Cultivating health policy capacity through network governance in New Zealand: learning from divergent stories of policy implementation

Abstract

<jats:title>Abstract</jats:title> <jats:p>Wu, Howlett, and Ramesh’s understanding of policy capacity has been used to identify generalizable strengths and weaknesses of specific jurisdictions and policy sectors such as health. In an extension of this work, Howlett and Ramesh have argued that the mode of governance of a policy sector accentuates the importance of specific elements of policy capacity. In this paper we focus on the implementation of the System Level Measures Framework (SLMF) in New Zealand that has been specifically focused on health systems improvement and which aimed to do so by fostering network governance at the local level. However, this policy is introduced in a context in which there has been significant contestation regarding which mode of governance—network or hierarchy—is dominant in New Zealand health policy. By exploring three divergent local cases of implementation of the SLMF we develop three arguments that contribute to the literature on policy capacity and health. Firstly, local histories of interorganizational play a crucial role in shaping health policy capacity. Secondly, it is crucially important to understand the dynamics and feedback loops between operational, political, and analytical policy capacity. Network and hierarchical governance are characterized by distinct and contrasting understandings of the content of policy capacity elements and of the way in which they are dynamically related. Thirdly, the key challenge in developing policy capacity compatible with network governance is how to facilitate this capacity when connections between operational, political, and analytical policy capacity fail to fire.</jats:p>