OECD review of population health & health system performance

New Zealand’s Health Data is Incomplete and Comparison with Other Nations is Impossible

The OECD review of population health and health system performance for New Zealand

By Charlotte Korte

Co-Founder of The Health Consumer Advocacy Alliance


The latest OECD review of population health and health system performance for New Zealand is a valuable reminder of why independent international reporting matters. The strength of OECD reporting is that it allows countries to compare performance transparently and learn from each other.
Much of the data in the OECD’s latest review of population health and health system performance is incomplete or based on modelled estimates because New Zealand does not submit the full set of standardised health datasets to the OECD, and the health information we do collect is neither comprehensive nor consistently accurate.
For example, the OECD reports that no comparable data are available on treatable and preventable mortality or on the share of spending devoted to prevention. A 2025 NZIER report* notes that many of the gaps in OECD data arise from limitations in New Zealand’s reporting and the difficulty of aligning with OECD definitions, rather than major faults in the OECD’s analysis. Self-rated health illustrates the issue: the OECD reports that 2.9 percent of New Zealanders describe their health as bad or very bad, while the New Zealand Health Survey shows around 14 percent report fair or poor health, with stark inequities for Māori, Pacific peoples, disabled communities, and those living in areas of high-deprivation. Neither source alone captures the full reality of New Zealanders’ health, highlighting the urgent need for transparent, consistent, and comprehensive data collection. International evidence shows that poorly designed targets can distort behaviour and mask underlying system pressures, rather than improving patient outcomes.
Incomplete reporting reduces transparency around delays, inequities, and safety concerns. It weakens accountability and can give a misleading picture that does not reflect the experiences of patients and whānau. Reliable and transparent data is essential, not only for identifying harm, but also for how the system responds, learns, and improves care. A 2023 government briefing to the Minister of Health notes that targets can, if not carefully implemented, create unintended incentives or distortions in reporting, without necessarily improving patient outcomes. Missing or inconsistent data also distorts planning and funding decisions, making it harder to target resources to the communities with greatest need. Without accurate information, risks remain hidden and opportunities to prevent future harm are lost.
The absence of NZ data on unmet needs is confirmed by the OECD. This is a critical measure of access and equity, and its omission raises concerns. Over-optimistic reporting based on incomplete data can mislead those using OECD statistics to inform policy decisions. While New Zealand collects information on access and equity, the indicators do not align directly with OECD definitions, making international comparisons difficult. New Zealand has not submitted a full set of comparable data to the OECD for the last seven years. Strengthening independent reporting in New Zealand and submitting complete, transparent health data to the OECD would ensure the figures we provide are accurate, reduce political spin, and allow decisions to be guided by the real experiences and needs of consumers. Health NZ’s 2023/24 Annual Report acknowledges long-term underinvestment in the data and digital sector, and the recent disestablishment of roles has only compounded the challenge. New Zealand needs to properly invest in data infrastructure, both systems and capacity, to support robust reporting and better health outcomes.
Targeted investment and improved reporting in parts of New Zealand’s health system show that transparency and accountability can be strengthened when the right focus and resources are applied. Transparent, accurate, reliable and meaningful data collection and reporting from all organisations using public funds in New Zealand should be non-negotiable, and subject to independent audit.
The question remains: why are we still not submitting full data to the OECD?
New Zealand urgently needs independent oversight of its health system to strengthen transparency, close data gaps, and support evidence-based policy decisions that reflect the real needs of patients/health consumers. Without this, inequities, hidden harm, and missed opportunities to improve care will continue unchecked.
* New Zealand Institute of Economic Research (NZIER) is an independent New Zealand economic research organisation providing analysis on public policy and the economy.
  • How Does This Align with HCAA’s Patient Safety Campaign
  • This issue of incomplete and inconsistent data is central to HCAA’s patient safety campaign. Safe care depends on transparent information, accurate measurement, and the ability to identify where harm is occurring. Incomplete or inconsistent data makes this impossible. Gaps in reporting reduce transparency around delays, inequities, and safety concerns. They weaken accountability and can give a misleading picture that does not reflect the experiences of patients and whānau. Reliable meaningful data that focuses on outcomes is essential for identifying harm, tracking performance, and ensuring the system can learn. Without it, risks remain hidden and consumers cannot be confident that improvements are genuine.
  • New Zealand and the OECD sometimes use different terminology, so why don’t we align our terms so we can compare internationally and meet reporting requirements?
  • If on average in OECD countries “almost 8% of adults globally considered themselves to be in poor health in 2024” but in New Zealand it is under 3% it does make you start asking questions:
  • Do New Zealanders really feel this way?
  • If New Zealand participated in the OECD’s Patient-Reported Indicator Surveys (PaRIS), why haven’t we released any national results or a local report?
  • If other OECD countries can publish their PaRIS findings, what’s stopping us, and what does that mean for transparency in our own health system?
  • How can we be confident in the accuracy or completeness of our OECD contributions when the underlying data isn’t publicly available here and we don’t know precisely what was submitted to the OECD?
  • If New Zealand hasn’t been submitting comprehensive data to the OECD, how complete do we think the picture of our health system really is?
The way forward: The OECD review of population health and health system performance for New Zealand reinforces the need for the Ministry of Health and Health NZ to strengthen their health data systems, invest in accurate and transparent reporting, and ensure independent oversight. Stronger data would allow the OECD to provide the full insight needed to guide better decisions and improve outcomes for consumers.The data we provide does not yet fully reflect who we really are. New Zealand urgently needs independent oversight, robust data systems, and a commitment to transparency so that the lives behind the numbers are never overlooked or lost.