A year in Auckland

Extract

I had acquainted myself with the psychiatric services in New Zealand some years ago during my student elective. I wanted to return to experience further a system which was both similar and different to the NHS. The New Zealand hospital system was funded in a similar way to the NHS. One organisational difference was the managerial layer, which was still filled by medical superintendents. Another difference was the extensive no-fault accident compensation scheme through which settlements were made without resort to lawsuits. Thus doctors paid low medical defence fees and were rarely sued, but the Government had regularly to meet a large bill. The psychiatric services were in the process of moving from hospital-based to community-based, in line with prevailing clinical and public attitudes. This was fuelled by some headline-making scandals over patient care in the asylums. One cause for general alarm was the poor health of ethnic minorities, especially the indigenous Maori. This issue resonated with racial and political overtones.