence. That separates the treatment role from the eligibility decision and gives a consistent standard rather than opinion versus opinion.”

The current scheme was too reactive, the spokesperson said. MSD could only require an independent examination once a person was already on a benefit, and only if their eligibility was questioned.

“ACT's proposal is that independent approval is required before a health-related benefit is granted – applied consistently against clear criteria, with existing recipients reassessed against those same criteria.”

If implemented, that would be an enormous task. As of March this year, there were 97,305 people on the Supported Living Payment and 96,852 on health-related benefits: all of whom would have to be reassessed.