New Zealand actually any good at health policy reform? A retrospective analysis
of the success of NZ health policy reforms from 1990 to 2015.
Since the 1990s at least, NZ has often been
held up as place in which it is possible to make major changes to health policy
and health systems (across a range of very different substantive health rpolicy
goals). Institutionalist approaches to understanding policy also regard NZ as
having the political architecture that facilitates major policy change in
comparison to other jurisdictions. But is it really true that New Zealand has a
greater capacity to transform its health system and health care services?
To answer this question, I review the
‘success’ of health policy reform in New Zealand in the 1990-2014 period, where
success is understood primarily in terms of stated policy intentions.
Substantive policy goals over this period have included achieving efficiency
and cost control, primary care reform; achieving better population health
outcomes; and integrating primary and hospital health services. I review these
policy intentions, the governance approaches that have been adopted, and the
success or otherwise of implementation. If New Zealand is actually capable of
successfully embarking on health policy reform, what are the lessons and
implications for other jurisdictions? If it isn’t, then how much does the
design of political institutions really matter when it comes to health policy?