The most recent act relating to mental health in New Zealand is the Mental Health Act 1992. Main health concerns and plans for remedial action: New Zealand currently has a life expectancy of 81 years, showing a sustained increase in life expectancy from 79 years in 2000 and 75 years in 1990. Gains have been primarily due to reduced child and maternal mortality, and improved longevity for other age groups, particularly for older people with chronic diseases. Life expectancy at birth in the Māori population is approximately eight years less than for non-Māori of both genders (2012). All district health boards (DHBs) are required to work towards improving the health of Māori and reducing health disparities between Māori and non-Māori. As part of New Zealand’s commitment to improving the health of indigenous people, each DHB is required to have a Māori Health Plan (MHP) that highlights the DHB’s efforts to this effect. In 2013 an estimated 5.4 per cent of the estimated resident population had diabetes and 30 per cent of adults were obese. Obesity is one of the most important modifiable risk factors for these diseases. Each year the Ministry of Health for New Zealand publishes health targets to provide a focus for action. The targets are designed to improve the performance of specific health services. The ministry has set a target to carry out more heart and diabetes checks nationwide, aiming for 90 per cent of the eligible population to have had their cardiovascular risk assessed within the last five years, as well as being tested for diabetes. Other targets include 85 per cent of patients receiving their first cancer treatment, or other support, within 62 days of being referred and for five per cent of infants aged eight months to have completed their primary course of immunisations on time. There are also targets on providing support and advice to help smokers quit – an estimated 5,000 people a year die from smoking-related illness in the country. For definitions and sources see page 314. Universal health coverage Less than a fifth of health care in New Zealand (17 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constitutes 10.3 per cent of GDP (2012), of which 83 per cent (US$2,723 per capita) is covered by the government. Primary health care in New Zealand is not generally free, with charges making health care less accessible to the economically disadvantaged. Government research found that one in four adults and one in four children reported unmet need for primary health care in the past year in 2013. Unmet need for primary health care was found to be more common among Māori and Pacific adults and children, and in those living in the most deprived areas. However, there was found to be low rates of unmet need, due to cost, among children aged less than six years. Fees for primary health care vary, as doctors’ practices and medical centres are privately owned and so set their own fees. Charges for children under six are usually lower than those of adults. Some general practices are members of a ‘low cost access’ programme N ew Z e a l a n d run by their primary health organisation, which means they get extra government funding to keep their fees at low levels. GPs can also charge a fee for services provided outside of a consultation, such as a repeat prescription or referral letter to a specialist. However, mothers of babies born in New Zealand are entitled to free essential care during and after their pregnancy. Specialist care is free through the public health system. Improving indigenous disparities in the distribution of health and its determinants is a priority of the New Zealand government, with 15.4 per cent of the population currently identified as indigenous (2012). Primary care costs appear to be a particular problem, as Māori are less likely to seek medical care when a payment is levied. Other issues include cultural barriers and lack of facilities in some areas. New Zealand’s Māori Health Strategy, He Korowai Oranga, sets the overarching framework that guides the government and the health and disability sector to achieve the best health outcomes for Māori. New Zealand has signed and ratified the International Covenant on Economic, Social and Cultural Rights, which includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: In 2013, 14 per cent of the population was over 65 years of age, with people aged 60 expected to live for an additional 24 years, on average. Almost five per cent of pensions (4.7 per cent) were paid out of public funds in 2009, with Superannuation paid monthly by the state at a rate of US$1,263 per person (2007–12) on a universal basis. Pensions were first introduced in New Zealand in 1898, becoming universal in 1940. Population over 65 A range of support services for older people are funded by the DHBs, most of which are aimed at helping people to live independently for as long as they can. The services include help with personal care (such as getting out of bed, dressing and bathing), help with shopping, cooking or cleaning, and installation of specialist equipment. DHBs are also responsible for funding residential care services for the elderly under the Social Security Act 1964. The Ministry of Health’s Health of Older People Strategy includes a scheme to identify older people at risk of developing disease, disability or mental health problems, and provide appropriate preventive care. There is also screening available for vision and hearing loss. Further information Ministry of Health: www.health.govt.nz Commonwealth Health Online: www.commonwealthhealth.org/health/pacific/new_zealand Commonwealth Health Partnerships 2015 227 14%
Commonwealth Health Partnerships 2015
To see the actual publication please follow the link above