New Zealand’s health system provides a high standard of care, at an overall cost which is modest by international standards. People who are accustomed to considering health systems based on either a “private, for profit” or a “public” basis will find our system takes a little getting used to, because it is a hybrid of those two, normally competing, models (with a few unique Kiwi bits thrown in).
Free Public Hospitals, accessible to all.
The backbone of New Zealand’s health system is a network of “Health Boards”, organized by region, providing high quality hospital care and coordinated community health programmes. Services from these Health Boards are taxpayer funded and costs are not charged directly to patients who are New Zealanders. While, clearly, not every single regional hospital can provide world class services in every conceivable specialty, the system as a whole, (with patient transfers between facilities required in some cases), does do so, and is the primary reason for New Zealand’s international reputation for excellence in health care.
Private Hospitals, supported by Insurance.
One of the ways the publicly funded, free system achieves its efficiency is by engaging in a degree of “rationing” of non-essential services that allows a private, fee-for-service hospital system to thrive alongside the “free” public system. If you are faced with an immediate life threatening illness or accident you will receive immediate world class care in the public system; but if faced by an “elective” (that is, not immediately life threatening) problem, say a hernia or varicose veins, you may find yourself on a “waiting list” for service in the public system, in which case you may elect to have immediate treatment in a private hospital. This private system is supported by a non-compulsory heath insurance industry, to which many New Zealanders subscribe. The growth of the private sector is not subject to Government control so, to a degree, the demand for urgency of any particular form of treatment can be a matter of perception or public opinion. For example, quite complex heart surgery may be undertaken in either the Public or Private sectors; depending on patient choice.
Specialist doctors that straddle both systems.
Doctors may work in either public or private systems, or even often in both, at the same time. Your specialist, available in his comfortable private rooms, on a fee-for-service basis, may be the same person whom you would see at the Public Hospital, for free, at a weekly clinic. The quality of care you receive will be first class, in either system; the difference will be the speed with which and the location at which, you receive treatment, if your condition is not life threatening.
Primary Health Care.
Primary Health care (your local General Practitioner) is almost exclusively provided by the private sector. Your attendance at your local doctor is heavily subsidized by the taxpayer with the doctor retaining the right to charge you a little extra if he wishes. Some choose to exist entirely on their subsidy (providing you free care), others charge modest fees. Few charge fees at a level that would be regarded as normal in overseas systems. You can elect to take private insurance to cover the modest cost of these GP fees, if you wish. If you require referral to a specialist, your GP will normally give you the choice of being referred to a private or a public service.
Prescription charges are heavily subsidized by the taxpayer. If your doctor prescribes beyond approved lists you may find yourself incurring higher costs, but that is not true for most prescriptions. Once again, insurance can be used to cover all or part of these modest costs.
Whether you interface with the New Zealand health system because of an illness or an accident, you will get the same high quality of care. But behind the scenes, the way your costs are funded is different. In the case of illness the government funds the cost through the tax base. In the case of an accident, however, there is a unique New Zealand system based on the presumption that people do not mean to cause accidents and that suing each other makes lawyers rich but seldom fixes problems. New Zealanders have given away the to right to sue each other for “causing” accidents and have placed the task of putting things right in the hands of a public corporation funded by a levy on salaries and the cost of licensing motor vehicles. When an injury occurs as a result of an accident, treatment occurs in the health system as described above but is funded by the Accident Compensation Corporation. Their interest continues through all stages of recovery and rehabilitation, to the provision, if necessary, of long term care and re training. The focus is on full rehabilitation, not cash compensation. ACC also accepts responsibility for accident prevention programmes and employers are incented to provide safe workplaces through variable levies based on accident records. This system applies whether the accident was work, home or sport related and irrespective of who “caused” it.
“Entering” the health system, as a new migrant.
There is no special registration procedure you will need to follow. Just by being in New Zealand and by being in need of treatment, you will be accepted and cared for. (Although, see notes below, about temporary visitors). It is common sense to identify yourself to your General Practitioner of choice as soon as possible, especially if you have children. Give your health history and participate in the readily available publicly funded vaccination and primary health programmes.
Consider whether you and your family want health insurance or not, and if so, at what level. It is your choice, is not compulsory. Shop around for the plan that best suits your budget and circumstances.
Visitors. A warning to non-resident visitors!
Visitors to New Zealand will always be given treatment, if needed. If that is the result of an accident, our ACC scheme will cover the costs (but you will not have the right to sue.) If the treatment is needed as a result of illness, you will be asked to pay the costs you incur. (Except for residents of UK and Australia, in which case there are government to government reciprocal arrangements in place.) For persons on Work Visas many but not all will be eligible to free healthcare. Travel insurance is strongly recommended for non-residents visiting New Zealand. A link is provided which will show you who is eligable for free healthcare in New Zealand.
District Health Boards
Bay of Plenty DHB
Capital & Coast DHB
Counties Manukau DHB
Hawke's Bay DHB
Hutt Valley DHB
Nelson Marlborough DHB
South Canterbury DHB
West Coast DHB
Private hospital web sites
Health insurance companies
The Accident Compensation Corporation