Transparency in Healthcare Reporting: The Case of External Contractors and Consultants in New Zealand's Healthcare System.

Adeel Akmal,Robin Gauld,Erin Penno

doi:10.34172/ijhpm.2021.69

Adeel Akmal, Robin Gauld + Show 1 more

Open Access

https://doi.org/10.34172/ijhpm.2021.69

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Abstract

This study investigates the quality of reporting around the spending related to the use of external consultant and contractors in New Zealand's 20 District Health Boards (DHBs). We make use of the publicly available annual reviews conducted by the New Zealand Parliament Health Select Committee (HSC) as well as DHB data which were retrieved using Official Information Act (OIA) requests. The quality of reporting was judged on the differences and discrepancies observed in the HSC reports each year as well as the DHB internal data. Perhaps, unsurprisingly, total spending on external consultants and contractors has been increasing over the years while the quality of reporting has been decreasing. Our analysis highlighted a number of quality issues-mistakes, discrepancies and an overall lack of standardised reporting in almost all of the DHBs. Some of these discrepancies included failure to provide information required by the HSC, differences in yearly total amounts in consecutive reports and differences between information provided to the HSC and to the authors of this article. It is hoped that this research and the prospective areas for improvement highlighted here are used as a guide to improve the quality of healthcare financial reporting.

Highlights

New Public Management (NPM) inspired reforms swept through the public sector in a range of countries from the 1980s, with New Zealand leading the way and often seen as the example to follow.[1,2] Such reforms led to complete reorientation of the public sector, with wide-ranging implications for how public sector work is performed and by whom
Total Spending on External Contractors and Consultants Our first findings are related to total spending by the District Health Board (DHB) on external contractor and consultant (ECC) and the reasons for ECC use between financial years 2016 and 2019
In cases when the reasons for recruiting ECCs were not provided, a search amongst the other DHB responses was conducted to determine whether another DHB used the same ECC, and the purpose was replicated in the list

Summary

Introduction

New Public Management (NPM) inspired reforms swept through the public sector in a range of countries from the 1980s, with New Zealand leading the way and often seen as the example to follow.[1,2] Such reforms led to complete reorientation of the public sector, with wide-ranging implications for how public sector work is performed and by whom. A core goal was to improve efficiency of public services work and organisation. One aspect of NPM reforms was the desire to contract private providers to deliver public services. While the New Zealand and other governments backed away from NPM from the late-1990s, elements persist, including the use of external contractors and consultants (ECCs).[3] in many countries and areas of public work, ECC use has increased over time including in healthcare

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