Photo: Unsplash / RNZ
New Zealand's healthcare system is outperforming Sweden's, Canada's and Germany's, according to a top-level financial presentation to Te Whatu Ora staff.
The financial performance briefing by the acting chief financial officer a few days ago leads with a chart* based on US research, showing New Zealand performed ahead of those three countries, as well as ahead of Switzerland and France and the US.
It shows only the UK, Netherlands and Australia out of the 10 countries scored, were outperforming New Zealand.
Photo: Te Whatu Ora
The US inhabits a corner of its own, far ahead for high healthcare spending, and way down for performance, while Australia leads the pack at the other end.
New Zealand's healthcare spending as a percentage of GDP was middle-of-the-pack, slightly ahead of the UK, Canada and Sweden, and slightly behind France, Switzerland and Germany.
The five-page powerpoint presentation came as Health NZ struggles in a financial mire.
It said in September it faced a $1.7 billion deficit by mid-2025 if intervention was not taken.
The new presentation showed the aim was to put the brakes on enough to shrink the deficit to $499 million.
"We need to continue our back to budget process to get our run-rate down to achieve the budgeted deficit," the acting chief financial officer Richard Aldous told RNZ in a statement.
Health NZ is months into a reset under Commissioner Lester Levy that unwinds some of the mass centralisation of the first two years of the country's largest health reforms that began under Labour in mid-2022.
"Work on the reset to ensure we live within our means continues as we focus our resources on the delivery of clinical frontline healthcare," Aldous said.
"We are working to return to a break-even position by the end of the 2025/26 financial year [July 2026]."
His presentation also shows public health spending more than doubling (not adjusted for inflation) from 2012 when it hit $13 billion, and that it would hit just under $30 billion in 2026.
The biggest jump in the last two years was in personnel cots, from about $10b to over $12b, and payments to provider-partners had risen markedly since about 2015.
Against the grain, outsourced services - this can include where public-funded surgeries or radiology scans are done in private hospitals - have risen at a slower rate and in fact dipped after 2021-22, according to the powerpoint.
The document showed 2023-24 was an outlier year, in that $1.3b went on one-off or time-limited funding - as opposed to ongoing, baseline funding, such as for Covid-19 ($300m), planned care "catch-up" ($110m) and pay equity ($500m).
"Despite the financial challenges, Health NZ managed to care for more people than ever before in 2023/24 and made some inroads into wait times," Aldous said.
"Our ability to deliver the frontline health services New Zealanders expect requires us to be in a stable and sustainable financial position."
*HNZ said the chart was adapted from Blumenthal D, Gumas ED, Shah A, Gun- ja MZ, Williams RD II. Mirror, mirror 2024: a portrait of the failing U.S. health system: comparing performance in 10 nations. New York: Commonwealth Fund, September 19, 2024. Healthcare spending is presented as a percentage of GDP. "The performance scores are based on the standard deviation, calculated with the use of the nine-country average that excludes the US because of its status as a statistical outlier."
