Members of the public can use hospitals without a doctor’s referral only in the case of accidents and emergencies.
In all other cases your first point of contact is your family doctor, who will refer you to an appropriate hospital as necessary. The main criticism of healthcare reforms in recent years has related to the increase in hospital waiting lists, which are long and growing longer. There have been many horror stories of patients requiring urgent hospital treatment having to wait ten hours or more for a bed (not that this makes New Zealand any worse than many other countries).
Under the current system, regional health authorities must ‘buy’ the services you require (e.g. an operation) from the most cost-effective source, which will usually be your local hospital. However, if you’re willing to travel to another (or any) hospital, you should inform your doctor, as he may be able to book you into a hospital where the waiting list is shorter.
Once you’re given a bed in a public hospital, the standard of medical and nursing care is as good as you’re likely to find anywhere. New Zealand hospitals provide free in-patient healthcare, which includes medical and nursing care, medicines and accommodation. (The government experimented with a $50 per day ‘hotel charge’ in hospitals between 1991 and 1993, but this was dropped after public opposition.) Out-patient treatment in accident and emergency departments isn’t free and is paid for in the same way as visits to a family doctor (CSC holders pay reduced fees).
It can be difficult to identify hospitals in New Zealand since the 1993 changes to the state healthcare system, when they became known by various euphemisms such as ‘ healthcare centres’, ‘ mental care units’ (mental hospitals) or ‘ elder care units’ (geriatric hospitals). In addition to public hospitals, there are also many private hospitals in New Zealand, which allow the wealthy and those with medical insurance to avoid the public sector waiting lists.
Many private hospitals are owned by the medical insurance companies (as public hospitals don’t accept private patients) and accommodation may be more luxurious than in public hospitals, although the standard of medical care is the same and they’re often staffed by the same doctors.
Some private hospitals receive government subsidies and there are a number of projects where the public and private sectors co-operate to provide specialist services such as coronary care. Some charities also provide health services, e.g. community clinics, which are partially funded by the government. Some private hospitals and clinics specialise in non-essential cosmetic surgery.
The New Zealand Ministry of Health helpfully publishes hospital death-rate statistics to help you choose a hospital, although they won't help if you’re rushed to the nearest hospital in an emergency!