NZ rates poorly in medical poll

By FRANCESCA MOLD health reporter

A report comparing the world's health systems has ranked New Zealand 41st behind countries such as Chile, Morocco and Costa Rica.

The World Health Report 2000 gives an index of national health systems for the first time and their ability to achieve good health status for their population, be responsive to people's expectations and maintain fair financial contribution.

Top overall ranking of 191 World Health Organisation member states goes to France, closely followed by Italy. New Zealand trailed behind Britain at 18, Australia at 32 and the United States in 37th place. Worst-ranked was Sierra Leone.

The report graded fairness of financial contribution by measuring the portion of household income spent on healthcare, including tax, social and private insurance and out-of-pocket payments.

Colombia was top-rated in this category, with New Zealand ranked between 23rd and 25th, Australia 26th to 29th, Britain 8th to 11th and the US 54th to 55th. The least fair were Sierra Leone, Brazil, China, Vietnam, Nepal, Russia and Peru.

The president of the Public Health Association, Fran McGrath, said the report's findings seemed consistent with New Zealand data.

New Zealand's poor ranking showed that factors such as disparity in income, housing and education had an important effect on health.

"The challenge the Government is facing is finding ways to reverse disparities and gaps between groups in our society."

The WHO report said New Zealand spent about 8.2 per cent of gross domestic product (GDP) on healthcare.

Top-ranking France spends 9.8 per cent of GDP on health, while the US spends the most at 13.7 per cent but ranks only 37th in performance.

Britain spends only 5.8 per cent of GDP on health but managed to rank 18th. The lowest GDP expenditure on health was Somalia at 1.5 per cent.

The report found that New Zealand spent 71.7 per cent of its health budget on the public sector and just 28.3 per cent on the private industry.

Britain tops the scale for public health funding at 96.9 per cent, with the US splitting its spending - 44.1 per cent on public, 55.9 on private.

Health Minister Annette King said the report was "very disappointing but not surprising."

"The use of a competitive model in health has certainly not produced the benefits that were envisaged when it was carried out. It's of great concern because New Zealand has always prided itself as having one of the best health systems in the world."

However, she claimed New Zealand was "well down the track of turning it around."

New Zealand's rating of 23rd in terms of the fairness of the financial contribution towards healthcare was a reflection of the gap between rich and poor in New Zealand.

"Everything we did in the budget was about closing those gaps. Our health status would be better if we didn't have the poor, or Maori and Pacific people. It doesn't work that way - we've got to address those disparities."