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Primary care - including GPs, urgent care and aged care - has not been prioritised in the country's health reforms, even though it is facing critical difficulties, according to a progress report on the reforms.
The November report of the Ministerial Advisory Committee - which is monitoring the country's 20 district health boards conversion into Te Whatu Ora/Health NZ - has been released.
Primary care was facing "signficant pressures", but was not receiving the priority and focus needed, the report said.
"Not only do these pressures manifest in increased inequity, increased unmet need, declining patient experience and a burnt-out workforce, they also place pressure on the health system as a whole."
GPs have repeatedly warned about the difficulties they are facing, with half the workforce set to retire, many practices full, and huge rates of burnout.
The report said Te Whatu Ora had put some measures in place - including looking at funding changes - but was not doing enough to ensure primary care was sustainable.
The report singled out several other aspects that needed more work, included making sure workers understood what the reforms meant for them, better performance monitoring, and simplifying the "overwhelming" number of strategies and plans.
It said other aspects of the reforms were progressing well.
That included a successful national plan to manage pressures on the health system during winter, pooling of resources to address urgent nationwide workforce shorgages and breaking down geographical boundaries to care.
Te Aka Whai Ora - which was about to be disbanded - had done a good job to deliver care on the ground in the wake of Cyclone Gabrielle, the report said.
Health Minister Shane Reti blamed the previous government for some of the progress difficulties, saying it had made the reforms too complicated.
"I do want to acknowledge positives, including delivery of last year's Winter Preparedness Plan and a more effective way of transferring patients between areas to get access to treatment, but overall, it's clear that turning the health ship around will take years of intensive work," he said in a statement.
"For that to happen, it's going to mean putting workforce at the fore. Frontline health workers must have the resources and support they need to provide effective health services."