Network Seminar - September 23, 2015

Dr Tim Tenbensel (PhD Australian National University) teaches and researches health policy, and has been head of the Health Systems section in the School of Population Health at the University of Auckland, New Zealand since 2011. His research program focuses on investigating the implementation of New Zealand health policy initiatives, forms of governance in health (hierarchies, markets, networks) and comparative health policy. He has an interest in further developing theoretical frameworks for the analysis of health policy and public management, with a particular focus on relationships of accountability and collaboration between health sector organisations.

Is 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?