According to the 2022 Sapere report, the core issue is that funding does not align with patient need. This means that services that have a higher than average proportion of people with high health needs are not funded adequately to deliver care to their patients. This is a serious deficiency in a core part of New Zealand’s health system, which needs to be addressed if the sector is to sustain and flourish.

New Zealand is not alone in trying to encourage more innovation in the delivery of primary care. Industrialised countries throughout the world are increasingly interested in how to support their primary care systems to address the prevalence of chronic disease and improve health outcomes, particularly among underserved groups. As more resources are devoted to specialised care, countries are grappling with how to structure their delivery systems to support primary care and prevention.

Digital health readiness is the foundation from which data can be leveraged for primary and secondary uses to improve well-being, health outcomes, and resilience. It is a measure of the ability to make use of analytics, data, and technology for beneficial individual, community, and public health outcomes. Hence, “readiness” is a composite of abilities and structures across analytics, data, and technology. In addition, readiness requires human factors outlined above for capacity, co-operation, and oversight.

Having obesity puts children at greater risk of developing asthma, type 2 diabetes, digestive problems and joint pain, as well as depression and anxiety. Recent evidence indicates that childhood obesity-risk depends on the complex interaction of biological, developmental and socio-environmental factors, an exclusive focus on diet and exercise will do little to help.

"It takes a community to raise a GP". Over the course of the past 60 years, we have seen a major shift in medical school education across much of the world, wherein it moved the teaching and training of new doctors from communities into universities, where they learned basic sciences; and hospitals, where they got hands-on experience in patient care and research.

The New Zealand health system is a socialised, universal health care system, with maternity care free to all New Zealand resident women, from primary to tertiary level, unless a woman chooses to pay for a private obstetrician. A key point of difference of the New Zealand maternity service from many other countries is that the majority of women are cared for by autonomous, self-employed midwives who are contracted to the state.

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There is potential to make significant inroads into addressing workforce shortages by designing and implementing effective retention measures, taking into account the specific needs of different sections of the workforce. It takes time to train new people, to improve retention, and to recruit from overseas. There is no single mechanism which will ensure we have the health workforce we need, so this plan anticipates using all of these levers.

In a healthcare system, the application of the Theory of Constraints could be highly beneficial for streamlining processes, improving patient outcomes, and maximising resource utilisation.

One current challenge in healthcare delivery is the unequal distribution of healthcare resources, leading to disparities in access and quality of care. Unifying the system can help address this challenge by providing a single system that ensures equal access to healthcare services for all individuals, regardless of their socioeconomic status or geographic location.

Over the past decade, it has come to light that healthcare IT infrastructure networks, and security are outdated and unable to adequately support the introduction of new systems or manage increased cybersecurity issues. This outdated infrastructure also presents challenges to users accessing and using patient or clinical information across both internal hospital locations and wider health service settings.

Over the next few years, genetic testing will become more available and more affordable. Combining this with ongoing research around precision health, and we will begin to see clinical applications emerge. In parallel, we will require national policy and government regulations to form supporting guardrails that enable progress and protect New Zealanders.

Investments in infrastructure for health can be costly and seem untenable in resource constrained settings. These investments compete with other equally important areas. Nonetheless, infrastructure investments can contribute substantially to alleviating burdens of morbidity and mortality while also providing a positive return on investment in the long term.

New Zealand is not alone in facing an ageing population dynamic and difficulties in meeting the workforce required for aged residential care. It is of sufficient policy concern that the OECD has a Long Term Care work programme to address related policy concerns. According to experts, the sector is doing everything it can to maintain viability, however we will need to revisit the funding model, revisit how to address the workforce shortages and commit funding over many years, to find sustainable long-term solutions for the industry.

Rural hospitals are well placed to provide an integrative role in locality service provision, with many already long established in performing this role. It would be very remiss of the wider sector to undervalue the importance of the rural health system, its challenges and needs.

Most countries face an ageing population, increasing prevalence of chronic diseases and experience an ever tightening budget for providing health services. Involving patients in their own care by allowing them access to their patient data is a trend seen in many places. A number of commercial solutions that allow individual users to gather, store, use, and share health information are offered globally. It is, however, noticeable that only a few countries' governments have offered citizens access to their own health data on a national level.

Partnerships of academic institutions and governmental agencies are needed to establish quality standards and develop a monitoring system for online health information producers to reduce healthcare waste and improve health outcomes.

Future investment in clinical trials is likely to continue to produce large health benefits. Prioritisation of trials should be based on factors such as disease burden, gaps in health outcomes between different populations, and include those areas where there may be potential to have a greater impact and return on investment.

Despite favourable evidence, the implementation of such teams has also been criticised. A systematic review of CRTs found a lack of evidence to evaluate their effectiveness; they found wide variation in the implementation of these teams, differences in hours of operation, staffing, and incident responses. Another criticism of CRTs includes a possible increase of the pressure on already stretched police and mental health services, making adequate resourcing crucial.

There are a range of ways in which young people can and need to be supported. There is good evidence for regular physical activity, good nutrition, and adequate sleep. Support from family, schools and the broader community is also important. A decision to use medications should be on the basis of shared decision-making.