Department of Medicine, University of Otago-Christchurch, Christchurch, New Zealand.
Canterbury Charity Hospital Trust, Christchurch, New Zealand.
Intern Med J. 2020 Jul;50(7):883-886. doi: 10.1111/imj.14903.
Radical market-oriented health reforms in New Zealand in the early 1990s failed to deliver key financial targets, resulted in unnecessary patient deaths, adversely affected public healthcare services, induced serious tensions between clinicians and managers and encouraged a predisposition to private healthcare. A more co-operative health system was implemented in the late 1990s but remaining problems of inadequate patient access led to establishment of a charity hospital in Christchurch which, by November 2018, had registered over 18 000 patient visits. This is one indication of the need to resurrect our public healthcare system. In this paper, we discuss briefly the health reforms of the 1990s then, for discussion and debate, provide seven suggestions for how this resurrection might be achieved thereby avoiding the need for charity hospitals throughout the country.
20 世纪 90 年代初，新西兰实施的激进市场化医疗改革未能实现关键的财务目标，导致不必要的患者死亡，对公共医疗服务产生不利影响，在临床医生和管理者之间引发严重紧张关系，并助长了对私立医疗保健的偏好。20 世纪 90 年代末实施了一种更为合作的医疗体系，但由于患者就医机会不足的遗留问题，导致在克赖斯特彻奇建立了一家慈善医院。截至 2018 年 11 月，该医院已登记了超过 18000 名患者就诊。这表明需要重建我们的公共医疗体系。在本文中，我们简要讨论了 20 世纪 90 年代的医疗改革，然后为了讨论和辩论，提供了实现这一重建的七个建议，从而避免了全国各地都需要慈善医院的情况。
