Do we need to revisit financial boundaries between the public and private health care systems in New Zealand to balance patient choice and health equity?

New Zealand’s healthcare system is currently facing significant challenges, particularly due to the dual pressures of public and private healthcare demands. Recent studies and reports highlight the strain on public healthcare resources exacerbated by the private health sector's activities.

A 2023 report from the University of Otago has revealed that private health patients are costing the public system an estimated $115 million annually. This is due to the need for follow-up treatments and complications managed by public hospitals, which are not fully compensated by private insurers. The study also notes that while private healthcare can offer quicker access to surgeries, it inadvertently increases the workload on public health services, which are already struggling to cope with demand.

A separate study from the New Zealand Medical Journal emphasises the complexity of readmissions among older New Zealanders, suggesting that readmission rates are often misinterpreted as indicators of poor hospital quality. Instead, these rates should be viewed cautiously, as they reflect a myriad of factors including patient age, comorbidities, and socio-economic conditions.

The New Zealand Health Strategy (2023) calls for a more integrated approach to healthcare delivery, aiming to reduce disparities and improve efficiency across both public and private sectors. This strategy includes proposals for better utilisation of private hospital capacities to alleviate the burden on District Health Boards (DHBs). 

Furthermore, data from the National Minimum Dataset (NMDS) highlights the urgent need for structural reforms in the health system to manage the growing demands driven by population ageing and increasing chronic health conditions. Projections indicate that by 2028/29, the healthcare system will require substantial increases in both funding and workforce to maintain service levels.

As we navigate these challenges, it is crucial to foster collaboration between public and private healthcare sectors. This will ensure that all New Zealanders have timely access to high-quality healthcare without placing undue strain on any single part of the system.