Our health system supports every New Zealander at times in their life.
The things we need for our health and independence can vary widely. For example, we may need primary care and community services to support our wellness and prevent illness, services to help us manage long-term conditions, or urgent help to deal with accidents or acute illness.
New Zealand’s health system (the system)1 has many skilled and dedicated health workers and organisations working in a wide range of services, including public health services and personal health services.2 In many ways, our system performs well.
However, our system is not always well equipped to help people interact easily with services. Connecting people with health services, and joining these up with disability services and social services, is essential. This integrated approach will improve people’s overall wellbeing and get the greatest value from the public funding invested in health services.
‘… a much more systematic, scaled and long-term approach to implementing key systems and cultural changes… will influence clinician and patient behaviours and choices towards a more sustainable and equitable health system.’
–Primary health organisation
Our system can struggle to give all New Zealanders equitable access to health services: some population groups continue to benefit less from the health system than the population as a whole. We have to rise to the challenge of achieving better outcomes for everyone, within the resources we have. This means we must find new ways of working to deliver the services we need.
To perform to a high standard, the system needs more than a skilled health workforce and resources. It needs a shared view of its overall purpose and the direction it is going, combined with effective ways of working.
The legislation that governs New Zealand’s publicly funded health and disability services requires the Minister of Health to have a strategy for health services – a health strategy – aimed at improving the health of people andcommunities.3 Legislation also requires a strategy for disability support services (the New Zealand Disability Strategy).4 Taken together, the two strategies provide a framework for the full range of services that comprise the wider health and disability system.5
The previous health strategy was developed in 2000. We have made significant progress since then in areas such as the affordability and organisation of primary care and elective surgery waiting times. However, the challenges now facing the health system make it necessary to again clarify the shared future direction of health services.
This update of the New Zealand Health Strategy will provide this clarity and enable different parts of the system to work together to improve it.
On behalf of the Minister of Health and Government, the Ministry of Health (the Ministry) has led the development of this strategy as part of its role as steward of the health system. In this context, stewardship means focusing on the long-term future and performance of the whole system, and taking steps to improve performance as necessary.
In its stewardship role, the Ministry is uniquely placed to lead the whole system and strengthen the links between its different parts. However, stewardship also involves recognising that partner organisations will lead and support much of the transformation required in the sector. These organisations include local entities such as district health boards and primary health organisations, and national bodies such as the Accident Compensation Corporation and the Health Quality and Safety Commission New Zealand.
A strategy is a guide for achieving the sort of future that you want. It can help people, organisations or a whole system work together more effectively on the most important things. Without a strategy, small problems today can become big problems over time.
The Strategy has two parts.6
- The New Zealand Health Strategy: Future direction (this document) outlines the high-level direction for New Zealand’s health system over the 10 years from 2016 to 2026. It lays out some of the challenges and opportunities the system faces; describes the future we want, including the culture and values that will underpin this future; and identifies five strategic themes for the changes that will take us toward this future.
- The New Zealand Health Strategy: Roadmap of actions 2016 (companion document) identifies specific areas for action over five years to make the Strategy happen. This roadmap will be periodically updated over the 10-year lifetime of the Strategy.
The image below identifies the components of the Strategy, and where to find them in this document and the companion Roadmap of Actions.
Components of the New Zealand Health Strategy
New Zealand’s health system performs well
In 2014, 90% of New Zealanders reported they are in good, very good or excellent health, the highest percentage reported by any country in the Organisation for Economic Co-operation and Development (OECD); for those aged over 75 years, the figure is 87%.
80% of adults reported they are satisfied with the care they receive from their usual medical centre and 83% of people rate their care in emergency department services as good or very good.
95% of New Zealanders are enrolled with a primary health organisation.
New Zealanders are more likely to report being able to get a doctor’s appointment on the same or next day than people in the United Kingdom or Australia.
Waits for emergency department care are the shortest of 11 countries surveyed by the Commonwealth Fund.
Life expectancy for New Zealanders is 79.5 years for males and 83.2 years for females, both above the OECD average.
Our health system supports:
- 12.6 million daytime visits to general practitioners (GPs) per year (and 2.8 million visits to general practice nurses)
- the dispensing of 65 million pharmaceutical items
- 24 million laboratory tests
- 1 million emergency department visits per year.
Sources: Health and Independence Report 2015, Patient Experience 2011/12: Key Findings of the New Zealand Health Survey, the Commonwealth Fund International Survey of Primary Care Physicians and the Commonwealth Fund International Health Policy Survey in eleven countries. Also unpublished Ministry data.
1. By ‘health system’, we mean the range of organisations contributing to the health of New Zealanders, including but not restricted to the organisations established through the New Zealand Public Health and Disability Act 2000, such as district health boards and other Crown entities.
2. In this strategy, ‘health services’ refers to services focused on improving health, including public health and population-level services as well as services for individuals.
3. The New Zealand Public Health and Disability Act 2000 Section 8(1) requires the Minister of Health to ‘determine a strategy for health services, called the New Zealand health strategy, to provide the framework for the Government’s overall direction of the health sector in improving the health of people and communities’.
4. The current New Zealand Disability Strategy was released in 2001. An update is proposed for 2016.
5. This health strategy provides direction for providing health services for people with disabilities. Many of its themes are also relevant to disability support services that health system organisations fund and provide, and they will inform the updated New Zealand Disability Strategy. See the diagram Overview of the New Zealand health and disability system.
6. Both parts of the Strategy together comprise the ‘New Zealand health strategy’ required by Section 8(1) of the New Zealand Public Health and Disability Act 2000.