Doctors have been told that the health system is facing a doubling of demand at a time when the country's ability to fund it is at its limits.
The head of the Auckland University medical school, Professor Des Gorman, told an Association of Salaried Medical Specialists conference that the health service is under threat.
Demand is increasing due to the ageing population and increased expectations, but the country is small and poor, he says.
The increased demand comes at a tipping point in New Zealand's ability to pay, a situation also faced by other countries.
Professor Gorman told the doctors they have the chance to direct decisions, but is also fearful about whether they will have the ability to provide the leadership needed.