From Theory to Practice: The Promise of Primary Care in New Zealand

Prepared by Amy Downs, 2017

With funding from the sponsors of the Ian Axford (New Zealand) Fellowships in Public Policy

About the author

2017 Axford Fellow Amy Downs

Amy Downs from Denver, Colorado, researched access and equity in New Zealand’s primary health care system at The Treasury.  At the time of her Fellowship Amy was Vice President of the Colorado Health Institute where she led the organisation’s policy analytics work.  On returning to the United States Amy has taken up the role of Executive Director at Family Star Montessori, a comprehensive family education service.

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Abstract

As health care expenditures and the prevalence of chronic disease increase throughout the world, many countries seek to promote primary care to improve their residents’ health, narrow inequalities in health outcomes and mitigate health care expenditure growth. New Zealand implemented major policy reforms within its health care sector to advance these objectives.

While New Zealand’s health care sector performs well based on international standards, the goals of these reforms have not been fully realised. While some health outcomes have improved, disparities between different populations persist. Nearly one-third of New Zealanders report difficulties accessing needed primary care and challenges remain in integrating primary and hospital care. Significant concerns exist among primary care providers and the public regarding how and at what level the system is financed.

The following report analyses the primary care sector in New Zealand and the extent which changes could help address primary care policy objectives. The report includes 15 recommendations to the government that span a number of themes:

• Collect and synthesize primary care data to monitor the sector and develop data-driven policy options;
• Review and revise the primary care funding formula to explore more rigorous and rate setting and incentivise new models of care;
• Explore reorganisation of the sector to mitigate fragmentation and encourage more innovation;
• Evaluate primary care models in different regions to learn what innovations have worked and why. Scale innovation when appropriate;
• Strengthen the capability and capacity of health policy leadership in New Zealand. Collaborate with the health sector to identify policy priorities of strategic importance.

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From Theory to Practice: The Promise of Primary Care in New Zealand