Prioritising Health Services: A background Paper for the National Health Committee

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Prioritising Health Services: A Background Paper for the National Health Committee

Date of publication: October 2004

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This internal background paper from the National Health Committee (NHC) provides an overview of themes central to the area of resource allocation in publicly-funded health systems. It also outlines the development of explicit prioritisation processes in New Zealand.

This report begins by acknowledging that almost all decisions made in the health sector are, to some extent, prioritisation decisions. It is an environment of limited resources. Money, time, space, and available staff all constrain the ability of both the system to provide - and people to access - health care services and health promotion programmes. Consequently, these resources need to be allocated in some fashion, and unless allocated completely randomly – and arguably even then – it is an exercise in prioritisation.

Health professionals, the NHC found, prescribe interventions requiring resources and, while the type and features of the intervention may be constrained by other decision-makers, clinicians are the ones who mainly control (in consultation with the people concerned) the demand for resources.

This paper is structured in two sections, the first of which provides a basic introduction to key concepts in prioritisation, and an overview of themes that have emerged in the international development of explicit prioritisation systems. The second section looks at the development of explicit prioritisation in New Zealand, in the early 1990s through to the current way in which prioritisation is approached at each layer of the New Zealand health sector.

The report outlines the comparative advantages and disadvantages of implicit and explicit decision making in the health sector and explains how decision making is carried out at three levels: central government, administrative and individual health practitioner level.

The report also looks at the major themes running through the international development of prioritisation processes, and the difficult and controversial nature of prioritisation in general and the establishment of explicit prioritisation systems in particular.

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This publication is available in Word and PDF format below:

Prioritising Health Services: A Background Paper for the National Health Committee (Word, 380 KB)
Prioritising Health Services: A Background Paper for the National Health Committee (PDF, 468 KB)

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Prioritising Health Services: A Background Paper for the National Health Committee

Summary

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