Cecilia Robinson and her husband James founded Tend in 2020, a digital-first healthcare provider offering comprehensive online and in-person GP services. With advanced technology and clinical expertise working together, Tend is making healthcare more accessible. Already one of the country’s largest healthcare providers, it’s been praised for its innovation and ability to meet the pressing need for change. NZBusiness sat down with Cecilia for a discussion on entrepreneurship, the ‘why’ behind Tend, and the challenges New Zealand faces in transforming healthcare.
There is no doubt that New Zealand’s healthcare system is in crisis. Doctors regularly raise the alarm about staff shortages and burnout while patients share stories of long wait times and often slow diagnoses. When Cecilia Robinson co-founded Tend, she was struck by the many obstacles facing the industry, especially primary healthcare.
She describes the system as “quite broken,” saying that it impacts all other facets of healthcare. “Effective primary care should reduce pressure on emergency rooms and improve preventative care outcomes. But currently, it does not. Healthcare is, without a doubt, the most complex issue facing New Zealand.”
Cecilia points to issues such as an ageing GP workforce, inadequate replacements, and a funding model that doesn’t deliver necessary outcomes. The latter she says is the biggest challenge facing the sector – a lack of direction around outcomes-based care. “I don’t necessarily subscribe to the narrative that healthcare is entirely underfunded in New Zealand. We spend more than places like Singapore, but we’re not good at generating productivity and outcomes from how we spend,” she explains.
She also points to the fragmented nature of the system, where healthcare runs on “130 different systems” and doctors often use outdated platforms like Windows 7. “You can see your GP, then go to the emergency room, and the ER doesn’t even know who you are. It’s so fragmented, and it shouldn’t be,” she says.
When Tend launched in 2020, its mission was clear: “We want to help New Zealanders be the healthiest people in the world,” says Cecilia. Tend is not just an online service either, simultaneously opening physical clinics. Today, this dual infrastructure remains central to its approach with 25 clinics across New Zealand, Tend’s change management strategy involves hands-on transformative care, clinic by clinic. This includes integrating new technology and reviewing staff roles to align with an evolving healthcare model.
“Change management is not an app you give someone,” she explains, emphasising that true transformation requires reworking both the digital and physical aspects of healthcare. Tend services include medical examinations, certificates, mental wellness support, skin health services, repeat prescriptions online, and urgent prescriptions. The result? Simple: greater accessibility and control over personal health.
The woman leading the charge
The move into healthcare was deeply personal for Cecilia, an already successful entrepreneur and winner of EY’s Young Entrepreneur of the Year in 2013, Tend was driven by her own experiences with the system. After the devastating loss of two babies – a stillbirth and another baby at 17 weeks – she and James endured poor experiences with the healthcare system. They realised that to make a real difference, they needed to create a business that addressed the system’s challenges.
The now mother of three – Thomas, Leila, and Charlie – and New Zealand Innovator of the Year for 2024, is passionate about empowering women and helping working parents navigate their daily challenges.
Tend was founded with the purpose to help make New Zealanders the healthiest people in the world. Cecilia is confident this goal is achievable, especially given the country’s response to the COVID-19 pandemic. She envisions a future where New Zealanders can enjoy some of the highest life expectancies in the world, with Tend playing a key role in delivering better healthcare.
And she certainly has the proven track record to turn this goal into reality. Originally from Sweden, Robinson moved to New Zealand in 2005 to support her brother. On her first night, she met James Robinson, who would later become her husband and business partner. Together, they launched My Food Bag in 2012, transforming home cooking for Kiwis and growing one of New Zealand’s most successful start-ups, which soon exceeded $100 million in revenue.
Rethinking healthcare roles
A common sentiment in New Zealand is that we need more GPs. However, Cecilia believes that the healthcare industry’s problems cannot and will not be solved simply by increasing the number of doctors.
By 2032, New Zealand will have 1,000 fewer GPs, leaving over a million people without access to primary healthcare unless the model changes.
Tend aims to address this by triaging patients through its online doctor app and distributing care across a broader range of healthcare professionals, including nurses, nurse practitioners, health coaches, and pharmacists. This model allows highly skilled GPs to focus on complex cases while empowering other professionals to manage less critical health concerns. “We need to distribute the level of patient interactions across the broader workforce,” Cecilia stresses.
She also points out inefficiencies in the current system, where patients often use the same service, such as a GP visit, for minor conditions like a rash or UTI, which adds unnecessary strain to the system. “It’s not how you resolve the system pressures,” she emphasises.
While many healthcare companies focus on niche offerings, such as reproductive health or mental health apps, Tend takes a comprehensive approach. She explains that focusing on one aspect of health means “you don’t get the full view of the person.”
Innovating for a healthier tomorrow
Cecilia says that her path to entrepreneurship wasn’t defined by a single moment, but by a series of experiences. Describing herself as an “accidental entrepreneur,” she recalls her time as an au pair in America, which inspired her first business, Au Pair Link. This venture quickly grew into one of Australasia’s largest au pair agencies.
Fast forward to being recognised as Innovator of the Year is something Cecilia reflects on humbly, attributing Tend’s success to the collective effort of her team. “It’s definitely not about me; it’s about the team.”
Unlike her previous ventures, where ideas could move quickly from concept to market, healthcare innovation requires a much more cautious approach. “We have to get it right,” she says, acknowledging the high stakes involved in healthcare.
Despite resistance to change within the healthcare system, she remains focused on the long-term goal of making Tend one of New Zealand’s largest healthcare providers in the next decade, improving patient outcomes and delivering better care.
“Large, meaningful change” is what drives Cecilia. The complexities of the healthcare sector may present significant challenges, but for Cecilia, this only strengthens her resolve to transform the industry.
Cecilia is making meaningful change in more ways than one: this year, Tend launched the first Woman’s Health Week in NZ. “I couldn’t believe it. It was offensive to me that there wasn’t one,” The success of Women’s Health Week went beyond raising awareness – many women took actionable steps toward improving their health by scheduling check-ups.
Ultimately, her vision is for a seamless, personalised healthcare experience for all New Zealanders, where proactive care is integrated into everyday life. “It should just be delivered to you,” she says, believing that technology will play a key role in creating a more connected and efficient system.
Despite the challenges faced by healthcare in the country, Cecilia is optimistic: “I think we can become the best country in the world. Every day there’s a negative headline about healthcare in New Zealand, but I think we can turn it around. I want to be able to leave a better legacy for our Tamariki. I want my kids to be able to feel like they can grow up in New Zealand and have the best healthcare system.”