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Table 1 Thirty years of New Zealand health reforms

From: The evolution of New Zealand’s health workforce policy and planning system: a study of workforce governance and health reform

Policy mode

Centralised

Decentralisation

Recentralisation

Timeframe

Pre mid-1980s

Mid-late 1980s

Early 1990s

Mid-late 1990s

2000s

Late 2000s on

Focus

Universal access

New public management

Efficiency

Value for money

Responsiveness

Performance

Organisation

Centralised and relatively stable

Regionalisation: 23 area units established

Commercialisation: hospital part-charges introduced

Return to free-at-entry services

Democratisation: partially elected District Health Boards (DHB)

DHB and PC alignment

Alliance contracting

Means of control

Department of Health manages all facets and payments

Policy Ministry with purchasing entity

Regional services through contracts and financial targets

Internal market model

Hospitals operated as independent business units

Policy Ministry with 4 regional funder-provider authorities

DHB plans and funding agreements with Ministry;

New PC focus

Partial re-centralisation

New focus on patient-focussed care

  1. Sources: [9, 11,12,13,14]