A window on quality 2021: COVID-19 and impacts on our broader health system – Part 1 | He tirohanga kounga 2021: me ng...

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Aotearoa New Zealand has been recognised internationally for a successful early response to the global pandemic of COVID-19. This year’s A window on quality 2021: COVID-19 and impacts on our broader health system – Part 1: March 2020 to August 2021 | He tirohanga kounga 2021: me ngā pānga ki te pūnaha hauora whānui – Wāhanga 1: Poutū-te-rangi 2020 ki Here-turi-kōkā 2021 (Window) explores the secondary impacts of our response on selected aspects of the functioning of our health system so we can learn from that experience and shape resilient system responses in the future.

A second part of this Window, scheduled for June 2022, will explore other critical aspects not covered here, as data emerges from the system, revealing the effects of the Delta outbreak on other services.

The Window begins with a broad view of the conditions and context in which the Aotearoa New Zealand health system responded to the challenges of COVID-19 between 2020 and 2021. Since the beginning of 2020, we have, on average, experienced less-stringent restrictions than any comparable country. Our economy has been less badly affected than elsewhere, and lockdowns have had the effects of decreasing all-cause mortality since 2020 (mostly among older people) and increasing life expectancy, in sharp contrast to most other countries.

However, Aotearoa New Zealand’s particular patterns of inequity before the pandemic were both a failure of the Crown’s obligations under Te Tiriti o Waitangi (Te Tiriti), and presented fertile ground both for the virus and for the unintended negative effects of measures to contain it. The impacts of COVID-19 on health care must be considered in view of inequitable health service provision that has occurred historically and continues today, but also because pandemics compound and promote pre-existing social and economic inequities, especially in terms of precarity of housing, overcrowding and poverty.

The pandemic presents an opportunity to think about what a future health system in Aotearoa New Zealand can look like. A return to ‘normal’ is not desirable. A system that is underpinned by a whole-of-government approach to health, is pro-equity, complies with Te Tiriti and is anti-racist must provide the transformative policies and actions necessary to address systematic, entrenched and pervasive inequities.