Sector state of play: Health

Health and disability infrastructure supports the quality and the level of service that our health system delivers, contributing to our wellbeing. This infrastructure includes community-based facilities, aged residential care facilities, District Health Board (DHB) facilities (including hospitals), and privately funded health care facilities.

Health and disability infrastructure also encompasses the network of soft infrastructure services required to support effective and equitable service delivery. This includes the skilled workforce, research and regulation, governmental structures, training and educational resources, data connectivity, the natural environment, social connections, and cultural norms.

This research looks closely at the health sector in New Zealand, investigating the state of the sector, the issues it faces as well as those it needs to prepare for.  The findings are based on our own research, a survey of infrastructure owners as well as conversations with people within the sector.

This research was prepared prior to the Government’s health announcements on 21 April 2021, and so it reflects the state of the sector’s infrastructure at a point in time.  However, the announced changes to the health system’s organisational structure are also not expected to have an immediate effect on physical infrastructure.

Key findings

• There has been historic underinvestment in the sector’s infrastructure, resulting in poor building, site-wide infrastructure and clinical facility condition. A funding, governance, and regulatory system is needed that plans for, incentivises, and funds appropriate levels of investment in health and disability infrastructure.
• Health and disability facilities are increasingly not fit-for-purpose due to growing diversity, rising rates of chronic disease, and increasing complexity in the way we care for people with illness, injury or disability. There is a need to implement new facility design standards and achieve better long-term planning to facilitate modern care practices to meet future demand and consumer.
• Technological advancement is disrupting the sector, for example, artificial intelligence and ‘big data’, which are resulting in increased treatment options and improved diagnosis (and higher costs).
• New Zealand’s ageing population will continue to place strain on the health and disability system’s capacity.
• Advances in information technology will also be a driver for the system to increase data access, integration, and storage infrastructure to prepare for future challenges, demand requirements, and rapid health technology advancement.
• People are well informed of their healthcare challenges and service offerings, and in combination with changing care requirements, this will add to the strain on infrastructure.