New Zealand's health system is too fragmented to support those it needs to, a new report has found.
The report, published in medical journal The Lancet, found the system is compounding inequities in access to care and health outcomes.
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It was written by University of Auckland professor Felicity Goodyear-Smith and health economist Toni Ashton.
Goodyear-Smith told Newshub the pair looked at the history of the health system and how it's performing now.
"What it shows is that despite the fact that we're the first country in the world to promote the idea of universal health coverage... it really hasn't worked across the system and we still have some enduring inequities."
The report identified seven weaknesses in New Zealand's health system:
- complexity and fragmentation
- a divide between first-line community-based health care and hospitals
- a divide between treatment for injuries versus other conditions
- failure to tackle underlying drivers of health inequalities, like housing, alcohol and racism
- funding not keeping up with rising costs
- historical pressures and incentives to neglect infrastructure
- health workforce issues.
Goodyear-Smith said it won't be a simple fix.
"I don't think it's just a matter of putting more money into primary care, that's part of it, but it's actually a restructure that's needed as well," she told Newshub.
One of the things she suggested was a cut to the number of district health boards, down to a maximum of six.
But she's not sure if anything is going to change any time soon.
"The Government is taking a review of the health system in the moment and I think its preliminary report is going to be out soon and I suspect they're going to come up with the sort of recommendations that this paper's also saying.
"The million-dollar question is whether once these recommendations have been made whether the Government makes any changes.
"Similar reviews happened a decade ago and similar suggestions were made, strengthening primary care, reducing inefficiencies and complexities, and not a lot changed."