Change through continuity:a quiet revolution in primary health care in New Zealand

2005 ◽  
Vol 29 (4) ◽  
pp. 380 ◽  
Author(s):  
Toni Ashton
Keyword(s):  
New Zealand ◽  
Health System ◽  
Structural Changes ◽  
Health Sector ◽  
Major Change ◽  
System Reform ◽  
Whole Process ◽  
And Performance ◽  
High Level ◽  
Key Aspects

IN A RECENTLY PUBLISHED paper entitled Continuity through change: the rhetoric and reality of health reform in New Zealand, I and my co-authors Nick Mays and Nancy Devlin pointed out that, in spite of a series of major health sector reforms during the 1990s and early 2000s, some key aspects of the system have endured.1 Moreover, many incremental changes to existing processes and systems that occurred during the reform period have, arguably, been more important to improving the functioning and performance of the system than the more high level (and more visible) structural changes. Since that paper was written, many further changes have occurred in the organisation, funding and management of the New Zealand health system. However, in contrast to the 1990s, the focus now is on continuity and stability rather than on any need for further major change. Indeed, terms such as ?reform? or ?restructuring? have now all but vanished from any debate about health policy in New Zealand. Perhaps the reformers have learned that health system reform is akin to training for the Olympics. The whole process takes a fair bit of time and effort, and results are unlikely to be achieved in the short term. Further major reform is also not regarded as politically viable. As noted in an article in the New Zealand Herald just before the general election in September, there is ?. . . considerable public sensitivity over any whiff of restructuring in health?.2

Used vehicle global supply chains: perspectives on a direct-import model

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yangyan Shi ◽  
Tiru Arthanari ◽  
V.G. Venkatesh ◽  
Samsul Islam ◽  
Venkatesh Mani
Keyword(s):  
New Zealand ◽  
Time Management ◽  
Design Methodology ◽  
Structured Interview ◽  
Global Supply Chains ◽  
Business Practices ◽  
Content Type ◽  
And Performance ◽  
Key Aspects ◽  
Practical Implications

Purpose This study aims to provide a comprehensive understanding of the supply chain (SC) operations of importing used vehicles into New Zealand and how such SCs affect business practices and performance. Design/methodology/approach The study uses an exploratory qualitative semi-structured interview approach to interview the different stakeholders involved in the global used vehicle SC. Findings The research identifies the overall network structure of the used import vehicle SC from Japan to New Zealand and characterises key aspects of its operations and network connections. This paper finds that Japanese buying agents have integrated increasing numbers of services to provide a trouble-free trading platform, which has created a direct-import model for used vehicle companies in New Zealand. Practical implications The findings and recommendations are useful in designing and managing the used vehicle SC for all stakeholders and effective real-time management of uncertain factors. Originality/value The paper primarily analyses SC operations by researching the cooperation and coordination between SC components and networks, based on providing the flow of used vehicles from Japan to New Zealand. It constitutes a pioneering practice-perspective research paper in this domain.

A national quitline service and its promotion in the mass media: modelling the health gain, health equity and cost–utility

2017 ◽  
Vol 27 (4) ◽  
pp. 434-441 ◽  
Author(s):  
Nhung Nghiem ◽  
Christine L Cleghorn ◽  
William Leung ◽  
Nisha Nair ◽  
Frederieke S van der Deen ◽  
...  
Keyword(s):  
New Zealand ◽  
Mass Media ◽  
Cost Saving ◽  
Health System ◽  
Tobacco Control ◽  
Health Equity ◽  
Health Gain ◽  
Health Sector ◽  
Cost Utility ◽  
The Mass Media

BackgroundMass media campaigns and quitlines are both important distinct components of tobacco control programmes around the world. But when used as an integrated package, the effectiveness and cost-effectiveness are not well described. We therefore aimed to estimate the health gain, health equity impacts and cost–utility of the package of a national quitline service and its promotion in the mass media.MethodsWe adapted an established Markov and multistate life-table macro-simulation model. The population was all New Zealand adults in 2011. Effect sizes and intervention costs were based on past New Zealand quitline data. Health system costs were from a national data set linking individual health events to costs.ResultsThe 1-year operation of the existing intervention package of mass media promotion and quitline service was found to be net cost saving to the health sector for all age groups, sexes and ethnic groups (saving $NZ84 million; 95%uncertainty interval 60–115 million in the base-case model). It also produced greater per capita health gains for Māori (indigenous) than non-Māori (2.2 vs 0.73 quality-adjusted life-years (QALYs) per 1000 population, respectively). The net cost saving of the intervention was maintained in all sensitivity and scenario analyses for example at a discount rate of 6% and when the intervention effect size was quartered (given the possibility of residual confounding in our estimates of smoking cessation). Running the intervention for 20 years would generate an estimated 54 000 QALYs and $NZ1.10 billion (US$0.74 billion) in cost savings.ConclusionsThe package of a quitline service and its promotion in the mass media appears to be an effective means to generate health gain, address health inequalities and save health system costs. Nevertheless, the role of this intervention needs to be compared with other tobacco control and health sector interventions, some of which may be even more cost saving.

scholarly journals Inputs of Iranian health system reform plan from health sector managers and policy-makers' points of view

2018 ◽  
Vol 7 (1) ◽  
pp. 126 ◽  
Author(s):  
Mahan Mohammadi ◽  
MohammadHossein Yarmohammadian ◽  
Elahe Khorasani ◽  
MohsenGhaffari Darab ◽  
Manal Etemadi
Keyword(s):  
Health System ◽  
Health Sector ◽  
System Reform ◽  
Policy Makers ◽  
Health System Reform ◽  
Reform Plan ◽  
Points Of View ◽  
Iranian Health System

scholarly journals Health Sector Collective Bargaining and the Employment Contracts Act: A Case Study of Nurses

1970 ◽  
Vol 19 (1) ◽  
Author(s):  
Sarah Oxenbridge
Keyword(s):  
New Zealand ◽  
Collective Bargaining ◽  
Health Sector ◽  
Health Board ◽  
Employment Contracts ◽  
Employee Union ◽  
High Level ◽  
Area Health ◽  
Conditions Of Employment

This case study describes and analyses the negotiation of a collective employment contract between an area health board management and regional representatives of the New Zealand Nurses Association during the first set of negotiations conducted under the Employment Contracts Act 1991. The study found that, contrary to claims by the Act's proponents, the Act does not lead to improved co-operation and communication between employers and employees. However, a high level of communication and co-operation was evident in the employee-union relationship, and it was found that certain provisions of the Employment Contracts Act afford employees greater power to determine their conditions of employment.

scholarly journals Improving Net Banking Security with Face Recognition Based Bio-Metric Verification

2019 ◽  
pp. 82-91
Author(s):  
V. Manju ◽  
S. Madhumathi
Keyword(s):  
Face Recognition ◽  
Banking System ◽  
Internet Banking ◽  
Security Requirements ◽  
Security Breaches ◽  
And Performance ◽  
Social Environmental ◽  
Hand Geometry ◽  
High Level ◽  
Key Aspects

Internet banking services must be more responsive towards security requirements. Now a days with the network world, the way for cybercrime is become easier for hacking purpose. Because of this reason, network security has become one of the biggest concerns of today security environment. While there is no doubt that Internet banking transaction must have layered safety towards protection threats, the vendors should technique protection issues as part of their provider services. And heard a lot about hackers and crackers ways to steal any logical password or pincode number character, crimes of ID cards or credit cards fraud or security breaches. In existing work, Identification can be processed to a username and is used to authorize access to a system. As usernames can be lost or stolen, it is necessary to validate that the intended user is really the person he or she claims to be – the authentication process. Biometric based totally authentication and identification structures are the new answers to deal with the issues of safety and privacy. The Face Recognition is the examine of physical or behavioral traits of individual used for the identification of individual. These biometric characteristics of a person include the various features like fingerprints, face, hand geometry, voice, and iris biometric device. Here implement real time secure authentication system using face biometrics for authorized the person for online banking system. The general objective of our project is to develop fully functional face recognition, verification system provide and understand the key aspects of these major technologies, social environmental system and performance aspects. And also provide multiparty access system to allow the multiple persons to access the same accounts by providing access privileges to original account holders. Experimental results show that the proposed system provide high level security in online transaction system than the existing traditional cryptography approach

Encouraging participation in health system reform: is clinical engagement a useful concept for policy and management?

2012 ◽  
Vol 36 (4) ◽  
pp. 378 ◽  
Author(s):  
Dimitra Bonias ◽  
Sandra G. Leggat ◽  
Timothy Bartram
Keyword(s):  
Public Health ◽  
Health System ◽  
Employee Engagement ◽  
Healthcare System ◽  
High Performance ◽  
Health Sector ◽  
System Reform ◽  
Health System Reform ◽  
Australian Health ◽  
Clinical Engagement

Objective. Recent health system enquiries and commissions, including the National Health and Hospital Reform Commission, have promoted clinical engagement as necessary for improving the Australian healthcare system. In fact, the Rudd Government identified clinician engagement as important for the success of the planned health system reform. Yet there is uncertainty about how clinical engagement is understood in health policy and management. This paper aims to clarify how clinical engagement is defined, measured and how it might be achieved in policy and management in Australia. Methods. We review the literature and consider clinical engagement in relation to employee engagement, a defined construct within the management literature. We consider the structure and employment relationships of the public health sector in assessing the relevance of this literature. Conclusions. Based on the evidence, we argue that clinical engagement is similar to employee engagement, but that engagement of clinicians who are employees requires a different construct to engagement of clinicians who are independent practitioners. The development of this second construct is illustrated using the case of Visiting Medical Officers in Victoria. Implications. Antecedent organisational and system conditions to clinical engagement appear to be lacking in the Australian public health system, suggesting meaningful engagement will be difficult to achieve in the short-term. This has the potential to threaten proposed reforms of the Australian healthcare system. What is known about the topic? Engagement of clinicians has been identified as essential for improving quality and safety, as well as successful health system reform, but there is little understanding of how to define and measure this engagement. What does this paper add? Clinical engagement is defined as the cognitive, emotional and physical contribution of health professionals to their jobs, and to improving their organisation and their health system within their working roles in their employing health service. While this construct applies to employees, engagement of independent practitioners is a different construct that needs to recognise out-of-role requirements for clinicians to become engaged in organisational and system reform. What are the implications for practitioners? This paper advances our understanding of clinical engagement, and suggests that based on research on high performance work systems, the Australian health system has a way to go before the antecedents of engagement are in place.

scholarly journals Evolution of Public Health Expenditure Financed by the Romanian Social Health Insurance Scheme From 1999 to 2019

2021 ◽  
Vol 9 ◽  
Author(s):  
Ciprian-Paul Radu ◽  
Bogdan Cristian Pana ◽  
Daniel Traian Pele ◽  
Radu Virgil Costea
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Health System ◽  
Structural Changes ◽  
Emergency Services ◽  
Health Sector ◽  
Social Health Insurance ◽  
Social Health ◽  
State And Local ◽  
The Impact

The Romanian health system is mainly public financed (80.45%) through the following sources: Social Health Insurance (65%), State and Local Authorities Budget (15.45%), while the private sources (voluntary health insurance and out of pocket) adds an additional 19.55% to the public funds. The shares of the types of expenditure reflect the importance of each sector in the overall health system, and trends in expenditure show the impact of financing on the health sector's structural changes. We analyzed the 20-year trend of the Social Health Insurance budget, from 1999 to 2019. The influences of the different allocations, subcategories, and new budget categories appearing over time were adjusted to reveal relevant trends. Of the 14 medical service categories and the stand-alone Administrative expenditure category, six expenditure categories including Hospital services, Total drugs, and Primary care showed stationary 20-year trends; five including Medical devices, Dialysis, and Homecare services showed ascendant trends; and four including Dentistry and Emergency services showed descendant trends. Stationary trends imply no structural changes in the health sector of relevant magnitude to impact the financing shares of major categories: hospitals, drugs, or primary care. Emerging trends related to the impact of different reforms were revealed only in the low share of expenditures categories. The allocation methodology and statistical analysis of the trends reveal a new perspective on the evolution of health sector in Romania.

Management of Health System Reform: A View of Changes within New Zealand

1998 ◽  
Vol 11 (3) ◽  
pp. 182-191
Author(s):  
D. Ritchie
Keyword(s):  
Health Care ◽  
Transformational Leadership ◽  
New Zealand ◽  
Health System ◽  
Management Style ◽  
Active Management ◽  
Successful Implementation ◽  
System Reform ◽  
Publicly Funded ◽  
Health System Reform

This paper reports on the context and process of health system reform in New Zealand. The study is based on interviews conducted with 31 managers from three Crown Health Enterprises (publicly funded hospital-based health care organizations). A number of countries with publicly funded health services (e.g. UK, Australia and New Zealand) have sought to shift from the traditional ‘passive’ health management style (using transactional management skills to balance historically-based expenditure budgets) to ‘active’ transformational leadership styles that reflect a stronger ‘private sector’ orientation (requiring active management of resources—including a return on ‘capital’ investment, identification of costs and returns on ‘product lines’, ‘marketing’ a ‘product mix’, reducing non-core activities and overhead costs, and a closer relationship with ‘shareholders’, suppliers and customers/clients). Evidence of activities and processes associated with transformational leadership are identified. Success of the New Zealand health reforms will be determined by the approach the new managers adopt to improve their organization's performance. Transformational leadership has been frequently linked to the successful implementation of significant organizational change in other settings (Kurz et al., 1988; Dunphy and Stace, 1990) but it is too early to assess whether this is applicable in a health care context.

scholarly journals Measuring Productivity in the Health Sector

2018 ◽  
Vol 14 (3) ◽  
Author(s):  
Patrick Nolan
Keyword(s):  
New Zealand ◽  
Health System ◽  
Health Sector ◽  
State Sector ◽  
Productivity Commission

Over the next few decades governments will increasingly need to balance the new and growing demands facing the health system with a tighter fiscal outlook. The best way to protect standards while responding to these pressures will be to lift productivity. This article draws on a recent New Zealand Productivity Commission inquiry into state sector productivity and discusses the implications of this work for the health sector. It begins by highlighting the importance of health sector productivity, particularly given the fiscal outlook. It then discusses recent efforts to measure productivity in the health system, before outlining possible next steps in measuring the sector’s productivity.

scholarly journals Health System Reform Plan and Performance of Hospitals: an Iranian Case Study

2017 ◽  
Vol 29 (3) ◽  
pp. 201 ◽  
Author(s):  
Yusefzadeh Hasan ◽  
Salem Parviz ◽  
Nabilou Bahram
Keyword(s):  
Health System ◽  
System Reform ◽  
Health System Reform ◽  
Reform Plan ◽  
And Performance
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