In Australia, the Health and Hospitals Reform Commission is considering options for restructuring the Australian Health System. And in New Zealand, while there is a sense of reform fatigue, many incremental changes and innovations in health services are continually being introduced. How can health service researchers respond to these current needs for health care and health system reform? Rewarding good performance necessitates performance measurement and monitoring. What is being done in Australia and New Zealand? And what can we learn from other countries?