For over 50 years, comprehensive health services, most of them supported by the state, have been available to all New Zealanders. About 80% of all health care costs are met by the public sector. Treatment at public hospitals is free for people ordinarily resident in New Zealand. In private hospitals, medical care is subsidized; a full range of maternity services is paid for by the Department of Health. The Health Service provides hospital treatment, maternity services from a general practitioner, most prescribed drugs, laboratory diagnostic services, dental care, routine immunizations for children under 16, and some health appliances free of charge. Partial benefits are paid for private hospitalization, X-ray services, physiotherapy, and hearing aids. Care is free for infants and preschool children. Most children are immunized free by their family doctors, but the Department of Health also has immunization clinics. In 1994, children up to one year old were vaccinated against tuberculosis, 20%; diphtheria, pertussis, and tetanus, 84%; polio, 84%; measles, 87%; and hepatitis B, 81%. In 1999, rates for DPT and measles were, respectively, 88% and 83%. In 1991, the government announced plans to expand health care resources for those in financial need.
Area health boards, formed to combine primary and hospital care facilities for each region under a single administrative unit, were established in 1985. Market-oriented health care reforms were introduced in the 1990s, but many were reversed at the end of the decade when a Labour-Alliance government came to power. The country's health care system is still mostly tax funded. Twenty-one district health boards were formed by the New Zealand Public Health and Disability Act of 2000. As of 1999, total health care expenditure was estimated at 8.1 % of GDP.
Public hospitals are managed under the supervision of the Minister of Health by local hospital boards, whose members are elected; all costs are borne by the state. Private hospital costs are partly paid for by the state; additional fees may be claimed from patients. Voluntary welfare organizations make valuable contributions to public health and are assisted by grants from public funds. Most physicians practice under the National Health Service, established by the Social Security Act of 1938, but private practice outside the scheme is permitted. As of 1999, there were an estimated 2.3 physicians and 6.2 hospital beds per 1,000 people.
As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 14.2 and 7.6 per 1,000 people. About 70% of married women (ages 15 to 49) were using contraceptives in 1990–95. In 2000, the total fertility rate was two children per woman living throughout her childbearing years. Infant mortality in 2000 was 6 per 1,000 live births for the total population. Life expectancy at birth was 78 years. The principal causes of death are heart disease, stroke, chronic obstructive pulmonary disease, and lung and colorectal cancer. There were about six reported cases of tuberculosis per 100,000 people in 1999.
The health of the Maori people, although greatly improved over recent decades, is still not on a par with that of the general population. Alcoholism is a significant public health problem in New Zealand. Estimates of the number of chronic alcoholics range upward from 53,000 and another 250,000 New Zealanders may be classified as excessive drinkers. Tobacco consumption in New Zealand has decreased from 2.3 kg (5.1 lbs) a year per adult in 1984–86 to 2.0 kg (4.4 lbs) in 1995. The heart disease mortality rate for those over 65 years old is higher than the average for countries defined as high human development by the World Bank. As of 1999, the number of people living with HIV/AIDS was estimated at 1,200 and deaths from AIDS that year were estimated at fewer than 100. HIV prevalence was 0.06 per 100 adults. New Zealand has adopted needle exchange programs to reduce HIV spread among IV users.