1st February 2019, Volume 132 Number 1489

Robin Gauld, Carol Atmore, Jo Baxter, Peter Crampton, Tim Stokes

In the UK, 2018 marked the celebration of the 70th anniversary of the founding of the National Health Service (NHS), including the principles on which it was founded and how…

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Summary

The 2018 year signalled the 80th anniversary of the Social Security Act 1938. In order to implement this legislation, a historic compromise between the government and the medical profession created institutional arrangements for the New Zealand health system that endure to this day. The 2018 year also marked commencement of a Ministerial review of the New Zealand health system. This article considers two intertwined arrangements which stem from the post-1938 compromise that the Ministerial review will need to address if goals of equity and, indeed, the original intent of the 1938 legislation are to be delivered upon: general practice patient charges; and ownership models. It describes the problems patient charges create, and options for ownership that the Ministerial review might contemplate.

Abstract

The 2018 year signalled the 80th anniversary of the Social Security Act 1938. In order to implement this legislation, a historic compromise between the government and the medical profession created institutional arrangements for the New Zealand health system that endure to this day. The 2018 year also marked the commencement of a Ministerial review of the New Zealand health system. This article considers two intertwined arrangements which stem from the post-1938 compromise that the Ministerial review will need to address if goals of equity and, indeed, the original intent of the 1938 legislation are to be delivered upon: general practice patient charges; and ownership models. It describes the problems patient charges create, and options for ownership that the Ministerial review might contemplate.

Author Information

Robin Gauld, Pro-Vice-Chancellor and Dean, Otago Business School, University of Otago, Dunedin; Carol Atmore, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin; Jo Baxter, Kohatu – Centre for Hauora Maori, University of Otago, Dunedin; Peter Crampton, Kohatu – Centre for Hauora Maori, University of Otago, Dunedin; Tim Stokes, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin.

Acknowledgements

The content of this article stems from a panel discussion in which the authors participated hosted by the Centre for Health Systems and Technology at the University of Otago on 30 July 2018.

Correspondence

Professor Robin Gauld, Pro-Vice-Chancellor and Dean, Otago Business School, University of Otago, Dunedin.

Correspondence Email

robin.gauld@otago.ac.nz

Competing Interests

Dr Atmore is employed by Southern District Health Board as Chair of Alliance Leadership Team for Alliance South district health alliance.

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