New Zealand Pae Ora Healthcare Reforms ۲۰۲۲: Viable by Design? A Qualitative Study Using the Viable System Model
Publish Year: 1402
نوع سند: مقاله ژورنالی
زبان: English
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JR_HPM-12-0_087
تاریخ نمایه سازی: 17 مرداد 1403
Abstract:
Background The New Zealand (NZ) Pae Ora (Healthy Futures) health reforms came into effect in July ۲۰۲۲ with the establishment of Health New Zealand (HNZ) (Te Whatu Ora) and the Māori Health Authority (MHA) (Te Aka Whai Ora) – the organisations charged for healthcare provision and delivery. Given these changes represent major health system reform, we aimed to conduct an early evaluation of the design of the reforms to determine if they can deliver a viable and sustainable NZ health system going forward. Methods The evaluation was informed by Beer’s viable system model (VSM). A qualitative exploratory design with semi-structured interviews and documents analysis using thematic analysis was used. We conducted ۲۸ interviews with senior healthcare managers and reviewed over ۳۰۰ official documents and news analyses. Results The VSM posits that for a system to be viable, all its five sub-systems (operations; co-ordination; operational control; development and governance) need to be strong. Our analysis suggests that the health reforms, despite their strengths, do not satisfy this requirement. The reforms do appreciate the complexity of the healthcare environment: multiple stakeholders, social inequalities, interdependencies. However, our analysis suggests a severe lack of detail regarding the implementation and operationalisation of the reforms. Furthermore, resourcing and coordination within the reformed system is also unclear. Conclusion The health system reforms may not lead to a viable future NZ health system. Poor communication of the reform implementation and operationalisation will likely result in system failure and inhibit the ability of frontline health organisations to deliver care.
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Authors
Adeel Akmal
Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Nataliya Podgorodnichenko
DBA Programme, Otago Business School, University of Otago, Dunedin, New Zealand
Robin Gauld
Department of Management, Otago Business School, University of Otago, Dunedin, New Zealand
Tim Stokes
Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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