Mr. Kiener promoted the power of his "K1 Fund Allocation System," and is accused of taking advantage of lax lending oversight by banks during the credit boom.
As part of this the funding, allocation and payment systems are being switched from a face-to-face contact to a more web-based "self-service" system.
Clearly, this poses a challenge for the New Zealand government as well as for local DHBs who must work within a fixed funding allocation yet create systems that support staff involvement in activities such as clinical governance development.
System and organisational barriers included: limited funding allocation, weak regulatory and administrative systems, few learning opportunities, limited human and material capacity and poor incentives for conducting research.
A fairer system for funding allocation is possible, but only if we as an international community hold those responsible of the funding accountable.
System level barriers impact on all levels through often dysfunctional regulatory and administrative systems, insufficient funding allocation and limited ethical review capacity.
The current policy settings for health system and research funding allocation urgently needs to be reviewed, since there may be imbalances present regarding socio-economic features.
While the "Sector-Wide Approach"—a resource allocation system that pools all health sector resources from all sources and allocates funds based on need had been effective in Malawi for coordinating donor support, lack of accountability of funds provided directly to the government limited contributions to the basket fund.
For example, the slowing down of systems and processes, such as getting ethical clearance; and funding allocation that does not benefit all causing dissention among staff.
In the past, this strategy worked only as well as the ability of the resource allocation system providing for it: an open-ended credit card with an unclear path to replete funds.
It will also make the organ allocation system fairer.
