During the process of analysing the data, it was identified that there was a conceptual relation among the shifting perceptions, promoting collaboration and funding and investment …show more content…
And the consequence of that is the centre gave up the ability to have direct influence over the way services are delivered. They had lots of things that they could do and some things they took on board themselves but very few like the national vaccinations services and so on. But most of the key health delivery in this country is done by District Health Boards who in that sense are primarily around hospitals, primary healthcare organisations which are funded 70% by the government, and that funding goes through the DHBs. But the DHBs have very little influence over what the primary practices do and how they spend their money. That’s changed but certainly been the case for a long period of time.”
The suggestion is made that the funder-provider split contributed to two things – a commencement of competitiveness between some DHBs and continued weariness in interaction between DHBs and the central government. The analysis of the interviews indicates, and is confirmed with the last interviews, that The Plan itself and engagement efforts and leadership from The Board helped in facilitating change in some …show more content…
For most participants, the main issue is DHBs fear of infringement on their autonomy. Specifically, there is discourse at the DHB level and those working with the DHBs of their worry about the misaligned priorities. Some participants describe DHBs had a lot more worries and operational issues to consider outside of IT investment. This is explained as one of the reasons why some DHBs historically lagged behind. This was a common perception held by many of the interviewees. Furthermore, the way by which DHBs were funded and made decisions has preserved their autonomy. Each DHB has been (and continues to be) responsible individually for their spending and IT implementation, operations, workforce, etc. Initial fears of challenging those conditions took some time for people to get on board with The