“Between 1984 and 2000, the health system in Aotearoa New Zealand underwent multiple structural reforms, with the pendulum swinging back and forth between administrative centralisation and decentralisation [8]. From 2000 onwards, the health system featured 20 publicly owned District Health Boards (DHBs) that each had responsibility for planning services, delivering public health, hospital and hospital-related services, and funding and contracting for most other health services in their geographic district. The Primary Health Care Strategy (PHCS) (2001) provided increased funding for primary care services and changed the ways in which primary care providers were paid, from fee-for-service payments for general practitioner services to capitation payments for enroled registers of patients. It also established Primary Health Organisations (PHOs) as non-governmental primary care entities that could contract with government for primary care services at scale. In the early 2000s reforms, the government aimed to strengthen local decision-making, expand and develop new models of primary care services to keep people well and out of hospital, and reduce inequities in health, especially for the indigenous Māori population.
“As part of this reform agenda, public spending on health in the 2000s increased significantly (by around 3–6% per annum in real per capita terms). However, from 2010 to 2018, real per capita public spending on health increased by less than 0.5% per annum as a centre-right government prioritised a return to budget surpluses in the aftermath of the Global Financial Crisis of 2008 [9].”
Source: Tim Tenbensel, Jacqueline Cumming, Esther Willing, The 2022 restructure of Aotearoa New Zealand’s health system: Will it succeed in advancing equity where others have failed?, Health Policy, Volume 134, 2023, 104828, ISSN 0168-8510, doi.org/10.1016/j.healthpol.2023.104828.
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Page last updated June 30, 2026 by Doug McVay, Editor.