NZ health and disability system review

The most significant review of New Zealand’s health and disability system for decades was released in June 2020. It proposes wide-ranging reform of the system.

What is the review about?

The Health and Disability System Review was charged with recommending system-level changes that would be sustainable, lead to better and more equitable outcomes (so for all New Zealanders and shift the balance from treatment of illness towards health and wellbeing.

In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.

The review panel sought submissions from stakeholders and people around the country over several months.

In August 2019, the review panel published an interim report that identified areas where submissions and its own analysis indicated that change was needed.

These were grouped around 4 key themes:

  • ensuring consumers, whānau and communities are at the heart of the system
  • culture change and more focused leadership
  • developing more effective te Tiriti based partnerships within health and disability and creating a system that works more effectively for Māori
  • ensuring the system is integrated and deliberately plans ahead with a longer-term focus.

The review’s final recommendations are grouped around these themes.

What did the review recommend?

The review’s key recommendations include:

  • shifting to a greater focus on population health – factors that affect the wellbeing of everybody
  • creating a new Crown Entity, provisionally called Health NZ, focused on operational delivery of health and disability services and financial performance
  • reducing the number of DHBs from the current 20 down to 8-12 within five years, and moving to fully appointed Boards
  • creating a Māori Health Authority to advise on all aspects of Māori Health policy and to monitor and report on the performance of the system with respect to Māori
  • greater integration between primary and community care and hospital/specialist services.

What happens next?

Cabinet has accepted the need for reform of the system in the general way outlined in the review, in particular, changes to reduce fragmentation, strengthen leadership and accountability and improve equity of access and outcomes for all New Zealanders.

Decisions on individual recommendations will be taken to Cabinet over coming months and into the next term of Parliament.

Learn more

The following links provide further information about Health and Disability System Review. 

Health and disability system review executive overview Health and Disability System Review, NZ, 2020
Health and disability system overview in te reo Māori Health and Disability System Review, NZ, 2020
Health and disability system review recommendations Health and Disability System Review, NZ, 2020
Health and disability system review full report Health and Disability System Review, NZ, 2020
NZ health and disability review Health and Disability System Review, NZ, 2020


  1. Achieving equity in health outcomes Ministry of Health, NZ, 2019
Credits: Health Navigator Editorial Team.