Policy, politics and nursing: a case study of policy formation in New Zealand
- Publication Type:
- Thesis
- Issue Date:
- 2003
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The aims of this thesis were to: describe the political development of nursing in New
Zealand; promote an understanding of policy and politics and the nursing profession;
provide policy learning for the international nursing community; and provide insight
into the role of the government Chief Nursing Advisor, especially in relation to
engaging with professional groups and central government. The thesis focuses upon a
significant event in the history of New Zealand nursing politics and policy: the 1998
Ministerial Taskforce on Nursing. In 1998, after public outcry at the excesses of the
health reforms, nursing professionals took advantage of the opportunity to put nursing
on the government's agenda through a Ministerial Taskforce on Nursing. The Taskforce
ended its work in a flurry of publicly expressed controversy. To develop the case study
an Expert Reference Group was established to assist in the selection of subject matter
and to provide sources of material and validity of interpretation. Sources of data
included participant observations, reports and documents in the public domain, media
and secondary sources from nursing, medical and policy, literature and diary entries
from the researchers own records. The researcher held multiple roles as Chief Nurse
Advisor Taskforce member, public servant and nursing leader. Analysis from all of
these points of view aimed to identify the stage of nursing's political development as
defined by Cohen et al (1996) and to explicate how nurses engaged in agenda setting as
described by Kingdon (1995). Analysis was informed by locating the Taskforce in the
policy and political contexts, especially policy entrepreneurship. Analysis revealed the
mechanisms nursing organisations use to engage in agenda setting. Moving from agenda
to action was non-linear and fluid. No one organisation or individual brought about the
events of the case nor their outcomes. Analysis suggests a refinement of the Cohen
model to include behaviours of responsible actors in nursing politics and policy. The
role of the policy entrepreneur is developed especially in the Chief Nurse position. The
thesis widens the understanding of how nursing engages not only in policy formation
among nursing organisations but also with government. Implications for policy,
practice, education and research not only for New Zealand but also for other countries
are presented.
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