Public Policy Implementation and the NSW Public Health System: Commensurability of the Health Services Act 1997 (NSW) and Area Health Service Performance Agreements

Abstract

This study critically examines the commensurability of the Health Services Act (1997) of New South Wales (NSW) and the Performance Agreements. The broader purpose of the study is to pursue a greater understanding of public policy implementation in the NSW public health system. This study traces the New England Area Health Service's Performance Agreements from 1997-2001 and focuses on the implementation process related to their achievement. Through the use of interview's with key political, bureaucratic, health professional and lobby group actors, archival material, related literature and primary other sources, the study identifies some of the key factors that influenced the Health Service Act's implementation process. The study interprets the empirical findings in the light of the theoretical literature on policy implementation, focusing particularly on Sabatier and Mazmanians' (1980) implementation framework and the relationship between New Public Management and traditional public administration. It identities some of the ways the NSW Department of Health influenced the implementation process and the specific manifestations of commensurability between the Health Services Act and the Performance Agreements. It concludes that whilst commensurability between the Health Services Act and the Performance Agreements was evident, its achievement was somewhat tempered by the Department of Health's employment of traditional public administration practices outside the Statute in managing the implementation process essentially to reclaim lost power, position, and authority that it experienced prior to the introduction of New Public Management.