Critical Review of the Aotearoa New Zealand Healthcare System

This presentation provides a comprehensive overview and critical analysis of the healthcare system in Aotearoa New Zealand, offering a detailed comparison with the healthcare framework in India. The presentation begins with a historical overview of both healthcare systems, tracing their development and key milestones. It then delves into the organization and governance structures, examining the roles of the Ministry of Health, District Health Boards (DHBs), and primary health organizations (PHOs) in New Zealand, and contrasting them with the decentralized healthcare responsibilities in India. The presentation explores primary, secondary, and tertiary healthcare services, highlighting funding models, user experiences, equity in accessibility, and healthcare provisions for special groups in both countries. Key aspects such as funding sources, insurance systems, accountability, transparency, health information management, and recent policy changes are also discussed. The analysis further covers healthcare targets, performance milestones, challenges, and future prospects of both healthcare systems, offering valuable insights for understanding and comparing healthcare approaches in New Zealand and India. The presentation concludes by emphasizing that the healthcare system in New Zealand is more advanced than the one used in adopted in India.

Aotearoa New
Zealand Healthcare
System
NAME OF STUDENT
INSTITUTION AFFILIATION

1. INTRODUCTION
• Different countries have adopted a
healthcare framework based on the needs
of the people as well as the capacity of the
government to meet these needs (Health
Quality & Safety Commission, 2018).
• This presentation provides a critical review
of the healthcare system in New Zealand
and highlights a comparison to the

2. Historical Overview
• The healthcare system in New Zealand could be traced back to
the 1980’s
• Healthcare system is funded by the collected revenue from the
public and corporate activities.
• The healthcare management is under the leadership of the
Ministry of Health with a planning and funding board from 20
districts.
• Today, the country enjoys a high level of healthcare equality and
accessibility (Health Quality & Safety Commission, 2017b).
• In India healthcare policies have been tailored to foster equality
and accessibility over the years; however, the key milestones
have not been attained (Kasthuri, 2018).

3. Organization and
Governance• The healthcare system in New Zealand is majorly supported
through public funding with significant help from private non-
governmental organizations.
• The advisory body in health affairs remains to the Ministry of
Health (Pegasus, 2018; Health Quality & Safety Commission, 2017a).
• Twenty health boards from each district are responsible for
planning and healthcare implementation.
• On the other hand, in India, healthcare responsibility is
disseminated to specific states through the help of the federal
government (Kasthuri, 2018).
• The national government in India, as seen in New Zealand, is
equally responsible for policy enactment, coordination, planning,
monitoring, and evaluation.

4. Primary Healthcare
• The primary healthcare services are offered through primary
health organizations (PHOs), which receive their funding based
on the number of consumers they have in their system (MOH,
2012c).
• The quality of PHOs services is monitored by the Office of Health
and Disability Commissioner (Health Quality & Safety Commission,
2018).
• When it comes to India, primary health is mandate of the public
sector where the primary health centers are owned and managed
by the state governments.
• In India, the states depend on the data collected by the HMIS to
determine the funding and capacity of the Primary Healthcare
Centers (PHCs) (Growth Analysis, 2013).

5. Secondary
Healthcare• Secondary healthcare in New Zealand is provided by the district
health centers and managed by the District Health Boards
(DHBs).
• Some critical services are contracted to enhance the quality of
outcomes, for example, mental health and aged care (Gauld &
Horsburgh, 2018).
• In India, the facilities could be divided into public and private,
which are also mandated with responsibility of offering secondary
care.
• Community health centers and district healthcare hospitals in
India offer secondary care (Kasthuri, 2018).

6. Tertiary Healthcare
• Publicly managed healthcare facilities also provide
tertiary care in New Zealand.
• Private hospitals play a central role in specialized
services such as long-term care and surgery.
• The DHBs created through the Public Health Act of 2000
are also in charge of tertiary care in the country (Health
Quality & Safety Commission, 2018).
• In India, the system is not so much advanced when
compared New Zealand. The country relies mostly on
private sector, which contributes to the growth in the
delivery of specialized healthcare services in the

7. Funding
• About 82% of the healthcare funds in New Zealand come from the
government through revenue collection while 8.4% comes from
compensation.
• The country has managed to improve its GDP to health
expenditure ratio from 6.8% to 10.1% in the recent ten years
(Family Violence Death Review Committee, 2016).
• About 38% of adults have insurance covers that contribute to
over 4.9% of the total annual health expenditures across all
districts.
• In India, the delocalization of funding has given the states more
responsibility in term of planning and implementation.
• According to NHSRC, India averagely spends 3.84% of its GDP in
healthcare. Government Expenditure accounts for 30.6%, which

8. Healthcare and
Insurance• New Zealand has a universal healthcare plan; however,
consumers are required to cater for out-of-pocket expenses.
• The out-of-pocket expenses for each patient vary based on
the individual physician or the PHO that the consumer joined
(Health Quality & Safety Commission, 2018).
• In India, the insurance system is not yet advanced and
patients still rely on;
1. Rashtriya Swasthya Bima Yojana (RSBY) for poor people.
2. Employees’ State Insurance Scheme (ESIS) is meant for
people in employment.
3. Central Government Health Scheme (CGHS) is another
option available for those with an income (Kasthuri,

9. User Experience and
Equity in Accessibility
• In New Zealand 37% of consumers agreed that the system
was favorable while about 51% stated that there is need for
improvement (Health Quality & Safety Commission, 2018).
• The state, through DHBs, has ensured that there is sufficient
access to healthcare for its citizens.
• In India, accessibility and affordability is still a critical
challenge in healthcare services especially for population
below the poverty level.
• According to WHO (2012), the country is experiencing a
change geared towards enhancing access to healthcare;
• With the implementation of subsequent healthcare plans,
India could achieve New Zealand’s milestones.

10. Healthcare for Special
Groups
• In New Zealand, special groups receive care through a
collaborative approach.
• Lead Maternity Carer offers maternity health (Gauld & Horsburgh,
2018).
• Children below the age of 18 receive free dental care.
• Ambulatory services are available in two options: volunteers and
staffed paramedics services.
• In India, special group healthcare is not as advanced when
compared to the system in New Zealand.
• Apart from mental hospitals, other special facilities in India such
as those taking care of cancer, TB, neurology, and cardiology
patients are also available (NHSRC, 2018).

11. Accountability and
Transparency
• In New Zealand, the government has set a framework
that ensures that there is a high level of accountability.
• The DHBs and the national boards play a significant role
in oversight and quality improvement (Health Quality &
Safety Commission, 2018).
• In India, the objective of NRHMC is to ensure that it is
affordable and quality service within a system that
recognizes and embraces accountability (Prashant, 2017).
• However, the inter-sectorial and coordinated healthcare
programs have created a complex environment in the
country.