Contracting public health and social services: insights from complexity theory for Aotearoa New Zealand

摘要

Public health and social services are often hard to specify, complex to deliver and challenging to measure. This research uses a complexity theory-informed lens to explore the challenges and opportunities of contracting out for public health and social services in Aotearoa New Zealand. This qualitative study considers the implications of complexity concepts with ten public sector managers experienced in contracting out for public health and social services. Our findings show that public sector managers are experimenting with different ways of contracting out, yet the underlying New Public Management ethos, which is being applied in many administrative arms of government, can hamper initiatives. There is a growing impetus to find alternative approaches to contract out more effectively. An alternative, complexity theory-informed, framing highlights where changes to contracting out organisation and practices may support more effective service provision. This research also provides insights into why achieving change is hard.