Section A
Question 1
Economic Liberalism is an economic doctrine which supports and promotes the economy of private belongingness in the means of production. Proponents of economic liberalism believe that it is not possible to separate political and social freedom from economic freedom. It opposes government interventions which inhibit free-trade and competition in free-markets. Social liberalism, believes in the inclusion of social-justice into liberalism. The good of the community is viewed as being proportionate with the freedom of the individual. In healthcare, liberalism affects policy choices.
Question 2
The advantages of interests groups in healthcare policies are that, first, they ensure that the needs of the patients, users and care-givers are taken care of. Secondly, they keep a check on the actions of the government in healthcare. The disadvantage of interest groups is that some of them are not run democratically (Julia, Miller, and Giacomini 7). Another disadvantage is that they have more power than others and they exercise their power privately instead of for the common good.
Question 3
District Health Boards (DHBs) are responsible for making sure that populations in particular areas get access to healthcare as well as disability services. The DHBs were introduced as part of a plan to nationalize healthcare. The advantage of DHBs is that they asses the needs of the people and assist in the development of District plans. DHBs also ensure that care is well coordinated. Some disadvantages associated with DHBs are that some of the workers do not feel valued. Another disadvantage is that some DHBs are not very effective and innovative in accessing local communities in areas such as diabetes, heart disease and breast scanning. The DHBs need more investment.
Question 4
Horn (Ministerial Review Group) Report of 2009 recommended changes to the Health system of New Zealand include the consolidation of back office functions in the DHBs, reduction of the number of advisory committees for the Ministry of health, reduction of bureaucracy so as to deliver frontline services. These recommendations have been implemented but in varying degrees in the DHBs.
Question 5
Hierarchical systems in New Zealand are utilized by government to steer health. An example of this is bureaucracy as practiced in District Health Boards responsible to a centralized body (Department or Ministry of Health) for the management of health in the district. The government also uses regulations to steer healthcare. An example is the Health Practitioners Competency Assurance Act and taxation (Fafard 6). Hierarchical systems can tend to be costly. This happens when the central authority becomes more intrusive, limiting regional bodies. This conflict has also led to politicizing of healthcare.
Question 6
Two differences between provider-based networks and community collaboration is that, first, a provider-based network is made up of providers (hospitals, practitioners and professionals) who depend on the resources of others in achieving their own goals. They adopt certain procedures and practices to improve healthcare quality while community collaboration involves the input of community members who are not necessarily professionals. Another difference is that provider-based networks are more costly than community collaboration efforts. The first similarity between provider-based care and community collaboration is that they have the same goal of improving healthcare and patient outcomes. The second similarity is that they built on trust developed between participants (Laurence, and Wright 12).
Question 7
Two possible benefits that may result from the use of market mechanisms to steer health service delivery is enhancing the reach of services to underserved populations and improving the understanding of patients and their needs from a demand and supply perspective. Disadvantages that may result include monopolistic practices by healthcare providers which may hurt healthcare consumers. Another disadvantage is that insurance providers would not be regulated. This would not favor low income populations.
Section B
Question 8
A policy may be a political success but a programmatic failure if it is perceived by the public as being beneficial to them either because they are expedient or favorable but ends up in programmatic errors. An example of this may be seen in the UK case of 1985 in which blood supply had to be secured against HIV infection through heat treatment (political success). HIV infection occurred in patients (programmatic failure).
Question 9
According to Christopher Hood, three ways of using performance data include for rankings, for intelligence and for targets. In terms of intelligence, performance information is used to provide the necessary backing for decision-making. In terms of rankings and targets, performance data is used to appraise and grade those responsible in maintaining high performance levels and evaluating whether objectives have been met.
Question 10
Proponents for top-down approaches to implementation would prefer hierarchical types of policy steering. This involves having a central control authority to oversee the operations of smaller institutions in particular regions in this type, the priorities of decision-makers are considered more than those of the subjects. Proponents of bottom-up approaches would prefer a network type of policy steering where teams are more collaborative.
Question 11
Program logic is a model framework which shows the flow of inputs, the activities performed on the inputs and the outputs. It also shows the categorization of the outcomes under short-term, intermediate and long-term. The purpose of this is to enable an understanding of a program implementation and the deliverables required.
Question 12
The same health policy may lead to different extents of success or failure in different parts of New Zealand because success is related to aims and values of different governance systems in different parts of New Zealand. Policies are also dependent of political dimensions, processes and interpretations, which may differ in different parts of New Zealand (McConnell 2).
Work Cited
Abelson, Julia, Fiona A. Miller, and Mita Giacomini. "What Does It Mean To Trust A Health System? A Qualitative Study of Canadian Health Care Values." Health Policy 91.1 (2009): 63-70. Print.
Fafard, Patrick. "Evidence and Healthy Public Policy: Insights from Health and Political Sciences." National Collaborating Centre for Healthy Public Policy 3.2 (2008): 1-18. Print.
Malcolm, Laurence, and Lyn Wright. "Clinical Leadership and Quality in District Health Boards in New Zealand." Clinical Leaders Association of New Zealand for the Ministry of Health 3.2 (2002): 1-20. Print.
McConnell, Allan. "Policy Success, Policy Failure and Grey Areas In-Between." Journal of Public Policy 30.03 (2010): 345-362. Print.
