title: Understanding accountability in an ever-changing New Zealand health system

authors: Zainal Abidin, Nor Azizah Binti

subjects: accountability

abstract: The purpose of this research was to understand how the constant adoption of reforms affected accountability understanding and its practices in the New Zealand public health system. 

This study adopted a qualitative methodology and took a critical hermeneutics approach in order to explore the reasons for, and formats of, public health reform, and the experience of health policy implementers in dealing with reforms, policy changes, and accountability. To develop new insights about accountability and its practices, this study reviewed a range of policy documents and relevant publications, and interviewed senior health managers who were experienced in dealing with reforms. 

The research evidence is presented in line with Ricoeur’s stages of understanding; these are: preunderstanding, understanding, and finally, comprehensive understanding. The preunderstanding was developed from study of secondary sources, while the understanding was achieved through interviews. A comprehensive understanding results from both review of and reflection on preunderstanding and understanding. 

The findings are that reform can be described as a ‘means without ends’ because it was continually implemented in a political loop, in which, demand and supply for change were determined by the government’s political interests. Postreform accountability was full of frustrations because of its complexity in practice. Surprisingly, despite that fact, the health managers still believe that accountability per se is essential. This study proposes that postreform accountability can be understood as two sides of the same coin: accountability means being accountable, in a normative sense, and not being able to be accountable, in practice.
The adoption of constant reforms has increased the level of organisational complexity. This has affected the notion of accountability and its practices because accountability rests in the organisational structures. This study suggests that accountability cannot be detached from its normative and mechanism perspectives. No matter how much the policy has changed or will change in the future, the possibility of policy implementers facing similar challenges and the same feelings is high because reform produces two identical outcomes for accountability: i.e., hopes and frustrations. 

The study contributes in three ways to an understanding of accountability in the context of reform. First, it offers valuable insights into the ongoing developments in the public health system and the issues of accountability. Second, it contributes to the wider understanding of the effects reform have on the notion of accountability and its practices. Third, it advances understanding relating to recent discussions on postreform accountability.

text: Understanding accountability in an ever-changing New Zealand health system The purpose of this research was to understand how the constant adoption of reforms affected accountability understanding and its practices in the New Zealand public health system. 

This study adopted a qualitative methodology and took a critical hermeneutics approach in order to explore the reasons for, and formats of, public health reform, and the experience of health policy implementers in dealing with reforms, policy changes, and accountability. To develop new insights about accountability and its practices, this study reviewed a range of policy documents and relevant publications, and interviewed senior health managers who were experienced in dealing with reforms. 

The research evidence is presented in line with Ricoeur’s stages of understanding; these are: preunderstanding, understanding, and finally, comprehensive understanding. The preunderstanding was developed from study of secondary sources, while the understanding was achieved through interviews. A comprehensive understanding results from both review of and reflection on preunderstanding and understanding. 

The findings are that reform can be described as a ‘means without ends’ because it was continually implemented in a political loop, in which, demand and supply for change were determined by the government’s political interests. Postreform accountability was full of frustrations because of its complexity in practice. Surprisingly, despite that fact, the health managers still believe that accountability per se is essential. This study proposes that postreform accountability can be understood as two sides of the same coin: accountability means being accountable, in a normative sense, and not being able to be accountable, in practice.
The adoption of constant reforms has increased the level of organisational complexity. This has affected the notion of accountability and its practices because accountability rests in the organisational structures. This study suggests that accountability cannot be detached from its normative and mechanism perspectives. No matter how much the policy has changed or will change in the future, the possibility of policy implementers facing similar challenges and the same feelings is high because reform produces two identical outcomes for accountability: i.e., hopes and frustrations. 

The study contributes in three ways to an understanding of accountability in the context of reform. First, it offers valuable insights into the ongoing developments in the public health system and the issues of accountability. Second, it contributes to the wider understanding of the effects reform have on the notion of accountability and its practices. Third, it advances understanding relating to recent discussions on postreform accountability.

year: 2015

title: Using quality of life to assess performance in the disability services sector

authors: Kober, Ralph

subjects: competitive employment

abstract: Measurement of performance is extremely important for not-for-profit agencies in terms of measuring the efficiency and effectiveness of agencies in achieving their goals. Performance indicators assist managers of agencies in strategic decision making and in fulfilling their accountability obligations for the best use of limited resources. This paper argues that not-for-profit agencies that serve people with intellectual disabilities can use quality of life as one measure of agency and/or program performance. This is demonstrated with reference to research conducted on the effect of different methods of employment on the quality of life for people with intellectual disabilities. Effectiveness of agencies and/or programs can be assessed based on comparisons of quality of life outcomes under different methods of employment or by reference to absolute percentage of scale maximum scores and whether homeostasis is defeated.

text: Using quality of life to assess performance in the disability services sector Measurement of performance is extremely important for not-for-profit agencies in terms of measuring the efficiency and effectiveness of agencies in achieving their goals. Performance indicators assist managers of agencies in strategic decision making and in fulfilling their accountability obligations for the best use of limited resources. This paper argues that not-for-profit agencies that serve people with intellectual disabilities can use quality of life as one measure of agency and/or program performance. This is demonstrated with reference to research conducted on the effect of different methods of employment on the quality of life for people with intellectual disabilities. Effectiveness of agencies and/or programs can be assessed based on comparisons of quality of life outcomes under different methods of employment or by reference to absolute percentage of scale maximum scores and whether homeostasis is defeated.

year: 2006

title: A Mātauranga Māori Perspective of Literacy for Adult Learners

authors: Furness, Jane Amanda

abstract: Globally, literacy can be conceived of in different ways. Two perspectives that have influenced adult literacy policy internationally are the economic functionalist and the sociocultural. In Aotearoa New Zealand, Māori educators have repeatedly advanced a mātauranga Māori perspective of literacy. This perspective has parallels with the embodied, practice-based multiliteracies and sociomateriality of the sociocultural perspective but less so with the dominant functionalist perspective. To address how Māori views have been side-lined in adult literacy policy development, we seek to clarify this view and foreground Māori-led policy recommendations that date back to the creation of the New Zealand Adult Literacy Strategy in 2001. We also highlight the relevance of this perspective by sharing the success and effectiveness of Māori-led adult literacy programmes. In doing so, we demonstrate the need for a biliteracy approach to adult literacy policy to reflect our bicultural nation and ensure Māori aspirations for literacy are met.

text: A Mātauranga Māori Perspective of Literacy for Adult Learners Globally, literacy can be conceived of in different ways. Two perspectives that have influenced adult literacy policy internationally are the economic functionalist and the sociocultural. In Aotearoa New Zealand, Māori educators have repeatedly advanced a mātauranga Māori perspective of literacy. This perspective has parallels with the embodied, practice-based multiliteracies and sociomateriality of the sociocultural perspective but less so with the dominant functionalist perspective. To address how Māori views have been side-lined in adult literacy policy development, we seek to clarify this view and foreground Māori-led policy recommendations that date back to the creation of the New Zealand Adult Literacy Strategy in 2001. We also highlight the relevance of this perspective by sharing the success and effectiveness of Māori-led adult literacy programmes. In doing so, we demonstrate the need for a biliteracy approach to adult literacy policy to reflect our bicultural nation and ensure Māori aspirations for literacy are met.

year: 2023-10-23