Analysis of New Zealand's Healthcare System: A Comprehensive Report

This report provides a comprehensive analysis of the healthcare system in New Zealand. It begins with an executive summary outlining the purpose of the report: to evaluate the administration of healthcare sectors in New Zealand, a country known for its robust healthcare system. The report uses the WHO building block framework to assess the country's healthcare system, examining service delivery, health information systems, health workforce, access to essential medicines, leadership/governance, and financing. It explores the country's healthcare policies, challenges, and performance, including the role of government and various healthcare organizations. The report also discusses the limitations of the WHO framework in evaluating the New Zealand system, and it concludes with recommendations for improvement based on the analysis of the system's strengths and weaknesses. The report highlights the country's universal health coverage and its commitment to public health.

Running head: HEALTH ADMINISTRATION
HEALTH ADMINISTRATION
Name of the Student
Name of the University
Author notes

1
HEALTH ADMINISTRATION
Executive Summary
The purpose of the report is the administration of the healthcare sectors in New Zealand.
Healthcare systems are the basic elements of a country system as it is directly related to the
people welfare and lifestyle management. New Zealand’s health care system is considered to
be one of the strongest healthcare systems in the world. The building block framework of the
WHO shows that the New Zealand healthcare system is quite effective and efficient in
managing the different aspects of it. There are some challenges in human resource
availability in healthcare. The country's government is taking responsibility for solving the
problem through its policies and supports to the hospitals. The report will have the
introduction, systems in the healthcare sector in the selected country evaluated through the
building block framework of WHO. Next, there will be performance evaluation and statement
of the influencing factors in the healthcare sectors. Finally, the conclusion will have the
recommendations for the improvement of the New Zealand Healthcare.

2
HEALTH ADMINISTRATION
Table of Contents
Introduction....................................................................................................................3
Healthcare System of New Zealand...............................................................................3
WHO building blocks................................................................................................3
Limitations.................................................................................................................7
Healthcare System Performance....................................................................................8
Overall Health System Performance..........................................................................8
Dimensions of Health System performance...............................................................9
Influencing factors.......................................................................................................10
The complementary framework...............................................................................12
Conclusion....................................................................................................................13
References....................................................................................................................14

3
HEALTH ADMINISTRATION
Introduction
Healthcare policies are not the same in all the countries. This changes according to
their governmental steps, the measures they make for the funding of the healthcare needs, and
policies of the states. The New Zealand healthcare system is considered to be an excellent
service. The country is full of diversity. Hence the challenges of managing healthcare and all
other facilities in the country are quite challenging. Despite the cultural and geographical
diversities, New Zealand governments have been able to set up a structured and effective
healthcare system. The country has both the private and public healthcare systems on point.
This country’s healthcare system is compared to that of the US and the UK. The country has
limited resources in every sector, yet effective policies, strategic implementation, and
constant changes in the plans make it one of the most prominent names in the healthcare
sectors1. The main reason for selecting this country as the case study for this report is to
analyze the ways the government of New Zealand works in managing their healthcare. The
WHO building blocks will be used to analyze the system through its elements and working
process.
Healthcare System of New Zealand
WHO building blocks
The context of the global health system has changed in recent years. The main reason
is that many of the states have not been able to prove their efficiency in healthcare, and the
population has suffered. The structure of healthcare is not efficiently maintained in most of
the countries. This is the reason that global health initiatives are used for standardizing
healthcare targets. WHO or the World Health Organisation is a specialized agency that works
for the United Nations. This organization is centered on public health aspects. The WHO has
1 Jowsey, T. (2018). Cosmopolitans in Australian and New Zealand Health Care Systems. Sites: a
journal of social anthropology and cultural studies, 15(2)

4
HEALTH ADMINISTRATION
its building block framework in order to assess the gap between the input and output of a
country’s healthcare system. The building block of the WHO framework is needed to suggest
a wide and harmonized evaluation system of healthcare all over the world. According to the
building block framework, there are six core components in the model to evaluate the health
system- 1. Service delivery, 2. Health information systems, 3. Health workforce, 4. Access to
essential medicines, 5. Leadership/governance, and 6. Financing2.
New Zealand government and healthcare authorities are well aware of the WHO
parameters of the health system framework. The analysis of the health care system of New
Zealand with respect to the building block shows that there are many access coverage and
outcomes of the same. The overall goals of the New Zealand healthcare are stated to be
providing better healthcare policies in primary and emergency services. On the other hand,
the intermediary goals of the healthcare system of the country are to enrich their public
healthcare, to reduce the waiting time for the patients in the care system, improving primary
healthcare, improving the accessibility of these services to the rural people and increased
responsiveness in the context of mental health care.
The functions of the New Zealand Healthcare system can be evaluated through the
building block framework.
1. Service Delivery
The healthcare service delivery is one of the most important aspects of evaluating
healthcare. Hospitals and nursing homes are the service delivery centers of the healthcare
system. The service delivery system has certain parts in it, for example- the waiting time for
getting the service, quality of the service, the number of people getting the service,
2 World Health Organization. (2010). Monitoring the building blocks of health systems: a handbook of
indicators and their measurement strategies. World Health Organization.

5
HEALTH ADMINISTRATION
availability of the service providers, and type of services available3. According to the health
care policies of New Zealand, the health care of the people living in the rural area are taken
special care of. The service providers, i.e., the hospitals and nursing homes, have been built
in these areas so that the service could be provided easily. The government has launched the
Primary Healthcare Policy in 2001, in which involves the inclusion of more healthcare
professionals in the system to provide quality service. The aim of the policy was also to
increase the proficiency of the care and to reduce the service waiting time for the patients.
The establishment of the Public health organizations or the PBO is another important step of
the government to improve the service for the people4. These PBOs are run by the not-for-
profit centers and include their communities in the governing process.
2. Health Information system
Most of the households in New Zealand could access their health care information
through websites of the health department. The period of the 1990s is considered to be
important for the structural reform of the information policies of the country. New Zealand
Health Information Service was established in 1992 that projects the National Health Index or
NHI5. This is a database of the patient identifier. The Ministry of Health's official website of
the country has ample and effective information on the country's health care provisions. Most
of the hospitals in the country have an improved IT system. All these works effectively to
improve the information system of the healthcare departments. The population of the country
has easy access to the internet, and they can get all the required information in the archives.
3 Stokes, T., Tumilty, E., Latu, A. T. F. A., Doolan-Noble, F., Baxter, J., McAuley, K., ... & Dummer,
J. (2019). Improving access to health care for people with severe chronic obstructive pulmonary disease
(COPD) in Southern New Zealand: qualitative study of the views of health professional stakeholders and
patients. BMJ open, 9(11).
4 Mounier-Jack, S., Griffiths, U. K., Closser, S., Burchett, H., & Marchal, B. (2014). Measuring the
health systems impact of disease control programmes: a critical reflection on the WHO building blocks
framework. BMC public health, 14(1), 278.
5 Came, H., & McCreanor, T. (2018). Challenging enduring health inequities. Kai Tiaki: Nursing New
Zealand, 24(11), 14-45.

6
HEALTH ADMINISTRATION
3. Health workforce
Managing and creating human and physical resources in an integral part of any
healthcare system. There is a scarcity in the number of healthcare professionals in the
country. The number of physicians per 1000 people is lesser than the OECD average6. But the
number of nurses is more than the required percentage. Also, the midwives manage more of
the pregnancy cases in the initial stages. Another important part of the healthcare
professionals in the country is the Plunket nurses. The Plunket nurses are provided by the
renowned NGOs for the after pregnancy mother and child care.
4. Access to Essential Medicines
The Medicine Amendment Act of 1999 as gone through several changes in past years.
The medicines are provided to the patients only after the prescription of the doctor. The act
also talks about the standing order, which is an important addition to the access to essential
medicines7. The standing order medicines are the medicines that can be provided by nurses or
some other healthcare professional by the standing order of the doctor. The prescription is not
necessary all the time.
5. Governance
The role of the government in policymaking and their implementation is most
important in the healthcare aspects. Much of the costs for the healthcare is bore by the
government in municipalities and county level. Therefore, governance is monitored by these
bodies. Along with that, the hospitals also have their expert and management groups to make
decisions in their internal aspects8. Leadership plays a significant role in nursing and patient
6 Rees, G. H., Crampton, P., Gauld, R., & MacDonell, S. (2018). New Zealand's health workforce
planning should embrace complexity and uncertainty. The New Zealand Medical Journal (Online), 131(1477),
109-115 7 Blake, D., Niland, P., & Johnston, D. M. (2019). Health emergency management in Aotearoa New
Zealand: Making sense of professional development. Journal of Emergency Management, 17(5), 359-369.
8 McPherson, K. (2019). The future of health research in New Zealand: a thought experiment. The New
Zealand Medical Journal (Online), 132(1501), 8-9.

7
HEALTH ADMINISTRATION
care factors. The PHC and PHOs are controlled and managed by the core expert boards of
advisory. The regular works in healthcare are monitored by the respective leaders in hospitals
and nursing homes.
6. Financing
National Healthcare services are funded by the mix of public and private finances.
The major part of the GDP is spent in the healthcare services of the country. The report of the
country government says that about 11% of the GDP is dedicated to the betterment of the
healthcare sections9. The public taxes used for financial support of the sector. Along with
that, private companies also help with insurance profits and investments. More than 77% of
the total healthcare expenses are provided by the government10.
Limitations
 The building blocks framework of the WHO has certain limitations in evaluating the
healthcare system of New Zealand. There are multiple aspects of a health care system,
while its structures and functioning details remain hidden. According to McCormick
& Thompson, the building block is a simple representation of the effects of health
care in some parts, but at the same time, it fails to register the impacts of the complex,
dynamic, and interlink systems11. For example, the six factors of the building blocks
have the sections that talk about the outcome and effects on the health care system as
a whole. But it is difficult to understand the continuous and complex mechanism of
the New Zealand healthcare system through these aspects.
9 Lee, C. H., & Sibley, C. G. (2017). Demographic and psychological correlates of satisfaction with
healthcare access in New Zealand. Do robots get burnout?, 130(1459)
10 health.govt.nz, (2020), Ministry of Health: NZ, retrieved from:
https://www.health.govt.nz/search/results/goals
11 McCormick, G., & Thompson, S. R. (2019). The provision of palliative and end-of-life care by
paramedics in New Zealand communities: A review of international practice and the New Zealand context.
Whitireia Nursing and Health Journal, (26), 51.

8
HEALTH ADMINISTRATION
 Some of the experts have the opinion that the main limitation of the building block is
that the same amount of importance has been given to each of the components of the
building block. The problems are the New Zealand health care services might face
more problems in their workforce management than in their financing sections.
 Another limitation is that this component of building blocks does not have any
interactive relations within themselves. Each of the components is judged
individually, and that is why there is a lack in its capturing the whole process12. The
New Zealand health sectors have to work in connection with the individual
components of the block. For example, the financial contexts of the sector are related
to the recruitment and management of the workforce; again, the governance and the
health care information sharing both are related as these are done by the government,
hospital authorities, or their bodies in most cases. Hence, through this framework, the
New Zealand health care sector components cannot be judged inter-connectedly.
Healthcare System Performance
Overall Health System Performance
The place of the healthcare system in New Zealand is held high in international
healthcare standards. This is one of the countries in the world that is known for its health care
policies and provisions. The country has a population of 4.49 million, and the current life
expectancy is 78 years for the men and 82 for the women13. This proves how effectively the
health care sectors work in this country.
The country has a universal health coverage system that is mostly funded by public
funds along with the NGOs, non-government based organizations, and private investors. The
overall responsibility of healthcare lies in the Ministry of Health. This department is the main
12 Cumming, J., Dunn, P., Middleton, L., & O’Loughlin, C. (2018). The health care home in New
Zealand: rolling out a new model of primary health care. Journal of Integrated Care.
13 Came-Friar, H., McCreanor, T., Manson, L., & Nuku, K. (2019). Upholding Te Tiriti, ending
institutional racism and Crown inaction on health equity. New Zealand Medical Journal, 132(1492), 62-66.

9
HEALTH ADMINISTRATION
advisory body for the health and disability-related sections. Other than this agency, the
Ministry of Social Development, Te Puni Kokiri, the Office for Disability issue, and the
Accident Compensation Corporation also give their contribution in the decision making14.
The District Health Boards or the DHBs are the responsible bodies for the funding
and planning of the healthcare services of the country. The DHB is the agency that plans,
monitors, and aligns the healthcare services15. The information management of the sectors is
also done by the DHBs. Another significant agency is the National Health Board, which was
established in 2009. This is the governing board for the DHBs.
The healthcare of New Zealand gives universal coverage to the residents of the
country. Right from the primary care to the mental health care, dental care, and emergency
care, all are covered by the health care policies of the country. The government has special
policies for the healthcare of the Maori people in the country. Health promotional services
and the primary health care of the community people are the responsibility of the PHOs in the
country16. The disability and health services of the country include mental health, surgical,
medical, aged care, and other obstetric services.
The Health and Disability Act of 2001 is the base of the standards and monitoring of
the health care framework. The accreditation of the health care centers and the medical
practitioners are governed by the Health Practitioners Competence Assurance Act 2003.
Dimensions of Health System performance
 Equity in healthcare is an integral part of any country. For a country like New
Zealand, the context of equity is all the more important as it has to deal with the
14 Jowsey, T. (2018). Cosmopolitans in Australian and New Zealand Health Care Systems. Sites: a
journal of social anthropology and cultural studies, 15(2).
15 Byers, V. (2016). Democratic Governance and Health: Hospitals, Politics, and Health in New
Zealand. 16 Came-Friar, H., McCreanor, T., Manson, L., & Nuku, K. (2019). Upholding Te Tiriti, ending
institutional racism and Crown inaction on health equity. New Zealand Medical Journal, 132(1492), 62-66.

10
HEALTH ADMINISTRATION
community’s diversity. The social and economic status should not be the reason for
one’s health care discrimination17. New Zealand government takes every care that this
should not be the case of the country. The equity in accessing health care in the urban
and rural areas is a great feature of the health care system; also, the government
makes sure that the patients that are not covered by the insurances, should get all the
primary or critical health care benefits whenever needed. The country believes no one
should be deprived of their right to get required medical help at any point in time.
 Quality of service in the health care sectors depends on multiple aspects. The
healthcare provider of the country makes sure of the quality and equity of the health
care services18. Physicians and other staff of the hospitals are well trained, and they
provide due care with skill.
 To increase the responsiveness of their services, the DHBs are working with the
PHOs. The country healthcare services have been able to reduce the waiting time for
the patients in the hospitals. Hence, they are working to increase the number of
physicians in hospitals, at the same, are time using IT to enhance service quality19.
Again, the PHOs has the responsibility to show responsiveness towards the health
need of the community people. The Maoris and other tribes in the country are
provided health care information through these NGOs and PHOs.
 Efficiency is the context of treating the patients with the right and effective kind of
services in the minimum time. The overall health care system is based on the
framework that takes the patient's safety and welfare seriously20. There is a special
17 Blakely, T., Kvizhinadze, G., Atkinson, J., Dieleman, J., & Clarke, P. (2019). Health system costs for
individual and comorbid noncommunicable diseases: An analysis of publicly funded health events from New
Zealand. PLoS medicine, 16(1).
18 Miles, M., & Francis, K. (2019). The Australian and New Zealand health care systems. In Chronic
care nursing: A framework for practice (pp. 65-79). Cambridge University Press.
19 Montayre, J., De‐Arth, J., Shrestha‐Ranjit, J., Neville, S., & Holroyd, E. (2019). Challenges and
adjustments in maintaining health and well‐being of older Asian immigrants in New Zealand: An integrative
review. Australasian journal on ageing, 38(3), 154-172.
20 Deravin, L., Coyne, E., Croxon, L., & Anderson, J. (2018). The Australian and New Zealand Health
Care Systems. In Acute Care Nursing (pp. 1-17). Cambridge University Press.

11
HEALTH ADMINISTRATION
provision for older people and the disabled. The preventive services, screening, and
health insurance are managed by the PHOs.
 Accountability in the service sectors plays an important role. The term accountability
means taking responsibility for one’s actions. The patients’ care is the priority for any
health care professional. This is an integral part of the responsibility of the doctors
and nurses. The New Zealand health sector professionals are well known for their
quick responsive nature and accountability towards the patients.
 The intrinsic ability to recover in an emergency or changed condition is known as
resilience. There have been various changes in the provision and policies of the health
care of New Zealand. All these measures were taken to adjust the functioning of the
hospitals and nursing homes so that changing demands in these sectors can be
managed. The healthcare sector can be said to be quite resilient to the challenges, and
this is why the country has been able to establish its name in high in healthcare
aspects.
Influencing factors
The factors that are influencing the health care system of New Zealand in present
conditions are related to their political, social, and economic sections. In this part of the
report, these sections of the country are discussed in light of their facilitation or limiting roles
in healthcare sectors.
Political Factors
The political factors have a huge influence on the healthcare sectors of New Zealand.
The country is able to bear most of the costs for healthcare through taxes. The policies and
provisions of healthcare are all decided by the government and its appointed agencies. This
way, the influence of political establishments are immense in the healthcare sectors. New