The New Zealand Health sector has undergone multiple reforms from the years 1989 to 2000. Much of the change can be attributed to the ideologies of the political parties leading government, as demonstrated by changes occuring shortly after a change in government. The internal political relations within the sector are also important factors in the structural design, where they are often active in shaping the way systems are created, although not always explicitly recognised. This occurs at local level devolved organisations, as well as at the central level.