In this climate of the first coalition government of MMP , with its focus on the political environment of policy making, any text on social policy would be hard pressed to hold the reader's attention. The authors of this book on social policy in contemporary New Zealand have set their sights high by attempting to integrate theory, analysis and commentary, and to meet the needs of students and a wider audience.
I do not think that they have succeeded, but they are to be highly commended for accepting the challenge.
The authors say that this is a New Zealand text on social policy which brings together theoretical and conceptual frameworks for understanding social policy in New Zealand and linking these with the activity of policy analysis. They also wish to outline indispensable components of policy analysis such as values and theoretical frameworks. The first of these is a tall order, which they partially meet, but the second they barely sketch out at all. To do so would require consideration of policy analysis as an ideal construct, something which is not satisfactorily done.
While attempting to provide a comprehensive discussion of social policy in New Zealand, this text is selective, both in the policy areas it considers and the level of detail covered. I wonder why there is no consideration of education, and why housing, a sorely neglected area of critique by academic commentators and policy advisors alike, is missing. Both areas involve significant reforms since 1984, and have re-defined notions of entitlement, targeting, consumer choice, service provision and private contributions (user pays). There are also problems of fact, interpretation and emphasis. I will illustrate some of these with reference to the health and Māori social policy sections. What follows is a selective assessment and, as Cheyne et al. observe of policy comment, not value free.
In my view, the chapter on health policy marginalises the major debates in health over the 1980s which drove the reforms, and fails to highlight aspects of the evolution of the health sector in New Zealand.
The chapter starts by saying that Britain, Australia and New Zealand all established publicly funded health in the context of the welfare state. But it fails, until much later, to point out that the 1938 first Labour Government was unable to establish comprehensive public provision of health services. General practitioners were able to access direct subsidy from Government, while at the same time retaining the right to charge patients. Even when this is mentioned, the ongoing implications for health policy - containment of demand-driven charges, access to services, and the integration of primary and secondary health care - are ignored.
Key issues which should be considered in any analysis of the health sector reforms include: readjusting the funding directed to primary, secondary and tertiary care, respectively; the search for better health outcomes for the money spent; the desire to control and reduce provider- driven demand; the desire to expand total health funding available by increasing private contributions; the increasing emphasis on health promotion and prevention initiatives; and increased access to primary health care (a significant issue for low-income, Māori and Pacific Islands groups).
The health reforms, while contentious and difficult, were attempts to address entrenched problems widely acknowledged among health sector funders, providers and consumers. For example, the funder / purchaser / provider split can be seen simply as a strategy to increase competition, and as a manifestation of new right liberal philosophy. But many in the health sector found this change attractive because it could potentially break the monopoly of the hospitals and the dominance of secondary and tertiary care, and provide opportunities for entry of new providers. Māori, for instance, have welcomed the growth of health services provided by Māori.
If this chapter had started with the problems identified by the range of stakeholders within the health sector, it might have more effectively drawn out the complex and contradictory discourse surrounding health policy. It might have also more strongly identified the deficiencies of the reform structure.
The book discusses Māori social policy and Māori affairs policy - although the distinctions between these two are not clearly articulated. My comments are focused on both the policy framework that the book presents, and its analysis of the State's organisational response to the need for a Māori policy capacity.
The authors state that government policy towards Māori is focused on two related areas: settlement of Treaty of Waitangi claims, and the provision of social services. Yet the ensuing discussion is much more concerned with Treaty claims concerning land and natural resources than with the provision of social services. There are currently over twenty claims to the Waitangi Tribunal on health and other social policy issues, and the report on the Waipareira claim is awaited with interest. While there is some discussion of the mainstreaming of social services for Māori, and mention of the development of Māori providers, the text largely ignores the impact of Treaty analysis on the practice of social policy and on the responsiveness of service providers. Such an endeavour would be a valuable contribution to social policy debate.
The book canvasses issues of ownership and control, but other policy concerns over the distinct roles and responsibilities of iwi and the state with regard to provision of services for Māori are not addressed. In particular, the authors do not make clear that achievement of Treaty settlements does not abrogate government from its Article 3 obligations to ensure citizenship rights to services, nor from its responsibility under Article 1 for good government. This lack of attention to claims pertinent to social policy is more than simple oversight; it weakens the book's analysis of fundamental social policy concerns about rights versus needs.
The authors observe that references to the Treaty or other Māori rights are missing from social legislation. Yet they mention, but do not examine, several instances where references are included, such as the Children, Young Persons and their Families Act 1989 which makes provision for the establishment of iwi social services, and the State Sector Act 1988. However, they ignore other important references, such as the Resource Management Act 1991 which includes some of the strongest clauses expressing the State's Treaty responsibilities. There is also reference in the Health and Disability Services Act 1993 to the Crown's objectives in relation to the "special needs of Māori".
While policy analysis must consider the role of legislation in influencing policy development, its role can be overstated. Of equal or perhaps more significance are government policy statements such as the Coalition Agreement, and departmental policy documents, purchase agreements, and "key result areas" (departments' specific responses to the Government's strategic result areas). The authors do not consider the role and implications of these policy statements, which vary in the attention they give to improving Māori outcomes as part of their strategic directions.
While the book could further examine the relationship between the Treaty and social policy, there could also be more clarity in the discussion of the role of a state agency charged with Māori affairs policy. For example, it is stated that the Department of Māori Affairs catered widely for Māori need (p.157). The Department provided programmes and grants in housing, vocational training, land development, business development and Te Kohanga Reo. However, these interventions were relatively limited. They mirrored and were generally subject to the same criteria as mainstream provision. Furthermore, the vast majority of health and education services for Māori have always been "mainstreamed", that is, the responsibility of other departments of the state. Historically, there have been problems of service delivery by state agencies, whether mainstream or Māori, and barriers to iwi or Māori development of services. While the Māori community vigorously challenged mainstreaming, there was strong support for devolving decision making and delivery to iwi structures.
The authors comment that, through the mainstreaming process, Te Puni Kokiri's role has become limited to policy advice, with the implication that this is a diminished and less influential role (p.157). This is a puzzling interpretation, when the introduction points out the significant political, academic and public attention given to policy matters. The development of Te Puni Kokiri is consistent with the separation of policy from operations across the public sector. Before the late 1980s, a Māori or treaty advisory role within the State was negligible. Now, as well as Te Puni Kokiri, there are several Māori units in major departments. This manifestation of agency responsiveness is a development that could have been examined. Also overlooked are mechanisms to monitor responsiveness, in particular, Te Puni Kokiri's statutory role of monitoring the adequacy of mainstream delivery of services to Māori.
While this text is uneven and selective in its coverage, there is a real need for such a contribution. The text provides a broad general overview, a survey of the issues and preoccupations of the arena of social policy, some useful insights, and a spur to alternative interpretations. Congratulations to the authors for accepting the challenge of producing such a text. It will make the reader who perseveres think and question.