Professor, Faculty of Law, University of Auckland, Auckland, New Zealand.
J Law Med. 2022 Dec;29(4):987-1005.
New Zealand has implemented a transformative overhaul of its public health system. Regulated by the Pae Ora (Healthy Futures) Act 2022 (NZ), the system has two key objectives: first, greater centralisation, with 20 regional district health boards replaced by two central commissioning agencies. New Zealand has a truly national health system for the first time, an aim being to end the "post code lottery". The second driver is to finally "get real" in tackling persistent inequities in health outcomes and access of disadvantaged groups, especially Māori, New Zealand's indigenous people, via various initiatives, including creation of a Maori Health Authority. A revolutionary aspect of the reforms is that the principles of the founding Treaty of Waitangi between Māori and the Crown have been embedded in the legislation as high-level guiding principles for all entities. Well-intentioned aims are a good start, but will need to be matched by realistic funding if the reforms are to have any chance of success.
新西兰对其公共卫生系统进行了彻底改革。该系统受 2022 年《Pae Ora(健康未来)法案》(新西兰)监管,有两个主要目标:一是加强中央集权,将 20 个地区区域卫生局由两个中央委托代理机构取代。新西兰首次拥有真正的全国性卫生系统,目的是结束“邮政编码彩票”现象。第二个驱动因素是通过各种举措,包括创建毛利健康管理局,最终“实事求是”地解决毛利人等弱势群体在健康结果和获得服务方面持续存在的不平等问题,毛利人是新西兰的土著居民。改革的一个革命性方面是,将《怀唐伊条约》(毛利人和英国王室之间的建国条约)的原则作为所有实体的高级指导原则纳入立法。良好的意图是一个好的开始,但如果改革要有任何成功的机会,就需要有现实的资金支持。