New Zealand has a predominantly tax-funded health system, providing
universal coverage. The population enjoys high health status overall, but with
significant inequalities in Māori and Pacific health.
Since the 1980s, there have been five major health system reforms.
Currently, a central Ministry of Health (MOH) oversees the health system,
while 20 District Health Boards are responsible for planning and funding
health services for their geographical areas. There are no user charges for
inpatient or outpatient services in publicly owned hospitals. Primary health
care (PHC) is provided through Primary Health Organisations (presently 36)
that receive capitation funding for their enrolled populations, and work with
general practices and other providers to deliver comprehensive PHC in the
community. Patients may pay user fees for PHC services, although most
children under six years of age pay no fees.
The Pharmaceutical Management Agency (PHARMAC) manages the New
Zealand Pharmaceutical Schedule and negotiates the purchase of drugs
from suppliers, successfully controlling supply-side expenditure. A recently
reformed National Health Committee is now responsible for strengthening
assessment of new technologies and services to promote the delivery of a
cost-effective mix of services in New Zealand.
The Accident Compensation Corporation (ACC) is a comprehensive, social
insurance, no-fault, personal injury scheme which funds treatment,
rehabilitation and compensation for people who are injured in New Zealand.
It sits alongside the tax-funded health system, and can fund a wider range of
services, raising concerns over equity of access between those whose health
condition is due to illness and those receiving services because of accidents.
Current challenges for the health system include reducing inequalities
in health, managing noncommunicable diseases and chronic conditions,
reducing waiting times, improving productivity, and ensuring greater
integration and coordination of services within and between primary and
secondary care, and intersectorally with other social services.