New Zealand. Reports on Health in New Zealand

Citation

Morris, B. (2003), "New Zealand. Reports on Health in New Zealand", International Journal of Health Care Quality Assurance, Vol. 16 No. 2. https://doi.org/10.1108/ijhcqa.2003.06216bab.001

New Zealand. Reports on Health in New Zealand

Edited by Barbara Morris

New Zealand

Reports on Health in New ZealandKeywords: Health information, Expenditure, Health workforce, Inequality

Two new reports on health in New Zealand were published at the end of 2001. The first of these, Health Expenditure Trends in New Zealand 1990-2001, is the latest in a regular series of reports which provides information on health and disability expenditure for use by both the public and health agencies. It reports on health and disability expenditure in New Zealand during 2000-2001, provides information on expenditure trends for the period 1990-2001, and analyses the trends of health funding in New Zealand and in relation to expenditure by other OECD countries. According to the report, New Zealand's total health expenditure as a percentage of Gross Domestic Product (GDP) in 2000-2001 was 8.8 percent, compared with 8.5 percent in 1999-2000. When the funding for "non-health" items (mostly disability support activities) is included, the proportion increases to 9.2 percent in 2000-2001, compared with 8.9 percent in 1999-2000.

The report also shows that total nominal health and disability expenditure rose 10.4 percent during 2000-2001 to $9,884 million. Publicly funded expenditure was up 8.6 percent and private spending increased 16.9 percent. Within the latter, private household spending grew 20.5 percent to $1,657 million. However, the report says that this rise is likely to be attributable to actual data being available rather than the estimate provided in the two previous years. Health insurance expenditure was up 8.8 percent to $610.1 million and expenditure by the not-for-profit sector was $33 million.

Real (consumer price index adjusted) total expenditure increased 7 percent for the year compared with a rise of 3.6 percent the previous year. Real publicly funded expenditure grew by 5.2 percent, and real private expenditure by 13.2 percent (3 percent in the previous year).

New Zealand's publicly funded health expenditure as a percentage of GDP was 6.8 percent in 2000/2001. When the funding for "non-health" items included in Vote Health is added, the proportion of publicly funded health and disability spending to GDP rises to 7.2 percent.

The second report is the Ministry of Health's second annual Health and Independence Report 2002. The report looks at the public funds which are allocated to health and disability support services in New Zealand, the services that are delivered and what those services are achieving by way of their contribution to the health of New Zealanders.

Many people are being cared for by the publicly funded health system. In 2000/2001, 190,000 people received publicly funded surgery. Director-General of Health Dr Karen Poutasi said that despite criticisms about waiting lists, more people are being treated in hospitals. For example, orthopaedic surgery has increased by 4.8 percent a year since 1996-1997, while non-urgent surgery has increased by 5.2 percent a year. However, a trend that is causing concern is the increase in avoidable hospital admissions for conditions and diseases that could have been treated through primary care intervention. Dr Poutasi said: "Since 1996-1997 there has been a 3.4 percent annual increase in such admissions, which is one of the reasons why the Government's put a lot of effort into its Primary Healthcare Strategy."

She added that primary health organisations should be able to influence these particular avoidable hospital admissions.

Health inequalities are also reported. For example, life expectancy at birth for New Zealanders has increased steadily since 1950, but that for a newborn Maori it is nine years less than for Europeans and others, and for a Pacific child it is five years less. Generally health statistics in areas such as obesity and Type 2 diabetes, present a less positive picture for Maori and Pacific peoples than for Europeans. Dr Poutasi said that the Government recognised that action on prevention and education is essential in tackling health inequalities. The Primary Healthcare Strategy is a major response, but other programmes such as He Korowai Oranga: Maori Health Strategy, the Pacific Health and Disability Action Plan are specifically aimed at reducing health inequalities.

The report also includes information about the health workforce. About 100,000 health professionals including nurses and doctors are operating in New Zealand and those numbers are constantly increasing for most health professionals, as is the amount of public money spent on health and disability services. The report notes that for GPs, nurses and most categories of health professionals, the numbers per head of population who are actively practising in New Zealand have been steadily increasing for the past decade. This is contrary to a frequent perception that numbers are declining. For instance, the report records that the number of GPs per 100,000 New Zealanders has increased from 188 to 225 in the last ten years. However, it also acknowledges that there are pressure points. The distribution of doctors and nurses is not spread evenly around the country; there are differences between regions and between metropolitan and rural areas.

The health workforce is becoming more specialised. While the number of active registered nurses rose from 707 to 853 per 100,000 people between 1990 and 2000, the number of enrolled nurses decreased from 187 to 112 per 100,000 during the same period. The report says the health and disability workforce is constantly affected by the international demand for skilled health professionals, and pressures from an ageing population, working conditions and the impact of new health technologies.

Further information: the two reports, Health Expenditure Trends in New Zealand 1990-2001 and the second annual Health and Independence Report 2002 can be accessed from the Ministry of Health Web site at http://www.moh.govt.nz