Select Page

The New Zealand Health System

The New Zealand health system is a mix of public and private ownership across a wide range of health ser¬vices which have been repeatedly restructured over the last three decades. The health system is funded mainly from general taxation (9.5% GDP) with 20 district health boards (DHBs) receiving three-quarters of this funding to plan, purchase and provide health services for their geo¬graphic populations. This includes funding primary care, hospital services, public health services, aged care ser¬vices, and services provided by non-government health providers including Māori and Pacific providers. Primary care is mostly provided by general medical practices run as state-subsidised small businesses clustered into non-profit Primary Health Organisations (PHOs). Every person in the country is expected to register with a PHO, which receives capitation funding on their behalf through the DHBs. Māori and Pacific providers can form PHOs or can contract separately with government agencies. Accident services are funded by the Accident Compensation Cor¬poration.
The foundational New Zealand Health Strategy [1] signaled the development of community-based primary healthcare. When it was recently “refreshed” for the next 10 years [2], the first acknowledged guiding principle was the special relationship between Māori and the Crown under the Treaty of Waitangi, signed in 1840. The Treaty guarantees partnership, participation and protec¬tion for Māori and the Government recognizes this as an obligation to ensure that Māori have at least the same level of health as non-Māori. The current status, however, is that Māori, Pacific peoples and those with lower socio¬economic status experience much higher levels of chronic disease, earlier in life [3], resulting in higher morbidity and lower life expectancy [4].
1. King, A. The New Zealand Health Strategy. Welling¬ton: Ministry of Health, Manatu Hauora; 2000.
2. Ministry of Health. New Zealand Health Strategy: Future direction. Wellington: Ministry of Health; 2016.
3. Ajwani, SBT, Robson, B, Tobias, T and Bonne, M. Decades of disparities; ethnic mortality trends in New Zealand 1980–1999. Wellington: Ministry of Health; 2003.
4. Blakely, TFJ, Atkinson, J, Tobias, M and Cheung, J. Decades of disparity II: Socioeconomic mortality trends in New Zealand, 1981–1999. Wel¬lington: Ministry of Health; 2005.