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Insights 42: 7 November 2025
New Research Note: Better health through better data,
Dr Prabani Wood
 
NZ Herald: Dr Prabani Wood on the data blind spot weakening NZ's health system
 
Newsroom: Dr Eric Crampton on how motorways gain from regulation changes
Better health starts with better data
Dr Prabani Wood | Adjunct Fellow | prabani.wood@nzinitiative.org.nz
After over 16 years as a GP, I can tell you what keeps me up at night. It is not the long hours or the difficult diagnoses. It is wondering how much of a difference the care I provide makes for my patients. 

I know my patients well. I know their histories, their families, their struggles. But I cannot tell you with confidence how many patients I have prevented from attending the emergency department or being admitted to hospital. I am unsure how my referral patterns compare to those of my colleagues.  

This is not just my problem. It is New Zealand’s problem. 

Other countries have figured this out. When doctors can see patterns in their own work – whether they prescribe safely or manage chronic conditions well – they improve. When policymakers see what works, they stop guessing. 

We already have the Integrated Data Infrastructure, which links health, education, income and housing data. The missing piece? General practice. Where most health care happens. 

Adding this would give us a complete picture of how health care works for people in their communities and how intersectoral collaboration can work to improve people’s lives. For example, we can see the impact of improved housing standards on conditions such as asthma. 

Canada shows what is possible. Since 2008, over 1,500 GPs have contributed data covering two million patients. The system is run by clinicians, not bureaucrats. Data are stripped of identifying information, analysed only for approved questions, all access is logged, and researchers can only access the part of the database which is relevant to their area of research. 

Here is what matters: doctors get useful feedback. They can see their prescribing patterns, compare themselves with peers, identify patients who need follow-up. When GPs saw their antibiotic prescribing rates, many changed their behaviour. Care improved as unnecessary antibiotic prescribing dropped. 

We could do this. Put GPs in charge of governance. Strip identifying information at source. Provide dashboards that help us better care for our patients. Start small by allowing practices to opt in, then actively expand to rural and high-need areas where the data matter most. 

Privacy concerns are real, but solvable. Patients can opt out. Access is controlled and logged. The Canadians won an international privacy award for their approach. 

Done right, we would finally know whether our care is truly working. We would be guided to improve our prescribing practices. We would know how many acute hospital admissions and emergency department visits our care prevented. We would know whether different communities are getting equitable treatment. 

I spent nine years building a general practice from scratch. I know what works in theory does not always work in reality. But this does work. Other countries prove it. 

Better data cannot treat patients alone, but better data will help every doctor who does. 

To find out more, read Prabani's research note "Better health through better data" here.​
A professional standards dilemma
Dr Michael Johnston | Senior Fellow | michael.johnston@nzinitiative.org.nz
Earlier this week, teachers’ unions accused Minister of Education Erica Stanford of a “blatant power grab.”  

This followed Stanford’s announcement that the Teaching Council will no longer set professional standards for teacher training. The Ministry of Education will take over this responsibility.  

Stanford also announced a shift in Council membership from a majority elected by the teaching profession to a majority appointed by the Minister. 

On the face of it, the unions have a point. Standards for doctors, lawyers, architects and accountants are all set by professional bodies, not by ministries.  

The Minister’s move is certainly unusual. It brings standards for teacher training under political, rather than professional, control.  

The dilemma is that the existing teaching standards do not reliably certify teacher competence. There is little prospect of the Teaching Council addressing that issue under the present arrangements. 

Last year, the Education Review Office reported that only 40 percent of interviewed principals believe that new teachers are adequately prepared for the classroom. More than a third of new teachers themselves said they could not effectively manage classroom behaviour. A third of primary teachers said they were unprepared to teach science. 

A recent OECD report paints an even worse picture. Nearly two-thirds of surveyed teacher graduates in New Zealand were not confident with the curriculum content they need to teach. Half were not confident in their teaching skills more generally. 

Considering these manifest deficiencies, the Minister is clearly not prepared to let things continue as they are. Politicising teaching standards has its risks, however. 

The standards could become a political football. Successive Ministers could use them to advance ideological objectives through the influence of the standards on teacher training programmes. 

The New Zealand Initiative has proposed a different approach. Instead of just one registration body for teachers, the Education and Training Act could enable many. Each could set its own standards within legislated parameters.  

Accountability is key to making this approach work. Publishing average measures of students’ educational progress for teachers registered under each set of standards would enable schools to identify which are most effective. 

A downside is that this competitive system would take time to produce improvement. Minister Stanford is clearly not prepared to wait. 

That is understandable. But in the longer term, a solution like that proposed by the Initiative could drive improvement, return the control of standards to the teaching profession, and protect teacher training from politicisation. 
A stadium proposal
Dr Eric Crampton | Chief Economist | eric.crampton@nzinitiative.org.nz
A commissioned report released this past week revealed a fact you may find surprising. 

Rules stopping a stadium from hosting many events cause an enormous amount of forgone revenue over time. Amounts that can hit the hundreds of millions of dollars.  

What’s more, fewer people will show up to spend a night in hotels and spend money in restaurants if the stadium hosts fewer events.  

Usually, this kind of consultancy report is rolled out by people trying to convince government, council, or both that they should spend a lot of taxpayer and ratepayer money on a new stadium. Academic work suggests the numbers in those kinds of studies are vastly inflated.  

But it wasn’t subsidy-seeking stadium-boosters who commissioned the report. It was the Ministry for the Environment. The Ministry for the Environment more typically makes other people hire expensive consultants to prove obvious things.  

And nobody here seems to be seeking government funding. Just the opportunity for an existing stadium, Eden Park, to do normal stadium things: host events.  

It is all a bit ridiculous. But figures help make regulatory burdens more tangible. Other studies proving the obvious might help too. How many more broken teeth could be fixed if government didn’t make it hard for foreign-trained dentists to set up shop? 

Unfortunately, Eden Park’s neighbours could still claim they’d experience unmeasured but even larger harms from more events. Who could tell?  

I have a modest proposal.  

The reports propose increasing the allowed number of events, but only up to a limit.  

Instead, abolish the limits: noise, time and number of events, all of it. Let the stadium really be a stadium.  

Simultaneously, offer to buy out every adjacent neighbour at a small margin above current market value, but with a warning. No complaints about anything stadium-related would ever again be entertained from those addresses. Take this offer or forever hold your peace.  

Then, upzone the bought-out properties. Sell them to a developer at a profit for apartments, townhouses, offices, and maybe even ground-floor cafés and bars. The developer could make the nearby stadium a selling-point. 

Everyone wins.  

The stadium would have better neighbours. Neighbours who like being near a stadium. And who wouldn’t have to travel as far for events.  

People who hate stadiums get to move away.  

And maybe, just maybe, there would be fewer future fights about whether stadiums are good places for concerts.  
 
On The Record
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