The 2022 restructure of Aotearoa New Zealand's health system: Will it succeed in advancing equity where others have failed?

Abstract

Aotearoa New Zealand has restructured its health system with the objective of addressing inequitable access to health services and inequitable health outcomes, particularly those affecting the indigenous Māori population. In July 2022, two new organisations were created to centralise planning, funding and provision responsibilities for publicly funded health services in Aotearoa New Zealand. Health New Zealand and the Māori Health Authority have been created to drive transformational change within the national health system and monitor and improve the health and wellbeing of Māori. At the local level, new Localities are to be formed with the aim of integrating services between government and non-government health and social services providers, while incorporating local Māori and local communities in co-design of services. These changes will be of interest to those in many other countries who are grappling with their own colonial histories and struggling to provide health services in ways that are equitable and contribute to positive health outcomes for their whole population. Although key aspects of the reforms are well supported within the health sector, the ambitious scope and timing of their introduction in the context of the COVID-19 pandemic and health workforce shortages can be expected to generate significant implementation challenges.