A recent policy shift allowing general practitioners and nurse practitioners to diagnose and prescribe ADHD medications aims to improve access, but experts warn that fundamental assessment issues remain unresolved, risking superficial solutions to a complex problem.
A forthcoming change to New Zealand’s ADHD prescribing rules is being billed as a way to widen access to treatment, but a new viewpoint in the New Zealand Medical Journal says it will not solve the main problem: too few people can get a proper assessment in the first place.
From 1 February 2026, vocationally registered specialist general practitioners and nurse practitioners will be able to diagnose ADHD in adults and prescribe stimulant medicines under the new framework, according to the Ministry of Health. The Government has said the move is designed to reduce long waits and improve access, while the Royal New Zealand College of General Practitioners has backed the reform as a practical step towards better care. Yet the journal article argues that the policy’s operational detail is thin, leaving important questions unanswered about training, supervision and quality control.
One of the paper’s authors, academic GP Steven Lillis, told the New Zealand Herald that the change is “an immense” shift in prescribing practice, but said it had not been planned carefully enough. He said the obstacle that matters most is still the assessment stage, which remains time-consuming and difficult to access in an overstretched primary care system. Lillis said it is not a matter of a routine GP appointment followed by an immediate prescription.
The article says a full ADHD assessment usually takes hours, not minutes, and that many doctors are unlikely to feel comfortable diagnosing and treating the condition without more structured support. It points out that adult ADHD is often complicated by other mental health or neurodevelopmental conditions, including anxiety and post-traumatic stress disorder, which can look similar to ADHD and make diagnosis harder. Publicly funded psychiatric services, the authors say, rarely have capacity to absorb the demand.
Lillis told the Herald that the cheapest route currently available for many patients is a private psychological assessment followed by a GP willing to prescribe on that basis, a pathway he said can cost about $800 to $900. He argued for a shared national pathway so that assessment standards are the same regardless of where a person lives. In his view, clearer rules could also help research and make care cheaper over time, while reducing the risk of the kind of “cowboy clinics” that, he said, have emerged in the United Kingdom.
The Ministry of Health says the rollout will be gradual and that not every eligible doctor or nurse practitioner will begin prescribing immediately. ADHD New Zealand and bpacNZ have also noted that primary care services will need time to build competence. That makes the reform less a quick fix than the start of a longer shift: one that may widen access to medication, but still leaves New Zealand facing the harder task of creating a consistent, affordable and clinically robust assessment pathway.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
