Among the main issues NGOs raised were concerns about how services are commissioned. These concerns are not new, mirroring the findings of a 2009 report into DHB contracting arrangements.153 However, they also apply more generally to all commissioning across the social sector,154 and many of the NGOs we heard from are contracting with government agencies in multiple sectors, not just the health sector. These concerns also reflect issues raised by NGOs in other countries, such as Australia.155
The types of issues raised in this inquiry and in other reports include:
Several people also spoke of a power imbalance between government funders and NGO providers, including a lack of genuine partnerships in commissioning processes and the lack of a ‘level playing field’, with district health boards (DHBs) tending to favour their provider arms when deciding how to deliver services.
The Social Investment Agency is consulting on its Investing in Social Wellbeing approach. Initial findings from that consultation identify similar dissatisfaction about the relationship between NGOs and commissioning agencies. Common frustrations include a lack of partnership between NGOs and central government and the lack of flexibility to allow for local solutions within a context of national goals.156
Given the importance of the NGO sector to the delivery of social services, getting contracting and commissioning right is essential because of the potential impact on the sustainability of providers and the need to make best use of resources. It is widely recognised that the dynamics around contracting for social services and with the NGO sector are different from other types of services.
As a result, many government agencies are working to improve commissioning and contracting for social services. For example, the Ministry of Business, Innovation and Employment has a lead role in building contracting capability within government agencies and developing markets.157 The Social Investment Agency produces tools and guidance to promote best practice commissioning in the social sector.158 The Ministry of Health’s Commissioning Framework for Mental Health and Addiction aims to ensure a consistent, outcomes-based approach across commissioners of services,159 but we have heard it has not yet been implemented.
We were told some agencies, including some DHBs, have significantly improved their approach to contracting by offering longer contracts, providing opportunities for partnering in the design and specification of services, and increasing the focus on outcomes. However, this improvement is not universal, so further improvement is needed.
Some of the issues raised, however, represent more fundamental, strategic issues that cannot be addressed simply through better contracting practices, and these have been the subject of much commentary over many years. Areas of discussion have included different partnerships between the government and non-government sectors, long-term development and sustainability, the shape of the NGO sector and the number of small organisations competing for discrete contracts being an inefficient use of resources, suggestions for amalgamation to improve long-term sustainability,160 and joined-up commissioning across agencies and sectors to address complex needs.
The guidance from multiple agencies about commissioning practices provides a strong basis to start from, but these more strategic issues require a different kind of approach. The issues are universal across social services and not unique to mental health and addiction services. Thus, some form of central government leadership, including a clear stewardship role with responsibility for advising on these issues, seems essential.161
Earlier this century, the focus was on building stronger partnerships between government and NGOs. Within government, there was an appreciation of the need to build capacity and capability in the NGO sector. One example was the establishment in 2003 of the Office for the Community and Voluntary Sector within the Ministry of Social Development. A core function of that office was to act as a central point of contact at a national level to address cross-agency issues affecting the sector when dealing with government.162 The office was transferred to the Department of Internal Affairs in 2011 and disestablished in 2013.
So far as we have been able to establish, no central agency has stewardship responsibility for the NGO sector.
We see a need for re-establishing an NGO stewardship role to advise on and respond to long-standing issues relating to the development and sustainability of the NGO sector. We suggest that a single government agency be identified to assume this role. If a social wellbeing agency were established (as discussed in chapter 7), it could take on this role.
Functions suggested in previous reports that could be part of this stewardship role include:
Several agencies can play a role in supporting and guiding improvements in the commissioning of social services. Potential exists for greater coordination of this activity, possibly as part of the overall stewardship role. Further work will be required to determine the exact scope and function of this stewardship role.
Strengthen the NGO sector
153 Platform Trust. 2009. 2008 NGO–DHB Contracting Environment (NgOIT series). Wellington: Platform Charitable Trust. www.platform.org.nz/uploads/files/ngoit-2008-ngo-dhb-contracting-environment.pdf(external link).
154 Productivity Commission. 2015. More Effective Social Services. Wellington: New Zealand Productivity Commission. www.productivity.govt.nz/inquiry-report/more-effective-social-services-final-report(external link).
155 J Schwartzkoff and G L Sturgess. 2015. Commissioning and Contracting for Better Mental Health Outcomes (research report by Rooftop Social for Mental Health Australia). https://mhaustralia.org/report/commissioning-and-contracting-better-mental-health-outcomes-report.(external link)
156 Social Investment Agency. 2018. Open Engagement Update Dashboard. https://sia.govt.nz/our-work/yoursay/latest-updates/(external link).
157 For example, see Ministry of Business, Innovation and Employment. No date. Social services procurement (web pages on the New Zealand Government website). www.procurement.govt.nz/procurement/specialised-procurement/social-services-procurement/(external link).
158 Social Investment Agency. 2018. Commissioning and partnerships (web page). https://sia.govt.nz/our-work/commissioning/(external link).
159 Ministry of Health. 2016. Commissioning Framework for Mental Health and Addiction: A New Zealand guide. Wellington: Ministry of Health. www.health.govt.nz/publication/commissioning-framework-mental-health-and-addiction-new-zealand-guide(external link)
160 See, for example, Platform Trust and Te Pou o Te Whakaaro Nui. 2015. On Track: Knowing where we are going. Auckland: Te Pou o te Whakaaro Nui. www.tepou.co.nz/resources/on-track-knowing-where-we-are-going/597(external link) and Productivity Commission. 2015. More Effective Social Services. Wellington: New Zealand Productivity Commission. www.productivity.govt.nz/inquiry-report/more-effective-social-services-final-report.(external link)
161 See, for example, J Schwartzkoff and G L Sturgess. 2015. Commissioning and Contracting for Better Mental Health Outcomes (research report by Rooftop Social for Mental Health Australia). https://mhaustralia.org/report/commissioning-and-contracting-better-mental-health-outcomes-report.(external link)
162 OCVS. 2008. Briefing to Incoming Minister. Wellington: Office for the Community and Voluntary Sector, p 22.
163 For example, see H Stace and J Cumming. 2006. ‘Contracting between government and the voluntary sector: Where to from here?’, Policy Quarterly 2(4): 13–20. https://ojs.victoria.ac.nz/pq/issue/view/501(external link) and J Cribb. 2006. ‘Agents or stewards? Contracting with voluntary organisations’, Policy Quarterly 2(2): 11–17. https://ojs.victoria.ac.nz/pq/issue/view/499.(external link)