Policy‐making in a Restructured State: The Case of the 1991 Health Reform Policy in New Zealand
The pressure for efficiency and accountability that led to reform of public institutions worldwide has had implications for public policy-making as well as the management of public services. The difficulties of providing a coordinated and efficient policy process that can respond to the requirements of a more managerialist style of government were evident in New Zealand in the 1980s and early 1990s. The policy process in 1990–91 leading to the introduction of health reform proposals provides an illuminating case study of the tension between participation and speed, and between traditional pluralist and managerialist approaches to policy development. The implications of this for subsequent implementation are discussed.