• Spending overview
• Policy overview
• Diseases overview

Spending overview

The vast majority of spending on health comes from the state sector. According to the health minister, Tony Ryall, the government's health budget has doubled in the past decade, but spending increases have not been matched by greater service provision. The World Health Organisation said in a recent report that rising expenditure on healthcare was not being reflected in improving health outcomes.
The government funds around 75% of healthcare spending. Free medical care is provided at hospitals for immediate and major medical problems, and free dental care is provided to those aged under 18 years. A fee-for-service programme exists for primary healthcare, and private hospitals also play a significant role, particularly for elective surgery.

The role of private-sector healthcare has increased as a result of growing dissatisfaction with public provision. Despite rising premiums, the proportion of patients with private medical insurance is around 40%—further evidence that the public healthcare system is not meeting the standards demanded by the population.

The availability of new medical procedures, drugs and technologies, and a growing awareness of health issues among New Zealanders all suggest that healthcare spending will continue to grow in the short term. In the long term the government acknowledges that demographic changes will cause the overall healthcare burden to rise, from 8.9% of GDP at present to around 13.5% by 2051.

Policy overview

The National Party, led by John Key, took office in November 2008, after almost a decade of Labour-led government. Irrespective of which party is in power, the country's egalitarian traditions will discourage any reduction of the public sector's substantial role in the provision of health services. Higher patient expectations and advances in medical technology will increase health costs, undermining the government's ability to continue funding as large a share of total healthcare spending in the long term. Any government in office will be loath to cut healthcare spending—even if it guarantees that service provision will remain at or above the current level—as doing so would be a death sentence for electoral prospects. Instead, it is likely that there will be an increase in private-sector coverage.

On the supply side, the National-led government is set to undertake major changes to the national health system; it hopes to improve frontline service provision by streamlining bureaucratic processes in the administration of healthcare services. In October 2009 the government announced that it would implement several of the group's proposals, including the creation of a National Health Board (NHB) within the Ministry of Health. New Zealand is heavily reliant on foreign-born doctors in its provision of medical care. Moreover, medical practitioners born in New Zealand have a propensity to migrate to other OECD countries, where salaries are often higher. The OECD has called on the government to focus on attracting practitioners back from overseas, reducing the attrition rate of health professionals (particularly in rural areas) and increasing the number of domestically trained doctors.

Diseases overview

Life expectancy in 2009, at an estimated 80.4 years, is on a par with that in most European countries. Life expectancy is much lower for Pacific Islanders and Maori (New Zealand’s indigenous population), who die an average of eight or nine years earlier than the majority of the population. Although the rate of infant mortality is declining, it is higher than in most developed countries. Rising life expectancy, the availability of more sophisticated treatments and increased community expectations are increasing the demand for health services, placing pressure on both government and personal budgets.

According to a report published by the Ministry of Health, New Zealanders suffer from a number of risk factors that could have a negative impact on their health. More than one-half of adults are overweight, and within this group around 26.5% are considered obese, according to the OECD. This figure makes New Zealand the world's third-fattest country, behind the US and Mexico. The rate of obesity among children appears to be levelling off, having held steady at around 10% in the last five years. Around 18% of New Zealand's adults smoke tobacco and almost 15% admit to smoking marijuana in the past year. In addition, around one in five adults take part in what the government categorises as "a pattern of hazardous drinking". Maori and Pacific Islanders have significantly poorer health profiles than the population that is of European descent.