ABSTRACT

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.

摘要

公共卫生和社会服务通常难以确定，交付复杂且难以衡量。这项研究使用了复杂性理论的视角来探讨新西兰奥特罗阿公共卫生和社会服务外包的挑战和机遇。这项定性研究考虑了复杂性概念的含义，该概念涉及十位在外包公共卫生和社会服务方面经验丰富的公共部门经理。我们的研究结果表明，公共部门经理正在尝试采用不同的外包方式，但是被许多政府行政部门采用的潜在的新公共管理理念却可能阻碍举措。寻找替代方法以更有效地外包的动力越来越强。根据复杂性理论的另一种选择，框架突出显示了将组织和实践外包的变更可以在哪些地方支持更有效的服务提供。这项研究还提供了有关为何难以实现变革的见解。