IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v93y2009i2-3p118-127.html
   My bibliography  Save this article

Implementing new modes of governance in the New Zealand health system: An empirical study

Author

Listed:
  • Barnett, Pauline
  • Tenbensel, Tim
  • Cumming, Jacqueline
  • Clayden, Clare
  • Ashton, Toni
  • Pledger, Megan
  • Burnette, Mili

Abstract

Health governance internationally has become more complex, with both hierarchical and network modes of governance explicitly represented within single public systems. Objective: To understand the implementation of new modes and mechanisms of governance under New Zealand health reforms and to assess these in the context of international trends. Research methods sought data from key groups participating in governance policy and implementation. Methods included surveys of board members (NÂ =Â 144, 66% response rate), interviews with chairs (NÂ =Â 14) and chief executives (NÂ =Â 20), and interviews with national policy makers/officials (NÂ =Â 19) and non-government providers and local stakeholders (NÂ =Â 10). Data were collected over two time periods (2001/2002; 2003/2004). Analysis integrated the findings of both qualitative and quantitative methods under themes related to modes and mechanisms of governance. Results indicate that a hierarchical mode of governance was implemented quickly, with mechanisms to ensure political accountability to the government. Over the implementation period the scope of decision-making at different levels required clarification and mechanisms for accountability required adjustment. Non-government provider networks emerged only slowly whereas a network of statutory health organisations established itself quickly. Conclusion: The successful implementation of a mix of governance modes in New Zealand 2001-2004 was characterised by clear government policy, flexibility of approach and the appearance of an unintended network. In New Zealand there is less tendency than in some other some other small countries/jurisdictions towards centralisation, with local elections and community engagement policies providing an element of local participation, and accountability to the centre enhanced through political rather than bureaucratic mechanisms.

Suggested Citation

  • Barnett, Pauline & Tenbensel, Tim & Cumming, Jacqueline & Clayden, Clare & Ashton, Toni & Pledger, Megan & Burnette, Mili, 2009. "Implementing new modes of governance in the New Zealand health system: An empirical study," Health Policy, Elsevier, vol. 93(2-3), pages 118-127, December.
    • Handle: RePEc:eee:hepoli:v:93:y:2009:i:2-3:p:118-127
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(09)00160-2
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Scholten, Gerard R.M. & Grinten, TED van der, 2005. "The integration of medical specialists in hospitals. Dutch hospitals and medical specialists on the road to joint regulation," Health Policy, Elsevier, vol. 72(2), pages 165-173, May.
    2. Malcolm, Laurence & Barnett, Pauline, 1994. "New Zealand's health providers in an emerging market," Health Policy, Elsevier, vol. 29(1-2), pages 85-100.
    3. Gianluca Andresani & Ewan Ferlie, 2006. "Studying governance within the British public sector and without," Public Management Review, Taylor & Francis Journals, vol. 8(3), pages 415-431, September.
    4. Thurston, Wilfreda E. & MacKean, Gail & Vollman, Ardene & Casebeer, Ann & Weber, Myron & Maloff, Bretta & Bader, Judy, 2005. "Public participation in regional health policy: a theoretical framework," Health Policy, Elsevier, vol. 73(3), pages 237-252, September.
    5. Tim Tenbensel, 2005. "Multiple modes of governance," Public Management Review, Taylor & Francis Journals, vol. 7(2), pages 267-288, June.
    6. Wild, Claudia & Gibis, Bernhard, 2003. "Evaluations of health interventions in social insurance-based countries: Germany, the Netherlands, and Austria," Health Policy, Elsevier, vol. 63(2), pages 187-196, February.
    7. Hefford, Martin & Crampton, Peter & Foley, Jon, 2005. "Reducing health disparities through primary care reform: the New Zealand experiment," Health Policy, Elsevier, vol. 72(1), pages 9-23, April.
    8. Gre[ss], Stefan & Niebuhr, Dea & Rothgang, Heinz & Wasem, Jurgen, 2005. "Criteria and procedures for determining benefit packages in health care: A comparative perspective," Health Policy, Elsevier, vol. 73(1), pages 78-91, July.
    9. Lega, Federico, 2007. "Organisational design for health integrated delivery systems: Theory and practice," Health Policy, Elsevier, vol. 81(2-3), pages 258-279, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Changwoo Shon & Myoungsoon You, 2020. "Evaluation of Health Policy Governance in the Introduction of the New DRG-Based Hospital Payment System from Interviews with Policy Elites in South Korea," IJERPH, MDPI, vol. 17(11), pages 1-18, May.
    2. Pettersen, Inger Johanne & Nyland, Kari & Kaarboe, Katarina, 2012. "Governance and the functions of boards," Health Policy, Elsevier, vol. 107(2), pages 269-275.
    3. Ellen A. Stewart & Scott L. Greer & Iain Wilson & Peter D. Donnelly, 2016. "Power to the people? An international review of the democratizing effects of direct elections to healthcare organizations," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(2), pages 69-85, April.
    4. Burau, Viola & Dahl, Hanne Marlene & Jensen, Lotte Groth & Lou, Stina, 2018. "Beyond Activity Based Funding. An experiment in Denmark," Health Policy, Elsevier, vol. 122(7), pages 714-721.
    5. Greer, Scott L. & Stewart, Ellen A. & Wilson, Iain & Donnelly, Peter D., 2014. "Victory for volunteerism? Scottish health board elections and participation in the welfare state," Social Science & Medicine, Elsevier, vol. 106(C), pages 221-228.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tenbensel, Tim & Cumming, Jacqueline & Ashton, Toni & Barnett, Pauline, 2008. "Where there's a will, is there a way?: Is New Zealand's publicly funded health sector able to steer towards population health?," Social Science & Medicine, Elsevier, vol. 67(7), pages 1143-1152, October.
    2. Melanie Levy, 2022. "The rise of the Swiss regulatory healthcare state: On preserving the just in the quest for the better (or less expensive?)," Regulation & Governance, John Wiley & Sons, vol. 16(2), pages 427-447, April.
    3. Katharina Fischer & Reiner Leidl, 2014. "Analysing coverage decision-making: opening Pandora’s box?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 899-906, December.
    4. Blackstock, K.L. & Kelly, G.J. & Horsey, B.L., 2007. "Developing and applying a framework to evaluate participatory research for sustainability," Ecological Economics, Elsevier, vol. 60(4), pages 726-742, February.
    5. repec:vuw:vuwscr:19064 is not listed on IDEAS
    6. Li, Kathy K. & Abelson, Julia & Giacomini, Mita & Contandriopoulos, Damien, 2015. "Conceptualizing the use of public involvement in health policy decision-making," Social Science & Medicine, Elsevier, vol. 138(C), pages 14-21.
    7. Artur A Steinerowski & Izabella Steinerowska-Streb, 2012. "Can social enterprise contribute to creating sustainable rural communities? Using the lens of structuration theory to analyse the emergence of rural social enterprise," Local Economy, London South Bank University, vol. 27(2), pages 167-182, March.
    8. Giliberto Capano & Benedetto Lepori, 2024. "Designing policies that could work: understanding the interaction between policy design spaces and organizational responses in public sector," Policy Sciences, Springer;Society of Policy Sciences, vol. 57(1), pages 53-82, March.
    9. Beck, Donizete & Ferasso, Marcos, 2023. "How can Stakeholder Capitalism contribute to achieving the Sustainable Development Goals? A Cross-network Literature Analysis," Ecological Economics, Elsevier, vol. 204(PA).
    10. Gerard Scholten & Linda Muijsers‐Creemers & Jan Moen & Roland Bal, 2019. "Structuring ambiguity in hospital governance," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 443-457, January.
    11. Thomson, Michael, 2019. "Who had access to doctors before and after new universal capitated subsidies in New Zealand?," Health Policy, Elsevier, vol. 123(8), pages 756-764.
    12. Viola Sallay & Tamás Martos & Lilla Lucza & Orsolya Papp-Zipernovszky & Márta Csabai, 2023. "Health Psychology Services for People in Disadvantaged Regions of Hungary: Experiences from the Primary Health Care Development Model Program," IJERPH, MDPI, vol. 20(5), pages 1-15, February.
    13. Joaquim Rubens Fontes‐Filho & Carla Kaufmann & Tania Maria Fonseca & Roberto Pimenta & Juliana de Souza & Ernane Novaes, 2021. "Governance of interorganizational health emergency networks: Facing the Zika pandemic," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 92(2), pages 333-354, June.
    14. Nicaise, Pablo & Dubois, Vincent & Lorant, Vincent, 2014. "Mental health care delivery system reform in Belgium: The challenge of achieving deinstitutionalisation whilst addressing fragmentation of care at the same time," Health Policy, Elsevier, vol. 115(2), pages 120-127.
    15. Deng, Chung-Yeh & Wu, Chia-Ling, 2010. "An innovative participatory method for newly democratic societies: The "civic groups forum" on national health insurance reform in Taiwan," Social Science & Medicine, Elsevier, vol. 70(6), pages 896-903, March.
    16. Elberse, Janneke Elisabeth & Pittens, Carina Anna Cornelia Maria & de Cock Buning, Tjard & Broerse, Jacqueline Elisabeth Willy, 2012. "Patient involvement in a scientific advisory process: Setting the research agenda for medical products," Health Policy, Elsevier, vol. 107(2), pages 231-242.
    17. Piotr Urbanek, 2019. "Teorie ładu akademickiego," Gospodarka Narodowa. The Polish Journal of Economics, Warsaw School of Economics, issue 4, pages 5-30.
    18. Fabrizio Sarto & Corrado Cuccurullo & Massimo Aria, 2014. "Exploring healthcare governance literature: systematic review and paths for future research," MECOSAN, FrancoAngeli Editore, vol. 2014(91), pages 61-80.
    19. repec:vuw:vuwscr:18937 is not listed on IDEAS
    20. Howell, Bronwyn, 2006. "Paying for the Hospital Waiting List Cull at the GP's Surgery: The Changing Locus of Financial Risk-Bearing in New Zealand's Primary Healthcare Sector," Working Paper Series 18937, Victoria University of Wellington, The New Zealand Institute for the Study of Competition and Regulation.
    21. Bailey Yee & Nisa Mohan & Fiona McKenzie & Mona Jeffreys, 2024. "What Interventions Work to Reduce Cost Barriers to Primary Healthcare in High-Income Countries? A Systematic Review," IJERPH, MDPI, vol. 21(8), pages 1-28, August.
    22. Howell, Bronwyn, 2007. "Contractual Pitfalls in Capitated Primary Health Care: Sharing Random Demand Risk in New Zealand's Strategy," Working Paper Series 3965, Victoria University of Wellington, The New Zealand Institute for the Study of Competition and Regulation.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:93:y:2009:i:2-3:p:118-127. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.