Progress towards achieving health for all New Zealanders by the year 2000

New Zealand has been faced in recent years with a serious failure to maintain its relative position, in comparison to other OECD countries, in its social, economic and health status indicators. Although health costs so far have been successfully controlled, through a largely capitation funded service, its health organisational problems are typical of developed countries including major problems of equity and efficiency. Despite these problems some important recent initiatives give optimism for future health improvement. These include the spread of the service concept through service development groups and moves towards decentralisation through area health boards. Population-based funding of hospital and area health boards, supplemented with service planning guidelines, has proved to be an important lever for change. Maori health initiatives are beginning to show the way to improving the status of this disadvantaged section of society and perhaps for other New Zealanders as well. Important issues yet to be faced include establishing an effective central organisation for the health services, education and training for leadership and a more central place for the still largely fragmented and isolated primary health care services.