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How it works in New Zealand

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Most of the funding for New Zealand’s health service comes from taxation, with government spending at NZ$16.2 billion in 2016/17 and NZ$16.78 billion in 2017/18. New Zealand generally spends less per capita on health care than other countries. In 2013, New Zealand spent $US3,328, less than the OECD average (US$3,453) and less than Australia (US$3,866), but more than the United Kingdom (US$3,235).

Compared to other countries, New Zealand tends to have a higher proportion of health expenditure from government sources.

The health system is overseen by a central minister and the Ministry of Health. Most health funding (75.6% of Vote Health) is channelled through 20 geographically distributed District Health Boards (DHBs), which are responsible for planning, delivering and funding services in their districts.

DHBs are governed by majority-elected boards and are accountable to the minister of health. They directly deliver hospital and hospital-led community services (such as district nursing services), and contract for primary health care services through 36 Primary Health Organisations (PHOs). These in turn contract with general practices or health care homes to delivery primary health care.

DHBs also hold contracts with a range of other primary health care providers, such as pharmacists and laboratories, and with many private for-profit and private not-for-profit organisations delivering community care (for example, services for mental health and home-based care for older people).

The Ministry of Health directly funds some national services, including disability support services for those aged under 65 years, public health services, well child services and midwifery services.

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