ABSTRACT
Since 1990, the New Zealand health system has been reorganized several times, with an emphasis on improving access to services, equity of access and funding, and the overall cost-effectiveness of the system. Although major organizational reforms in the 1990s proved controversial, not achieving their desired outcomes and being overturned in 2000, they left important legacies. Organizational arrangements established in the 2000s remain in place today, such that in the 2010s the emphasis is on more collaborative working arrangements. A lack of research evidence makes it difficult to assess the impact of recent changes, however, and significant challenges lie ahead in better linking publicly and privately owned parts of the system, if the performance of the system is to be improved further.
