Abstract
Developing a workable system of performance management in the health sector is not an easy task. Firstly, it must address the generic dilemmas of performance management, such as whether the emphasis should be on what is controllable versus what is really valued, and whether perverse and unintended consequences can be minimised. On top of these considerations, the health sector itself is highly complex, and the relationship between health service delivery and health outcomes is opaque. The health sector also contains multiple and divergent ideas of what constitutes performance and how it should be monitored and governed. Despite the degree of difficulty involved, many approaches to performance management and health system improvement have been adopted in New Zealand since 2000, including the health targets regime and the more recent System Level Measures approach.
In this presentation I will chart where New Zealand has been on this journey, what has been learnt so far, and speculate on what the proposed restructuring and reform of the health system, and the central emphasis on addressing inequities, will mean for the governance of health system performance.
About the presenter
Tim Tenbensel is an Associate Professor in health policy at the School of Population Health, University of Auckland, New Zealand, where he has been based since 2005. He has a PhD in Political Science and since the late 1990s he has researched and published extensively in the areas of health and public policy, comparative health policy, health policy implementation, and New Zealand health services research. His current research interests are focused on primary health care policy and performance management in New Zealand and he led and supervised research projects investigating the implementation of health targets and the System Level Measures Framework. He writes a monthly column 'Policy Puzzler' for New Zealand Doctor, and is a regular panellist on the System Fix Podcast which provides commentary on the current health system reforms.