The Review examined a wide range of issues relating to
the performance of the New Zealand health system. In
particular, it examined issues relating to the demand for
health care—critiquing the selective nature of primary
health care subsidies available in New Zealand, especially
in primary health care; the low level at which some subsidies
were set, leading to significant barriers to access to
care from user charges and contributing to inequalities in
health; and the impact of the benefits in influencing who
provides care, e.g. limited use of nurses in primary health
care given that the subsidy was paid for GP visits. The
Review also examined issues relating to the supply of
health care, noting that the rapid growth in hospital
expenditure in recent years was concerning, and the
growing evidence that primary health care investment
might be a better use of resources. It also noted issues
relating to market equilibrium, in particular raising concerns
over the long waiting times for elective services in
main centres, which in turn raised concerns over equity of
access (evaluation at the whole system level) with those
able to pay for themselves or through private health
insurance having much better access to such care [9].