Health Ministry Details The State Of Public Health

2003 Health and Independence Report: The Director-General's findings on the state of public health

The health system's annual report card is out. The Director General of Health's assessment of the state of public health finds the health and disability support workforce in New Zealand is busier than it has ever been.

In a typical year, there will be: 14 million visits to general practitioners 44 million prescriptions dispensed 620,000 hospital discharges for medical and surgical treatment 88,000 people accessing mental health services 414,000 cervical smears taken 320,000 free influenza vaccinations 53,000 free checks for people with diabetes 292,000 assessment, treatment and rehabilitation ‘bed days’ provided for some 14,000 people with disabilities or age-related disorders.

Director-General, Dr Karen Poutasi says "The report is intended to be a resource for a wide range of users of the health and disability support system and anyone with an interest in the sector. The evaluations provide critical information and direction for the health and disability support system, identifying successes and challenges facing the sector."

The number of people on waiting lists who don't have a care plan or date for their operation was 1,702 in the 2002/03 year compared with 50,422 in 1998/99. This is due to the patients either getting publicly funded surgery, being assessed as having lower priority circumstances and other forms of care. (pg 175)

On average, in real dollar terms, the government spent $1,769 per person in the 2000/01 year on health, compared with $1,390 ten years prior. (pg 22)

More than 44 million prescriptions were dispensed in the 2002/03 year and there is a breakdown of age and gender. Between 1997 and 2001 the number of prescriptions for most drugs rose substantially but spending has grown at a lower rate, mainly through price reductions negotiated with the industry by PHARMAC. Without PHARMAC interventions, it is estimated that the drug subsidy bill by the end of the 2002/03 year would have been $624 million higher. Since PHARMAC inception in 1993, pharmaceutical expenditure has increased by 3 percent per annum. In contrast Australia's expenditure has increased an average of 14 percent per annum in the 10 years to 2002. (pp 75-76)

Other highlights include the faster than expected take-up of Primary Health Organisations, with an estimated 2 million New Zealanders enrolled in PHOs in October 2003. (pg 171)

The Ministry of Health estimates that up to 90 percent of the population will be enrolled by the end of the next financial year.

Dr Poutasi says "Primary health care is central to improving the health of New Zealanders and, in particular, removing inequalities in health. Improved health is not evenly spread among ethnic groups, with Maori and Pacific peoples in particular having poorer health outcomes. We cannot manage chronic illnesses like diabetes without very effective primary care. PHOs bring together excellent first level care and public health approaches designed to help people stay well."

People on average only spend half the time in hospital than they did 20 years ago. The average length of stay used to be just under 7 days and is now just over 3 days. Reasons include advances in medical technology as well as more effective hospital administration. In general, more rapid mobilisation reduces complications and that is an added benefit. (pg 85)

Other points of note:

It's been estimated that there are approximately 67,000 professional health workers in New Zealand, with a further 30,000 informal workers providing home-based support services, and 10,000 alternative and complementary health practitioners (pg 47)

New Zealand ranks 14th out of 30 OECD countries for life expectancy in 2000. At birth in New Zealand, females live for an average of 80.8 years and males for 75.7 years. That's longer than the US, the UK an Ireland but shorter than Australia and Canada. (pg 210) The avoidable mortality rate decreased by approximately 40 percent in the last 20 years. Avoidable mortality are deaths that hypothetically could have been avoided with health promotion or treatment. Almost 80 percent of all avoidable deaths occur in the 45 - 74 year age group, dominated by chronic illnesses such as heart disease, diabetes and smoking-related cancers (pg 132)

Half of the adult Maori population smoke tobacco. Of the total population, a quarter of adults smoke (pp 135-137)

A significant increase in the number of cardiac and cataract procedures in the last six years, however the level of major joint replacements (hips and knees) is reasonably static despite additional funding (pp 174-175)

New Zealanders' health is, in general, relatively good, but with scope for improvement in some areas, including early diagnosis and treatment of some cancers and circulation problems leading to heart disease (pg 207)

There are evaluations of sector activities such as the 2001 Health Reforms (pg 214) and the Maternity Services Consumer Satisfaction Survey (pg 219) plus assessment of the screening programs (pg 99), suicide strategies (pg 103), obesity strategies (pg 91), alcohol and drug abuse (pg 94) and management of cardiovascular disease (pg 151).

The report is available on the Ministry of Health’s website: http://www.moh.govt.nz