The Great Experiment: Financial Management Reform in the NZ HealthSector
Authors: Lawrence, Stewart; Alam, Manzurul; Lowe, Tony
Source: Accounting, Auditing & Accountability Journal, Volume 7, Number 3, 1994 , pp. 68-95(28)
Publisher: Emerald Group Publishing Limited
Abstract:Examines the move towards a commercialized, economically driven, healthsector in New Zealand. Reforms involve extensive organizationalrearrangements and the creation of profit-driven businesses in place ofpublic hospitals. These institutional rearrangements involve thefabrication of new ways of accounting. Attempts to understand theprocesses involved in the development of information technologies beforethey become accepted "facts" of organizational life. The fabrication ofnew technologies cannot be understood as an autonomous sphere ofactivity, but has to be understood as part of a complex series ofpolitical, economic and organizational contexts. Accountants are viewednot as mere technicians reporting on what is, but as active agentscontributing to change. Accounting often acts as an arbiter in socialconflict. Nowhere is this more evident than in the way it is beingcalled upon to assist in the implementation of clause 25 of the Healthand Disability Services Bill, which requires hospitals in New Zealand toact as competitive profit motivated commercial enterprises while at thesame time meeting unspecified social obligations. The creation of apseudo-market for health services presents a challenge not only foraccountants, but for all New Zealand citizens. The outcomes of theradical reforms are uncertain and some fear that the massiverestructuring is in the form of an experiment. It is based on anideology lacking empirical support. In the end it may be shown to havebeen impractical in the New Zealand context.
Document Type: Research article
Publication date: 1994-03-01