New Zealand’s health system rates strongly on global transparency index
Embargoed until 5.00am, Wednesday 12 April 2017
New Zealand has performed strongly in a global report on healthcare transparency – although the study has identified
some key areas for improvement.
The just-released report by KPMG International compares the transparency of healthcare systems around the world. New
Zealand was ranked 7th out of 32 countries; slightly behind Australia and the UK, and equivalent to comparable countries
such as the Netherlands.
Andrew Tubb, KPMG’s Advisory Partner for Healthcare and Human Services in New Zealand, says the results are
“This is the first study of its kind to examine transparency in healthcare across a range of measures – from governance
and finance, to the sharing of personal healthcare data.”
Overall, he says New Zealand achieved a “well-balanced scorecard”.
“In some respects, we are the envy of the rest of the world. We can demonstrate high levels of transparency surrounding
the governance and funding of our healthcare system.”
In fact New Zealand received the highest ranking of 94% (along with Denmark) for transparency of governance. This
reflects the fact New Zealand’s healthcare model is predominantly publicly-funded, coupled with a strong regulatory
environment and expectations of public scrutiny.
“Ministry of Health and ACC funding processes, and DHB tenders for services are very robust and transparent,” says
Richard Catto, a Wellington-based Healthcare Director with KPMG.
“The study also revealed an interesting fact – we’re the only country that requires boards and healthcare providers to
maintain a register of gifts and hospitality received.”
The study also highlighted some key areas where New Zealand could improve, says Catto. The country had a relatively low
score on transparency of patient experience (54%).
“Traditionally, we have been very focused on measuring healthcare outputs, as opposed to outcomes. For example, we know
how many hip replacements have been performed, but not necessarily the extent of patient benefit derived from those
“However we are starting to do some good work in this area. The patient experience is probably the most important area
for New Zealand to focus on as we strive to become a truly quality-driven healthcare system.”
Another emerging area in global healthcare, notes Catto, is the trend towards patient-enabled healthcare. Both Denmark
and Norway have a patient portal; where patients can view, contribute to or add to their personal health data (including
“New Zealand has traditionally been hesitant to adopt this kind of technology, due to privacy concerns,” he says.
“But the concept of patient portals is almost certainly the way of the future. It is likely to be commonplace within the
next 5-10 years.”
—“Through the looking glass: a practical path to improving healthcare through transparency” published by KPMG International
—“Country Report Card: New Zealand”, published by KPMG New Zealand.
Interpretting the findings:
— A total of 32 countries were surveyed. The average transparency score was 55%, with New Zealand sitting
— The four Nordic nations (Denmark, Finland, Sweden and Norway) are at the top of the transparency rankings. The
second tier includes Australia, Netherlands, New Zealand, UK, Portugal and Singapore; while India and China were the
bottom two countries.
— There were six different measures of transparency: Quality of Healthcare; Patient Experience; Finance;
Governance; Personal Healthcare Data; and Communication of Healthcare Data.
— Even the high-performers lacked consistency across all measures of transparency.
- Transparency around ‘Quality of Healthcare’ was generally lower across all countries – suggesting this is the area
where health systems are most cautious to release data.