The New Zealand policies to reduce inequalities of access to healthcare : a thesis presented in partial fulfillment of the requirement for the degree of Master in Public Policy at Massey University, Auckland, New Zealand

Abstract

This research aims to provide an insight into different policies and strategies in addressing issue of inequality of access to healthcare in New Zealand's health system. Inequalities in health exist between ethnic and socioeconomic groups, people living in different geographic areas, people belonging to different generations, and between males and females. In New Zealand, as in most countries, socially disadvantaged and marginalized groups have poorer health, greater exposure to health risks, and lesser access to high-quality health services. The research attempts to pinpoint policies based on equity to promote equal access to healthcare in order to reduce inequality in health. The research design is a qualitative research and utilized system theory and policy analysis approach. The researcher derived information from primary and secondary data, and analyzed the issue of equal access to healthcare from Social Democracy, Neo-Liberal and Third Way perspectives. The main difference in the abovementioned perspectives is the perceived role and responsibility of the State in promoting equality of access to healthcare. The focus of the research is equity policy for Māori and Pacific people to access healthcare at primary care level. The findings discover that New Zealand has shifted from mainly universalism approach to a mix of universalism and targeted benefits approach; it also shifted from mostly State sector provision to a mix of public and private sector provision, and partnership with nonprofit sector. Māori and Pacific health providers are also encouraged. The key lever of the equity policy is the Primary Health Care Strategy. The thesis concluded that, being so used to swinging between different ideologies and reforming the health system accordingly, New Zealand government should make use of experiences from a readily available and proven established strategy rather than engage in further radical reform. Additionally, the government needs to find balance between universalism and targeted benefits.