New Zealand healthcare system


 
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This topic has been written to help New Zealanders, migrants and visitors to New Zealand understand how the health system works.





When you need healthcare, here's what you do

When you or someone in your family is unwell the first point of contact is usually a primary healthcare provider such as a general practitioner (GP), practice nurse, midwife, local accident and medical centre, family planning clinic, pharmacist (chemist), physiotherapist, optometrist (for eye care), dentist or complementary health practitioner.

Your local GP and community-based accident and medical centres can treat many injuries and complaints. If your condition requires hospital care a GP or midwife can give you a letter of referral to see a specialist (either in a public hospital or private clinic).

For all serious injuries and complaints you should go to a public hospital emergency department directly or in an ambulance (phone 111 if it is a life-threatening emergency).

If you are not sure about whether you need medical help you can phone Healthline on freephone 0800 611 116. Healthline lets you talk to a registered nurse any time, 24 hours a day, and it is free and confidential. The staff at Healthline will advise you what action to take. Healthline also incorporates PlunketLine, which is responsible for advice for children under five years of age.

Where to find a GP or accident and medical centre

GPs and medical clinics can be found in the front of the telephone directory ("White Pages") under the section "Registered Medical Practitioners".
Hospitals and other health services are also listed in the telephone directory.

Where to find a pharmacist

Pharmacists generally work in pharmacies in surburban shopping centres or malls. Pharmacies are also situated near to medical centres. Pharmacies are listed in the "Yellow Pages" directory.

Pharmacists can offer advice on the safety and correct use of medicines and some health problems. They are able to sell you over the counter medicines, which do not require a doctor's prescription, and dispense medicines you have been prescribed by your doctor.

There is generally no charge to talk to a pharmacist about your health or medicines. But not all staff in a pharmacy are pharmacists, so if seeking specific health or medicine advice ask to speak to the pharmacist in the store.

Where to find a midwife

Domiciliary midwives, hospital-based midwifery services and independent midwives are listed under "Hospitals and other Health Services" at the front of the telephone directory ("White Pages").

The Maternity Services Consumer Council has information on finding a person to care for you in pregnancy and childbirth: phone (09) 520 5314 or email mscc@maternity.org.nz

The New Zealand College of Midwives can also help you find a midwife. Write to NZCOM, Box 21 106, Christchurch, or phone (03) 377 2732 or email nzcom@nzcom.org.nz

Where to find sexual health and contraception services

Family planning clinics provide sexual health, contraception and fertility health care. Look in the telephone directory ("White Pages") under "Family Planning Association". Family planning clinics charge similar fees to GPs. Clinic locations and fees can also be found on their website www.familyplanning.org.nz, or you can call freephone 0800 372 5463

Sexual health services attached to public hospitals provide free, confidential, specialist sexual healthcare. You do not need to be referred by your GP, you can contact the service directly. Look in the telephone directory under "Sexual Health" or under your local hospital.

Where to find a physiotherapist, dentist, chiropractor, osteopath or optometrist

  • To find a physiotherapist who is a member of the New Zealand Society of Physiotherapists, go to their website www.nzsp.org.nz or look in the "Yellow Pages".
  • For dentists, the Dental Council of New Zealand website www.dcnz.org.nz has a search facility for registered dentists, or look in the "Yellow Pages".
  • For a list of New Zealand chiropractors try the New Zealand Chiropractors' Association website www.chiropractic.org.nz or freephone 0508 424 476 for their nearest member.
  • For a list of osteopaths, visit the Osteopathic Society of New Zealand website www.osteopathsnz.co.nz 
  • A list of optometrists can be found at the New Zealand Association of Optometrists website,  www.nzao.org.nz or freephone 0800 439 322 or look in the "Yellow Pages".

Where to find a complementary or natural therapist

Many natural therapists are registered with the New Zealand Natural Health Practitioners Accreditation Board. You can write for a list of registered natural therapists to Box 37 491, Auckland. This covers homoeopaths, osteopaths, herbalists, remedial body therapists and some other specialties. You can also look in the "'Yellow Pages" under "Natural Therapy". When looking for a healthcare provider, ask other people which practitioner they recommend and check out whether their service might suit your needs. Community health groups and women's health groups might also be able to help. Ask your local Citizen's Advice Bureau (phone number in the telephone book) how to contact them.

The 'Big Picture'

Each year the Government decides how much public money will be spent on healthcare. This is called "Vote: Health". The Government, through the minister of health, allocates money to the 21 District Health Boards (DHBs) to purchase health services for the people of New Zealand. This money is allocated using a weighted population-based funding formula.

The Government provides broad guidelines on what services the DHBs must provide. These services can be bought from a range of providers including public hospitals, non-profit health agencies, iwi groups or private organisations.

Each DHB has a board of directors, some of whom are appointed by the Minister of Health and some locally elected. There is Maori representation both on the Boards and their committees.

The DHBs run public hospitals and other services, such as the National Cervical Screening Programme, health promotion activities and public health nursing services.

Private healthcare can also be purchased. Private providers include private hospitals, laboratories, and radiology centres, medical specialists and general practitioners.

Community-based and non-profit providers such as the Family Planning Association, Plunket or IHC can also apply to be funded to provide health services.

What you might pay for healthcare

What you pay for visiting your doctor

The care provided by family doctors or general pracitioners (GPs) is partially subsidised by the Government but in most cases you will still need to pay a copayment. This fee is set by the GP and can vary from clinic to clinic. GPs who are part of a Primary Health Organisation (PHO) can often provide cheaper services, particularly if you are over 65 or under 25 years of age. Prescription charges are also often reduced (see below).

If you are a beneficiary or are on a low income, you may be eligible for a Community Services Card, or CSC. A CSC can entitle you to additional healthcare subsidies. Your doctor or practice nurse can tell you if you qualify, or you can call Work and Income on freephone 0800 999 999.

The same applies to people who use health services often and have long term illnesses. These people may be eligible for a High Use Health Card (HUHC), which allows subsidised healthcare. There is more information on the CSC and HUHC below.

The nurse at your GP's practice may provide some services at lower cost than the GP. Ask about cervical screening, blood pressure checks, injections and other procedures that can be carried out by the nurse.

School dental nurses and dentists provide free care to children up to 17 years of age and still at school.

Pregnancy and childbirth services

Care in pregnancy and childbirth is free for New Zealand citizens and permanent residents, or for their partners or spouses, except for care provided by private obstetricians and at private hospitals. This care covers the diagnosis of pregnancy, antenatal care, childbirth, postnatal care and miscarriage.

Women who are not eligible for publicly funded health services may be charged for antenatal, labour, birth and postnatal services provided to them. Also, babies born from 1 January 2006 will only be eligible for New Zealand citizenship if at least one of their parents is a New Zealand citizen or permanent resident. If you are not eligible for publicly funded maternity services and your baby is not eligible to be a New Zealand citizen, you will also pay any costs for your baby. For more information on eligibility see the Ministry of Health's website or the Department of Internal Affairs' website.

District Health Boards are required to purchase abortion services, which are free of charge to the woman. These services can be provided locally or, sometimes, outside your area. Contact your GP, midwifery centre or local family planning clinic for more information.

Specialist and hospital care

If your GP refers you to a specialist or hospital you can choose to go publicly or privately. Almost all essential medical services are provided free through the public health system (excluding dentistry and optometry).

If you go privately, you must pay or have private health insurance. If the doctor suggests a private specialist or hospital, but you would prefer to use public services, ask for a public referral.

Always contact the public service yourself and ask about waiting times in your area. There are wide variations in waiting times depending on location and type of health service required. Don't assume that you will "never be seen in time".

Private specialists and consultants charge for their services. Some services are only available publicly (such as radiotherapy) but you can still see a specialist privately.

If you wish to find out more about health, visit Health Navigator.

Accident treatment

Treatment for accident-related injuries is subsidised by the Accident Compensation Corporation (ACC), as long as this care is provided by a registered health professional. There may be a user part-charge for visits to GPs, or for physiotherapy, chiropractic and other recommended treatments.

Laboratory tests and x-rays

Mostly, laboratory tests and x-rays are free. But private radiology clinics charge for all tests undertaken - unless they have been contracted to provide them by a local District Health Board service. Breast screening is free for women between the ages of 45 and 69 years of age. Cervical screening is free for women aged 20 years or more and under 70 years who have ever been sexually active.

Blood tests are mostly funded by the District Health Board and will not cost you any money.

Drugs or medications

Some medicines are subsidised for patients in New Zealand. Pharmac, a government organisation, specifies which medicines will be subsidised (ie, these are the medicines on the Pharmaceutical Schedule).

Adult New Zealanders will pay either $15.00 (children $10.00) for subsidised medicines, up to 20 items per year. If you are aged 24 or under or 65 or over and your doctor is part of a Primary Health Organisation, you should be eligible for a $3 prescription fee. Prescription medicine for children under six years is often free.

For some medicines you also pay an extra part-charge. Some drugs are not subsidised at all, and must be fully paid for. Your doctor can tell you if a drug has an extra charge or is not subsidised. Nonprescription (over the counter) medicines must be paid for in full.

People who live in households with low incomes or which have healthcare needs can apply for a Community Services Card (CSC) or High Use Health Card (HUHC). CSC or HUHC allow adults and older children to pay only $3.00 per item for medicines and nothing for children under six.

A guide to prescription charges and an Interactive Schedule - a prescription cost calculator - for items on the Pharmaceutical Schedule can be found on the Pharmac website www.pharmac.govt.nz

Eligibility for Community Service Card

The CSC is available to low income individuals or those receiving a benefit, and their dependent family members. Eligibility is based on family size and income. Phone the Community Service Card Information Helpline 0800 999 999 for more information or visit www.workandincome.govt.nz

Eligibility for High Use Health Card

The HUHC gives an individual access to a higher government subsidy on visits to the doctor. To be eligible for this card an individual needs to have visited the doctor 12 or more times in one year. This card is not means tested. Your doctor will have a record of your visits, and he or she can make an application for your HUHC. Phone the HealthPAC Contact Centre 0800 252 464 for further information.

The HUHC Card gives the same amount of subsidy as the CSC on GP visits and prescription charges (there is no additional benefit to having both cards).

  • Adults with a HUHC get a subsidy of $15 for a visit to a doctor.
  • Children aged 6 to 18 get a subsidy of $20 for a visit to a doctor.
  • For prescriptions, the government prescription charge is reduced from $15 to $3 per item (but when the medicines themselves are only partly subsidised there will still be additional charges).

Pharmaceutical Subsidy Card

The Pharmaceutical Subsidy Card (PSC) allows the cardholder and named family members to pay a lower amount on the $15 government prescription charges. There is no income testing. The purpose of the card is to help people who face high prescription costs but who do not have a CSC or a HUHC.

Your pharmacist should have a record of your family's prescriptions. Your pharmacist will issue a PSC once a family unit has paid for 20 subsidised prescription items since l February of any year. If you use several pharmacies, keep your receipts until they number 20 in total. More on the PSC.

Other services

  • Independent nurse practitioners charge for their services, except when they are contracted to hospitals or DHBs to provide free or partly subsidised services. 
  • Dentists charge for their services. Limited dental services are available in public hospitals in some areas. Basic dental care for eligible school children is free up to 18 years of age.
  • Physiotherapists, osteopaths and chiropractors will charge you. This may be a part-charge if your doctor has referred you. 
  • Complementary or natural therapy is not subsidised so you must pay for the whole service, unless that care is being provided by a practitioner who is also a doctor or midwife. For example, some doctors provide acupuncture and homeopathy services. 
  • Long-term residential care for older people is asset-tested. To find out what you are entitled to, contact the local branch of New Zealand Income Support Service. 
  • Ambulances are provided by non-profit community-based services in most parts of New Zealand, as well as hospitals and private providers.

There is a part-charge that ranges from $45 to $67.50. However, there is no charge for the Wellington Free Ambulance Service or for patients covered by ACC.

Health insurance

Health insurance entitles those insured to get refunds for specific health services. The size of the refund and the services covered depends on the policy. There is often a shortfall between the amount of the refund and the actual cost of the service. While this sum may be small for some services (for example, a visit to a GP), for major surgery the shortfall may be very large. As some health services are only available in public hospitals, health insurance is of no benefit in particular circumstances. Many cancer treatments, intensive care and major trauma and accident treatments are examples of services not provided by the private sector.

Non-New Zealand residents

Health services are funded for New Zealand residents. People who are not permanent residents can be charged for their healthcare. Nobody can be refused emergency care because they cannot pay, although they may be sent a bill later.

Treatment after an accident is free or heavily subsidised for all people whether or not they are New Zealand residents. If you have been granted refugee status, you have the same rights as New Zealand residents. If you have been granted a temporary permit while your application for refugee status is processed and you intend to remain in New Zealand for two years or more, you have the same rights as New Zealand residents.

If you are not sure whether you are eligible for publicly funded healthcare, you can contact the Ministry of Health or visit the Ministry of Health's website page on  Eligibility for Publicly Funded Health and Disability Services.

Registration

New Zealand has no compulsory system of registration to receive healthcare. However, many New Zealanders who have used health services have been automatically registered on the National Health Index (NHI) and have been allocated an NHI number.

There are a number of other registers: The National Cervical Screening Programme has a register for women aged 20 to 70 years, which can be used only for cervical screening (freephone 0800 729 729).

BreastScreen Aotearoa offers a free breast cancer screening programme for women aged 45 to 69 (freephone 0800 270 200).
Some GP practices keep practice registers. This information should be confidential to the providers involved in your care. If information about you is to be passed on to any other agency, you must be told of this when the information is collected.

Your privacy

Under the Privacy Act 1993, you have a number of rights with regard to health information held about you. In general, you have a right to see that information.

If you have concerns about the privacy of your health records phone the Privacy Commissioner's Hotline Auckland phone (09) 302 8655, and other areas freephone 0800 803 909, or check the website of the Office of the Privacy Commissioner.

Health And Disability Commission

The 1994 Health and Disability Act is expressed as being "to promote and protect the rights of health consumers and disability services consumers, and, in particular, to secure the fair, simple, speedy, and efficient resolution of complaints relating to infringements of those rights". This objective is achieved through the implementation of a Code of Rights, the establishment of a complaints process to ensure enforcement of those rights, and the ongoing education of providers and consumers.

Complaints about the health services you receive can be directed to the Health and Disability Commissioner - freephone 0800 11 22 33, website www.hdc.org.nz.

Original material supplied by everybody.
Information current as of September 2016.

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