Detailed Report on Health Service Management in New Zealand: Analysis

This report provides a comprehensive analysis of health service management in New Zealand. It begins with an introduction outlining the current challenges and restructuring efforts within the nation's healthcare system. The report delves into the Treaty of Waitangi, discussing its principles of partnership, participation, and protection and how they underpin the relationship between the government and the Maori population. It then examines New Zealand's national health strategies, analyzing them through the lens of the Treaty's principles. The study further explores the New Zealand healthcare system, focusing on key organizations, consumers, providers, and policymakers. A comparative analysis between the Australian and New Zealand healthcare systems is conducted to identify challenges. Finally, the report identifies a specific health factor posing a significant challenge to the New Zealand health system and includes a PESTLE analysis to provide a strategic framework. The report concludes with a summary of findings and recommendations for future improvements.

Running head: HEALTH SERVICE MANAGEMENT
HEALTH SERVICE MANAGEMENT
Name of the Student
Name of the University
Author’s Note

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Table of Contents
Introduction......................................................................................................................................2
Answer 1..........................................................................................................................................2
Treaty of Waitangi.......................................................................................................................2
Principles of Waitangi underpinning the relationship between the Government and Maori......3
New Zealand’s National Health Strategies through analysis of three principles of Waitangi
treaty............................................................................................................................................4
Answer 2..........................................................................................................................................6
New Zealand Healthcare system with reference to key organization, consumers, providers and
policy makers...............................................................................................................................6
Answer 3..........................................................................................................................................9
Comparative analysis of Australian health factors with that of New Zealand for identifying
challenges to their health systems................................................................................................9
Answer 4........................................................................................................................................13
One of the health factors identified as main challenge to the New Zealand health system.......13
PESTLE analysis on New Zealand’s health care system..........................................................13
Conclusion.....................................................................................................................................16
References......................................................................................................................................17

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Introduction
The study provides an overview on the management of New Zealand health services. The
managers of health services in New Zealand strives to adopt best managerial practices amid huge
turbulence as well as restructuring that is prevalent in present health care system of this nation
(Abdelhak, Grostick & Hanken, 2014). This report highlights on the health strategies of this
nation through analysis of three principles of treaty of Waitangi. These three principles involve
participation, protection and partnership that underpin relationship between the government and
Maori. The health care system of New Zealand is also analyzed in the study in relation to key
organizations, providers, consumers and policymakers. Furthermore, comparative analysis of
Australian health care system with that of New Zealand is also elucidated in this study for
identifying challenges to health systems of these two nations. The last section focuses on the one
of the health factors creating challenge to this nation health system along with healthcare strategy
framework as well as action plan embedding PESTLE.
Answer 1
Treaty of Waitangi
The Waitangi treaty refers to the treaty that had been first signed on 6th Feburary, 1840 by the
Maori chiefs and British Crown representatives belonging from North Island of New Zealand.
This treaty has been largely significant in structuring political relation between this nation’s
government and population of Maori. This objective of this treaty was to allow the Maori people
and British settlers to stay together in this nation under general set of agreements (Crocket,
2013). This agreement also makes government of this nation held responsible to address

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indigenous people grievances and establish equality among the people of this nation. The treaty
of Waitangi is based on three principles that involves-
 Partnership- This involves the communities of Maori and the government working
together for developing strategies for appropriate disability as well as health services.
 Participation-This needs Maori to be engaged at every levels of health industry that
includes decision-making, framing, development and health services delivery (Ludbrook,
2014).
 Protection- This includes the government of this nation working to assure that Maori
have same health level as that of non- Maori and safeguarding the concepts of Maori
culture.
Principles of Waitangi underpinning the relationship between the Government and Maori
The Waitangi treaty principles plays vital role in this nation education system and the
method in which they work. The system of government in New Zealand has been strongly
affected by the principles of Treaty of Waitangi that is also known as Maori language. This
treaty mainly requires that Maori and this nation’s government act towards one another in good
faith. Two vital methods for achieving this has been through well-versed decision making that
involves consultation by government as well as through protection of rights of Maori under
Treaty by government. In addition, the government also established Waitangi tribunal for
investigating the grievances of Maori about the breaches of treaty of Waitangi. Crocket (2013)
opines that this treaty has also been important as it ensures that both Pakeha as well as Maori
rights are protected in account of accepting the Maori rights, identifying Maori land ownership
as well as protecting their life and entailing the government of this nation to meet their
requirement.

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New Zealand’s National Health Strategies through analysis of three principles of Waitangi
treaty
The health strategy of New Zealand mainly focuses on improvement of health of the people
residing in New Zealand. This people- powered health strategy of this nation sets direction for
action on the health of New Zealanders by providing nationwide structure within which this
health industry develops. This puts emphasis on decreasing disparities in status of health between
the population group, improving health outcomes of population and addressing issues relating to
treaty of Waitangi. Other health organizations of this nation apply the principles of treaty in
making their decisions regarding improvement in their health care structures (Ludbrook, 2014).
The Nursing council of this nation also governs the nurse practice by setting as well as
monitoring standards for registration through incorporation of treaty of Waitangi principles.
In addition, their new strategy also addresses issues regarding access to health care services
and lending support to mental health services development. The three principles of Waitangi
treaty plays vital role in national health strategies of New Zealand. Additionally, these principles
provide numerous benefits to the Maori people relating to their health care services. The
Waitangi principles are considered as appropriate framework for underpinning health policies
and health strategy of Maori because of several reasons, which includes-
 Treaty of Waitangi guides relations between the Crown and Maori
 The government as well as their agencies clearly demonstrates responsiveness to the
health of Maori
 This framework has been utilized for facilitating development of coherent as well as
comprehensive policies and reducing risk of missing areas for the policy attention.

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From the recent evidences, it has been reflected that most of population of this nation have
recorded good health as compared to other nations (Carayon et al., 2016). The new health care
strategies adopted by National Health committee of this nation involve increase in life
expectancy of both males as well as females. Furthermore, 83% of people residing in this nation
reported that their care in the emergency department services has been quite good. Their future
strategy builds around specific themes that involves-
Firstly, by making the people of this nation ‘health smart’ so that they can understand and attain
the information they require for managing their care.
Secondly, by enabling the people to make their choices regarding care they receive
Thirdly, by understanding the requirement as well as preferences of people and then partnering
with them for designing services (Boulware et al., 2016)
Fourthly, by communicating in proper manner and supporting individuals navigation of system
that involves utilization of technology such as internet or mobile phones.
The New Zealand’s national health strategies through analysis of Treaty of Waitangi principles
are illustrated below:
 Partnership- This involves the relationship between Maori and the DHB (District health
Boards). According to this relationship, Maori is needed to share their decision making
regarding their health services for furthering increasing its regulation. As efficiency is
one of the targets of this partnership, it can be achieved through redeployment of
resources at primary level of health care. However, DHB works with present population
funding formula and reallocates funds for meeting objectives for Maori health.

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 Participation- The participation principle is defined as innovating pathways of access
that facilitate Maori to participate within the health industry (Crocket, 2013). This policy
involves two approaches – provider development and allowing of health care service
users. This facilitates in providing equal opportunities relating to health care services.
 Protection-. This principle mainly highlights on the supply side mechanism in health for
assuring Maori proper health services. The aim of this specific principle is liberty, which
means the freedom of the individuals to exercise their choice regarding health services.
This principle is mainly applied in Oranga as duty of healthcare services for identifying
and responding to the cultural values, practices and beliefs of Maori.
Answer 2
New Zealand Healthcare system with reference to key organization, consumers, providers
and policy makers
New Zealand’s health care system has undergone considerable changes over the last few
decades. The reforms involve health insurance elements that create mixed public-private system
to deliver healthcare (Public and private health systems, 2018). The health services in this
country are generally delivered through complex network of people as well as organizations.
Regular business of health care system and funding is mainly administered by DHB. They plans,
administer, provide and buy healthcare services for people residing in their district in order to
assure that services are effectively arranged for New Zealanders. This involves funding for
hospital services, aged care and public health care services, services provided by Maori etc.
Besides this, there is huge range of research institutions that involves in provision of training as
well as services of the employees. In fact, there are several non- government enterprises and

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consumer bodies that offer services for interest of varied groups (Drummond et al., 2015).
Furthermore, the policymakers that is the Health Ministry also plays important role in this
system, which involves funding of national healthcare services.
This nation’s healthcare system is segmented into three broad categories that includes-
Health care Funding
The social security Act of this nation passed in the year 1938 was aimed to assure that
there must be worldwide access to health services funding via taxation system. The funding of
health care system in New Zealand mainly comes from Vote Health that is around $16.142
billion as recorded in the year 2016-17 (Funding, 2018). Other funding sources involve
government agencies, private sources namely insurance, local government and ACC (Accident
Compensation Corporation). The Health Ministry of this country allocates near about three
quarters of public funds that it manages via Vote Health to the DHB, who utilizes this to plan,
buy and provides services. The present framework of healthcare funding designed by Health
Ministry is not effective for the people residing in the nation for long period. Moreover, the
arrangements also lack in highlighting the outcome of healthcare funding. Although a primary
health care service in this country is funded by partial fee for payment, there arise inequalities in
access mainly with poorer individuals and Maori utilizing services at higher rates (Gauld, 2012).
In addition, as the recent funding system is complex, it makes it difficult for people to make
specific choices regarding prioritization of funding. The system adopted by Health Ministry is
not flexible and hence does not adapt with change in market demand. The gap that occurs in this
case is that some of the funding arrangements of this nation contribute to huge disparities

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between the high income groups and low income groups in access to healthcare services.
Sometimes it widens the gap to that huge extent in their healthcare systems.
Health care structure
This country has both private as well as public health care system that provide high
standards in health care. In public healthcare system, essential services are mainly offered free of
cost for New Zealanders. On the other hand, private healthcare system provides access to all
private hospitals regarding treatment of urgent conditions. The entire healthcare system ranges
beyond Ministry as well as DHB that is –PHO (public health organizations), crown entities,
Maori etc. The structure of healthcare system has been designed by policymakers in such a
manner at which it facilitates in controlling health services of this country (Gauld, 2013). Overall
their health care structure highlights that they have been performing better as compared to other
nations. Although this nation healthcare structure is strong, it reflects some gaps in health care
service. Lower income group of this country does not attain benefit from health system with
respect to others. The health system of this nation has undergone several restructuring for over
the last few decades. As they have much emphasis on the primary health care, it creates huge
gap in other sectors of their health systems. The health approach of population and the social
systems for closing this gap is also one of the features of restructuring of health care systems.
But still some gap exists between the Maori and non- Maori people this country. For example, it
has been predicted that dementia will increase among New Zealanders from about 2011 to 2026
(World Health Organization, 2015).
Healthcare Legislation

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The Health Ministry’s regulatory responsibilities within this system involve administering
legislation as well as associated regulations. The legislation within the management of health
care services tends to perform well but there arises some acts that do not offer services properly
according to need of New Zealanders. The legislation application of this nation health care
system consists of nine main parts that have direct bearing on National Collections work. This
includes- Public health and Disability Act 2000, Privacy act, Health Act, Health Regulation,
Health Information Privacy Code, official Information Act, Cancer Registry Avt and public
Records Act (Legislation 2018). Some of the legal principles regarding this system are concerned
with the health expert’s duty is to maintain privacy as well as confidentiality of data regarding
patient’s healthcare treatment. In addition, it also focuses on powers of litigants for attaining
access to information relating to healthcare services, which is relevant to some of the legal
proceedings.
Although this nation has good reputation in account of legislation, there are still some gaps in
the act. The gap occurs in the mental health legislation as this act is not serving in proper manner
according to the needs of population. This has been argued that this nation must respond to the
present trend and thus should evaluate mental health legislation for reducing obligation in mental
health care. The gap occurs in the cost barriers between Maori and Non- Maori to access health
care regarding their mental illness. For example, although this country provides high subsidy rate
for several mental health care services as well as treatments, there still exists huge gap in
accessing services for few people who have serious healthcare problems.

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Answer 3
Comparative analysis of Australian health factors with that of New Zealand for identifying
challenges to their health systems
Population
The estimated population in Australia is 23.5 million while the total population in New
Zealand is 4.5 million. The total per capita health expenditure in New Zealand is $3590 USD
whereas the total per capita health spending in Australia is $4708USD (theOECD 2018). . Some
of the leading reasons of people’s death in Australia are chronic pulmonary disease,
cerebrovascular disease, ischaemic heart disease, lung cancer etc. But the fastest increasing
chronic illness in this nation is diabetes. On the other hand, some of the main causes of death of
Maori and Non- Maori in New Zealand are lung cancer, diabetes, pulmonary disease etc. But the
major causes of New Zealanders death is lung cancer. The rate of infant mortality in New
Zealand is 4.3 with respect to 1000 live births while that in Australia is 3.2 per 1000 live births.
Furthermore, average life expectancy at birth in Australia is 82.5 years whereas average life
expectancy of birth in New Zealand is 81.7 years (theOECD 2018). Australian lives longer life
than that of the people residing in New Zealand.
Healthcare spending
In Australia, healthcare expenditure is mainly jointly funded by both private as well as
public sources and also by some individuals. Near about 40% of the health spending in Australia
is particularly on the hospital services and with less than about 2% expenditure on prevention
(Mossialoset al., 2016). One of the biggest components of Australia’s healthcare expenditure is
particularly on the primary health services that involves front -line healthcare services, which is

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being delivered in community namely dental services, GP services and other practitioner services
(Duckett & Willcox, 2015). Moreover, cardiovascular disease basically consumes the largest
proportion of the health dollars at near about 10% of total expenditure in disease. In the year
2015-2016, Australia’s healthcare spending declined in comparison with the year 2012-2013.
However, the healthcare spending per capita in this nation has been stable over the last few
years.
Recent evidences reflect that the healthcare spending in New Zealand has been much less
as compared to other nations. The government of this nation subsidizes primary health care via
primary healthcare enterprises. According to recent report, the share of this nation government in
total health spending is 80% and the per capita healthcare expenditure is US$3328. Moreover,
the healthcare expenditure trends of the country have larger proportion from the government
sources in comparison with other countries. Most of the healthcare funding comes from the
taxation system. However, this reflects that healthcare spending in New Zealand is less than that
of Australia.
Physician Capacity
This refers to the capacity of the physician to see total number of patients at time. Higher
physician capacity facilitates then to handle huge number of patients in less time while less
capacity of the physician aids to tackle lesser patients at more time. Recent evidences reflect that
the capacity of average physician is larger in New Zealand than that in Australian. In addition,
recent statistics highlights that a physician tackles larger number of patients in New Zealand as
compared to that of Australia owing to proper training in their field.
Hospital Spending

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Hospitals are considered as the vital part of the health landscape in Australia as it
provides services to several people residing in this country every year. Some of the recent
statistics highlights that the total spending in hospitals of this country has been enhancing at
faster rate than that of adjusted inflation (Friedberg et al., 2013). Recurrent hospital spending in
Australia generally for the public as well as private hospitals summed up to near about $55
billion in the year 2013-2014. According to the hospital statistics (2013-2014) of this nation, near
about $11 billion was spent by the private hospitals while $44 billion was spent by the public
hospitals. Other statistics reflects that around $18 million went to outpatient care, $6 million in
emergency care, $22 million for other services involving pathology, society health services and
pharmacy. Although the spending for the public hospitals in this nation increased by near about
4.4% on an average rate, the salaries of staffs working in these hospitals enhanced by averaged
rate of about 3.4% per year over the last few years.
For the past few years, the total hospital expenditure in New Zealand has been going
through series of cuts for reducing the costs of health care. Although the government of this
nation tries to cut cost in many fields of hospitals, they try to build several hospitals for
providing services to various groups of people. Thus, it can be seen that the hospitals spending in
Australia are higher than that of New Zealand.
Information/Medical Technology
Information technology plays vital in improving the health care system of the nation. HIT
( Health Information Technology) is mainly used by the hospitals that involves both computer
software as well as hardware for dealing with the retrieval, utilization of information relating to
health care, storage, sharing, communication, decision making etc (Agha, 2014). As information

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technology penetrates in the healthcare sector of these nations, physicians as well as patients’
experiences benefits regarding medical information. In New Zealand, the MTANZ (Medical
Technology Association of New Zealand) is the biggest industrial body that represents the
producers of medical technology, importers and medical devices distributors. They facilitates in
improving health system of this country by providing access to patients so that they avail good
medical services. They also involve workshops and seminar calendars for assisting the workers
of the organization. Besides this, they also work with this nation’s government for maintaining
regulatory environment and creating new services in healthcare system.
On the other hand, the MTAA (Medical Technology Association of Australia) refers to
the national association that represents enterprises in medical technology sector. They aim to
assure benefits of innovative as well as reliable medical technology are effectively delivered for
providing good health outcomes to individuals (Cresswell & Sheikh, 2013). They mainly
represents producers as well as suppliers of these technology that are being used in treatment,
diagnosis etc. Even the members of this association distribute most of non- pharmaceutical goods
that are used in diagnosis as well as treatment. They even play important role in offering
healthcare experts with proper training for ensuring effective utilization of technology.
Answer 4
One of the health factors identified as main challenge to the New Zealand health system
Both demographic as well as non-demographic factors create challenges to the health
care system in New Zealand. One of the health factors that have been identified as major
challenge to the New Zealand health system is distribution of age in population (Challenges and
opportunities, 2018). Ageing population impacts the health expenditure as individual tends to

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require more health care. Change in old age structure has been one of the rapidly growing issues
that occur due to ageing population in the nation. The present health care system of New Zealand
has been facing huge difficulty in adapting to changes in old age structure and meeting with the
demand of these people. This nation has been experiencing affect of ageing population on
regular basis with large number of people in the emergency department.
PESTLE analysis on New Zealand’s health care system
The strategic intentions of the health care system in New Zealand are illustrated below-
Smart System-This theme mainly focuses on utilization of technology for improving the patient
health and raising quality as well as efficiency of their health care system.
One team-This strategy creates cohesive health system through culture of trust and collaboration
of people working in the organization (Gauld, 2012).
People- powered system- The main intention of adopting this strategy is to involve the
individuals as users of the health care services and also as health care partners. In addition, it also
helps them informed about the preferences and health requirement of people’s.
PESTLE analysis refers to the analysis in which there is assessment of political, economic,
social, technological, legal and environmental factors of a specific sector. The healthcare sector
is also affected by these factors, which in turn influences the player’s performance working in
this sector. There are some factors that offer benefits to this sector while other offers challenges
to this sector. The PESTLE analysis of New Zealander’ health care system is illustrated below:
 Political- This factor highlights on the political environment of New Zealand that impact
on their healthcare system. The healthcare policies implemented by the New Zealand

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government affect both doctors as well as patients on different levels. Moreover, New
Zealand government also puts pressure on the healthcare expert in terms of delivering
high quality care on the patients (Savedoff et al., 2012). This in turn adversely impacts on
the health care environment of this nation. The government adopts new framework of
support for the disabled people, which in turn provides individuals more choice as well as
control over support (Godman et al., 2015). However, this also influences on their
services that are to be funded as well as delivered.
 Economic- This factor indicates how the things happening within the economy impacts
on the sustainability of the healthcare system and their workforce. The growth of national
income influences the health care sector in the economy. The growth in total productivity
drives real incomes as well as long run cost of workers, which is considered as the main
input in the healthcare services. Although few macroeconomic approaches with reference
to measurement in productivity suggest that there are productivity gains in services of
health care. Moreover, the reduction in consumer’s disposable income impacts the
population of New Zealand who uses health insurance for availing health services.
 Social- This factor reflects on the social attitudes as well as government policies that
impacts on the disability laborforce. The variation in attitudes as well as expectations of
the disabled individuals signifies that there has been higher emphasis on self-
determination. Recent study also focuses that cohesion level or society connectedness is
mainly related to individual’s health. In New Zealand, strong social networks facilitates
in creating better healthier conditions in different ways. Furthermore, rise in New
Zealabds aged population creates challenges for the health services as they needs huge
health services in comparison to other people.

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 Technology- There has been huge growth in R&D ( research and development) and
innovation in the healthcare technology in this nation. In fact, this country has been
considered as the hub for creative models relating to healthcare service delivery mainly
through public healthcare system (Cresswell & Sheikh, 2013). Moreover, advancement
in medical or information technology helps their healthcare sector to attain benefits
regarding services as well as systems. Implementation of new technology by this sector
improves communication process as well as treatment process. Thus, it also benefits the
workers by reducing the workload and saving time.
 Legal-This factor refers to the legislation that affects the healthcare system in provision
to offer huge range of varied services. The Health legislation Act 1956 provides New
Zealand’s Health Ministry role in improving, protecting and promoting population health.
It includes particular provisions that govern disclosure of information relating to health
between the providers and agencies. Furthermore, the health information privacy code
1994 refers to the codes of practice that is generally issued by privacy commissioner,
which in turn provides added protection to information relating to health owing to
sensitivity (Savedoff et al., 2012). This act mainly covers several health agencies and
protects health information regarding identifiable individuals.
 Environmental- This factor indicates the environmental considerations for planning the
healthcare systems. The aim of this health care industry is to decrease inequalities that
involve inequalities in environment influencing health. Some of the environmental
factors that impacts the healthcare system of this country involves variation in healthcare
trends, change in climate etc. Changes in technological trends impacts on the primary
health care organizations as the service providers find it difficult to adapt these

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technologies. Additionally, climatic variation also spoils the medicines and this impact on
both the organizations as well as patient. However, the Health Ministry of this nation
adopts few environmental measures for monitoring and improving the health of
population living in this nation.
Conclusion
From the above study, it can be concluded that healthcare system is one of the important
sectors in New Zealand. At the present decades, the performance of the health care system in this
nation has improved owing to funding by DHB and implementation of new technologies.
Moreover, the strategies adopted by the management of the health organization also help them to
increase their growth. As there are several factors that adversely impacts their healthcare system,
the policies adopted by their government helped them to face these challenges. Thus, this
nation’s health care system is still better some nations.

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