Solving the surgical waiting list problem? New Zealand's 'booking system'

This article discusses the development and implementation of New Zealand's booking system for publicly funded non-urgent surgical and medical procedures. The 'booking system' emerged out of New Zealand's core services debate and the government's desire to remove waiting lists. It was targeted for implementation by mid-1998. However, the booking system remains in an unsatisfactory state and a variety of problems have plagued its introduction. These include a lack of national consistency in the priority access criteria, failure to pilot the system and a shortfall in the levels of funding available to treat the numbers of patients whose priority criteria 'scores' deem them clinically eligible for surgery. The article discusses endeavours to address these problems. In conclusion, based on the New Zealand experience, the article provides lessons for policy-makers interested in introducing surgical booking systems.