Lessons for Structural Design
Reflecting on the background and political challenges identified in each case study with regard to the theoretical conceptions identified in the analytical framework section, a series of lessons for structural design can be identified. The table below identifies these lessons.
Summary of Lessons for Structural Design from Case Studies.
| Case study |
Lessons for Structural Design |
| Pharmac |
- Good design can prevail over political ideologies.
- Equalises relationships between parties with unequal power.
- Is efficient in transaction and management costs of the organisation as well as in knowledge.
|
| DHB System |
- System established as result of political ideologies.
- Disparity between expected and actual relationships between DHBs and Ministry of Health.
- Large number of transaction and management costs between DHBs and Ministry, while under utilising knowledge from within DHBs.
|
| NZPHCS |
- Establishment of PHOs seen as Ministry side-stepping the DHB system to avoid dealing with practical implications of system.
- Relationships within system are designed for control rather than to facilitate collaboration.
- High transaction costs, compared to using DHBs as means of providing primary health, however potentially reduces management costs involved with monitoring DHBs if they were providing primary care.
|
| Maori Health Strategy |
- Strategy designed in unfavourable policy context. Strategy can be seen as making token attempt to address Maori health.
- Strategy does not provide for how required relationships will function, assumes DHB system will be able to facilitate effective implementation.
|
