Commissioning in New Zealand: learning from the past and present
Jacqueline Cumming
+ Author Affiliations
- Author Affiliations
Health Services Research Centre, School of Government, Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand. Email: jackie.cumming@vuw.ac.nz
Australian Journal of Primary Health 22(1) 34-39 https://doi.org/10.1071/PY15164
Submitted: 25 October 2015 Accepted: 11 November 2015 Published: 29 February 2016
Abstract
Over the past 25 years, New Zealand has had significant experience with two very different approaches to commissioning health and disability support services. The first is the purchaser–provider split model adopted during the 1990s. The second is the approach that replaced it in 2001, the District Health Board model, which is still in place today. Although the New Zealand health system has several desirable characteristics and recent developments in commissioning arrangements are improvements on earlier approaches, the system is slow at reorienting care, particularly towards primary healthcare services. Alternative arrangements have strengths and weaknesses but the current ‘alliancing’ approach in New Zealand needs time to consolidate and demonstrate whether it can deliver before those alternatives are seriously considered.
References
Ashton T (1993) From evolution to revolution: restructuring the New Zealand health system. Health Care Analysis 1, 57–62.| From evolution to revolution: restructuring the New Zealand health system.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c3nt1yjsA%3D%3D&md5=ea03726aff67953afa46d431af9fce4aCAS | 10134358PubMed |
Ashton T (1995) The purchaser–provider split in New Zealand: the story so far. Australian Health Review 18, 43–60.
Ashton T, Cumming J, Mclean J (2004a) Contracting for health services in a public health system: the New Zealand experience. Health Policy (Amsterdam) 69, 21–31.
| Contracting for health services in a public health system: the New Zealand experience.Crossref | GoogleScholarGoogle Scholar |
Ashton T, Cumming J, McLean J, McKinlay M, Fae E (2004b) Contracting for health services: lessons from New Zealand. World Health Organization, Regional Office for the Western Pacific, Manila.
Barnett P (2001) ‘The Formation and Development of Independent Practitioner Associations in New Zealand: 1991–2000.’ (University of Otago, Dunedin)
Carryer J, Diers D, McCloskey B, Wilson D (2010) Effects of health policy reforms on nursing resources and patient outcomes in New Zealand. Policy, Politics & Nursing Practice 11, 275–285.
| Effects of health policy reforms on nursing resources and patient outcomes in New Zealand.Crossref | GoogleScholarGoogle Scholar |
Crengle S (1999) Māori primary care services. In ‘Discussion papers on primary health care.’ (National Advisory Committee on Health and Disability: Wellington)
Crown Company Monitoring Advisory Unit (1996) Crown Health Enterprises: briefing to the incoming minister. Crown Company Monitoring Advisory Unit, Wellington
Cumming J (2011) Integrated care in New Zealand. International Journal of Integrated Care 11, e138
Cumming J, Mays N (2011) New Zealand’s Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges. Health Economics, Policy and Law 6, 1–21.
| New Zealand’s Primary Health Care Strategy: early effects of the new financing and payment system for general practice and future challenges.Crossref | GoogleScholarGoogle Scholar |
Cumming J, Mays N, Gribben B (2008) Reforming primary health care: is New Zealand’s Primary Health Care Strategy achieving its early goals? Australia and New Zealand Health Policy 5, 24
| Reforming primary health care: is New Zealand’s Primary Health Care Strategy achieving its early goals?Crossref | GoogleScholarGoogle Scholar | 18990236PubMed |
Cumming J, Mays N, Daubé J (2010) How New Zealand has contained expenditure on drugs. British Medical Journal 340, c2441
| How New Zealand has contained expenditure on drugs.Crossref | GoogleScholarGoogle Scholar | 20483927PubMed |
Cumming J, McDonald J, Barr C, Martin G, Gerring Z, Daubé J (2014) New Zealand: health system review. World Health Organization, Geneva
Davis P, Lay-Yee R, Scott A, Gauld R (2007) Do hospital bed reduction and multiple system reform affect patient mortality? A trend and multilevel analysis in New Zealand over the period 1988–2001. Medical Care 45, 1186–1194.
| Do hospital bed reduction and multiple system reform affect patient mortality? A trend and multilevel analysis in New Zealand over the period 1988–2001.Crossref | GoogleScholarGoogle Scholar | 18007169PubMed |
DHB Shared Services Agency (2014) PHO performance programme. Available at http://www.dhbsharedservices.health.nz/Site/SIG/pho/Default.aspx [Verified 3 December 2015]
Gauld R (2009) ‘Revolving doors: New Zealand’s health reforms – the continuing saga’, 2nd edn. (Institute of Policy Studies and the Health Services Research Centre: Wellington)
Health and Disability Commissioner (1998) Canterbury Health Ltd. Health and Disability Commissioner, Auckland.
Health and Disability Commissioner (2001) Gisborne Hospital 1999–2000. Health and Disability Commissioner, Auckland.
Health Benefits Review (1986) Choices for health care: report of the Health Benefits Review.’ Health Benefits Review, Wellington
Health Funding Authority (1998) Service integration: guidelines for the development of integration demonstration projects. Health Funding Authority, Wellington
Hospital and Related Services Taskforce (1988) Unshackling the hospitals. Hospital and Related Services Taskforce, Wellington.
Kerr D, Malcolm L, Schousboe J, Pimm F (1996) Successful implementation of laboratory budget holding by Pegasus Medical Group. The New Zealand Medical Journal 109, 334–337.
King A (2001) The Primary Health Care Strategy. Ministry of Health, Wellington.
Kirk R, Barnett P, Clayden C, Cumming J, Heckert K, Penrose A, Pitama S, Richards D, Siataga P (2002) Evaluation of the Pegasus Health Global Budget Contract. New Zealand Health Technology Assessment (NZHTA), Christchurch.
Lovelock K, Martin G, Cumming J, Gauld R (2014) The evaluation of the better, sooner, more convenient business cases in MidCentral and the West Coast District Health Boards. Health Services Research Centre and Centre for Health Systems, Wellington and Dunedin.
Malcolm L, Wright L, Seers M, Guthrie J (1999) An evaluation of pharmaceutical management and budget holding in Pegasus Medical Group. The New Zealand Medical Journal 112, 162–164.
Maniparithy M (2008) Productivity performance of New Zealand public hospitals 1998/99 to 2005/06. New Zealand Business Roundtable, Wellington.
Mays N, Cumming J, Tenbensel T (2007) Health reforms 2001 research: overview report. Health Services Research Centre, Wellington.
McCloskey BA, Diers DK (2005) Effects of New Zealand’s health reengineering on nursing and patient outcomes. Medical Care 43, 1140–1146.
| Effects of New Zealand’s health reengineering on nursing and patient outcomes.Crossref | GoogleScholarGoogle Scholar | 16224308PubMed |
Ministerial Review Group (2009) Meeting the challenge: enhancing sustainability and the patient and consumer experience within the current legislative framework for health and disability services in New Zealand: report of the Ministerial Review Group. Ministerial Review Group, Wellington.
Ministry of Health (2012) Health expenditure trends in New Zealand 2000–2010. Ministry of Health, Wellington.
Ministry of Health (2014a) Briefing to the incoming minister 2014. Ministry of Health, Wellington.
Ministry of Health (2014b) New Zealand Health Survey: annual update of key findings: 2013/14. Ministry of Health, Wellington
Ministry of Health (2015a) The Health and Independence Report 2015. Ministry of Health, Wellington.
Ministry of Health (2015b) Update of the New Zealand Health Strategy: all New Zealanders live well, stay well, get well: Consultation draft. Ministry of Health, Wellington.
New Zealand Government (1969) A review of hospital and related services in New Zealand. Department of Health, Wellington.
New Zealand Government (1974) ‘A Health Service for New Zealand.’ (Government Printer: Wellington)
Raymont A, Cumming J (2013) Evaluation of the Primary Health Care Strategy: final report. Health Services Research Centre, Wellington.
Ryall HT (2007) Better, sooner, more convenient: health discussion paper. National Party of New Zealand, Wellington.
Smith J (2009) Critical analysis of the Primary Health Care Strategy and framing of issues for the next phase. Ministry of Health, Wellington
The Treasury (2005) Value for money in health – the DHB sector. The Treasury, Wellington.
The Treasury (2014) Briefing to incoming minister: health. The Treasury, Wellington
Timmins N, Ham C (2013) The quest for integrated health and social care: a case study in Canterbury, New Zealand. The King’s Fund, London.
Tukuitonga C (1999) ‘Primary healthcare for Pacific People in New Zealand.’ (National Advisory Committee on Health and Disability: Wellington)
Upton S (1991) Your health and the public health: a statement of government health policy. Minister of Health, Wellington.
Walker L (2008) A response to two recent reports citing apparent reductions in productivity. New Zealand Nurses’ Organisation, Wellington.
Wellington Health Action Committee (1992) ‘Health reforms: a second opinion.’ (Wellington Health Action Committee: Wellington)
