Rationalising Hospital Services: Reflections on Hospital Restructuring and its Impacts in New Zealand

This paper investigates recent patterns of hospital restructuring in New Zealand and discusses the extent to which emerging forms of governance and changes in hospital provision conform to Jessop's (1994) idea of the ‘hollowed out’ state. The paper places the 1993 reforms within their historical context and examines processes of decentralisation, downsizing, privatisation and cost shifting within the hospital sector. It concludes with a discussion of some of the implications of hospital restructuring for regions, communities and their medical care providers and lays out some of the key questions which should rank high on the geographical research agenda.