Placing health organisations in New Zealand's third sector

Abstract

Third sector organisations have long played a role in the New Zealand health system, both in mainstream service provision and at the periphery of traditional medical attention. More recently the place of the third sector has been romanticised and hailed as the solution to societal fragmentation. As an entrepreneurial promoter of citizenship, builder of social capital and provider of services the third sector arguably is 'all things to all people'. However the nature and structure of third sector organisations have changed over time, reflecting evolving societal values and shifts in the broader policy context. In this study an exploration of reported tensions between and within third sector health organisations and government agencies is undertaken. Particular attention is paid to the effects of the neoliberally inspired policies of the 1980s and 1990s and the subsequent purchaser-provider split. Accounts of change in the sector, particularly the organisational implications of a shift to a culture of contracting, are examined. Emerging from this changing policy environment is a process of organisational adaptation or resistance. This process is largely influenced by the vision of key individuals of the place of the organisation within a wider societal context.