Search results

New Zealand is a small country with a rich history of pioneering administrative reforms. This chapter describes administrative reform processes emanating from the ‘core agencies’ of the State Services Commission (SSC), Treasury and the Department of the Prime Minister and Cabinet. It describes the famous New Public Management reforms of the late 1980s–2000s, led by the Treasury that restructured ministries (creating more agencies that are single-purpose agencies), rewrote policy rules (e.g., the same laws for public and private sector employees) and created accountability from agency heads to ministers as well as SSCs who evaluate and re-appoint agency heads. It should be noted that in this Westminster system, ministers provide policy leadership but not executive leadership of ministries. The chapter describes in detail two reform processes led/administered by the SSC since the mid-2000s to increase accountability for ministry mid-term policy and organizational capability targets (performance improvement framework) as well as cross-ministry goals (better public services). These efforts have been evaluated over time as being quite effective and are noted for their sustainability and improvement.

The purpose of this paper is to provide new insights into the contribution and experiences of non-statutory sector (voluntary) services delivering care coordination.

This qualitative study, based on face-to-face semi-structured interviews with 17 managers from a range of non-statutory sector services, used thematic data analysis supported by a framework approach.

Four themes emerged: commissioning arrangements undermined non-statutory sector development; working relationships between statutory and non-statutory services required time and energy to navigate and sustain; the establishment of a niche role in the larger network of provision; and tensions relating to future developments. The non-statutory sector was found to provide a mix of services, including specialist provision targeting specific communities that complemented or substituted for those provided by the state. Managers wanted their services to be recognised by the statutory sector as equal partners in the delivery of care coordination and were also keen to retain their independence.

Findings provide information for service commissioners and managers from statutory and non-statutory sectors indicating a complex set of experiences and views regarding the role of the latter. This is particularly salient in a political landscape which has increasing expectations of their involvement in the provision of care coordination.

This study considers the work of the non-statutory sector in the delivery of care coordination to adults and older people, an area under-reported to date. It suggests that there are opportunities available for these services to become embedded within a wider social care system and to excel by retaining or developing specialist roles and services.

New Zealand is widely recognised as extreme in its New Public Financial Management reforms. Scrutiny of the reformed financial management system reveals its consistency with a controversial political agenda: trade liberalisation of even core social services such as social welfare, health and education. Further, the detailed requirements are systematically biased towards withdrawing from government services (by running them down) and/or privatising them (by artificially inflating reported costs, thus projecting an appearance of inefficiency). The legislation underpinning the New Zealand model was shepherded through parliament by a Minister of Finance who publicly opposed exposing social services to market forces. Drawing on archival records, this article provides a historical account of how this legislation came into being. The legislation handed key levers of power to extend the reforms to the Treasury. Particular attention is paid to the friction within the government of the time over extending the reforms to social policy, and the role of the Treasury. Possibly, some ministers who drove the reforms through did not appreciate their nature. Alternatively, the handover of the levers of power could be perceived as an attempt to avoid blame.

The United States Federal Communications Commission has taken action or is considering taking action on several controversial issues that arise from the growth of the Internet. In analyzing these issues, the Commission is applying a voice‐centric circuit‐switched telecommunications model that is based on an outdated view of the world and is attempting to protect a regulatorily created system of artificial prices and subsidies. The Commission has failed to come to grips with a new state of the world, characterized by packet networks and data traffic. This has led to a series of decisions that are ill‐suited to the new environment.

The purpose of the paper is to investigate the inter‐ and intra‐organisational relationships in the commissioning of secondary care by primary care trusts in England, using a principal‐agent framework.

The methodology is a qualitative study of three case studies. A total of 13 commissioning‐related meetings were observed. In total, 21 managers and six consultant surgeons were interviewed.

There are a number of different levels at which contractual and managerial control take place. Different strengths of control at one level can affect willingness to comply with agreements at other levels. Agreements at one level do not necessarily result in appropriate or expected action at another.

The system for commissioning in the National Health Service (NHS) has changed with the introduction of payment by results and practice‐based commissioning. However, the dynamics of the inter‐ and intra‐organisational relationships studied remain.

Incentives within organisations are as important as those between organisations. Within a chain of principal‐agent relations, it is important that a strong link in the chain does not result in the exploitation of weaknesses in other links. If government targets and frameworks are to be met through commissioning, it may be advantageous to concentrate efforts on developing incentives that align clinician with NHS trust objectives as well as NHS trust with primary care trust (PCT) and government objectives.

This paper is based on original empirical work. It uses a principal‐agent framework to understand the relationships between PCTs and NHS trusts and highlights the importance of internal NHS trust governance systems in the fulfilment of commissioning agreements.