15: Network Structures, Consumers and Accountability in New Zealand

Internationally, public sector restructuring has been justified as essential to improve public sector performance, using terminology such as efficiency, effectiveness and accountability. Often restructuring involves replacing larger, multi-objective entities with numerous smaller, ostensibly independent entities, each with their own more narrowly focused objectives. This type of public sector restructuring often includes a purchaser-provider split that leaves the public sector as a service purchaser, but not necessarily as a service provider because services may be purchased from either public sector or private sector providers. Consequently, the provision of many publicly funded services now requires the cooperation of a variety of entities, both public and private, if the desired performance improvements are to be achieved. Internationally, users of public sector services have been re-conceptualised as consumers with consumers’ rights. The restructuring of various public sector functions often includes creation of a set of consumers’ rights and processes for defending those rights. New Zealand’s health sector reforms created such a structure and this chapter seeks to identify generalizable lessons to be learned from New Zealand’s experience with this reformed structure.