Public purchasing and private priorities for healthcare in New Zealand

The 1993 Health and Disability Services Act heralded a range of structural reforms in the New Zealand health care system. Despite these reforms consid erable resources being spent on convincing consumers of their merits, have failed to gain widespread public approval. This paper examines two key issu es that have arisen during the reform process. These are the difficulties a ssociated with trying to set priorities in ways which are effective and pol itically acceptable, and the relationship between the public and private se ctors. Unacknowledged conflicts of interest have helped to undermine the pr iority setting process. The discussion suggests that it may be increasingly difficult for any government in future to determine the allocation of reso urces without taking private sector interests and rising public concern int o account. It remains to be seen which of these factors is more powerful. ( C) 2000 Elsevier Science Ireland Ltd. All rights reserved.