The stewardship deficit in New Zealand health policymaking

Abstract

The autonomy and capacity of a state to make and implement public policy (or to exercise its ‘stewardship’ functions) (WHO, 2000, p.122) is a fundamental characteristic of statehood. ‘Autonomy’ for a state is defined as ‘the ability of government institutions to resist being captured by interest groups and to act fairly as an arbiter of social conflicts’ (ibid.). ‘Capacity’ refers to the ability of government systems to make and implement policy and ‘springs from the expertise, resources and coherence of the machinery of government’ (Buse, Mays and Walt, 2007, p.81). Understanding the nature of autonomy and capacity in a particular state and how well that state is able to maintain or extend its autonomy or capacity to develop effective public policies is important because this enables states to strengthen these characteristics over time.