How does the operation of PHARMAC's 'Community Exceptional ...

Crown Entity and also was familiar with many constituents’ perceptions of
PHARMAC.
New Zealand Ministers are Electorate 57 or List MPs and are petitioned by both
Government MPs and Opposition MPs to assist constituents. This creates a
different type of pressure on a Minister, other than the pressure on a Minister
responsible for dealing with the legislation, lobbyists, department officials and
providing good stewardship of the portfolio.
However, despite Interviewee ‘E’’s wide ministerial experience and close
association with PHARMAC, ‘E’ did not know much about the Community
Exceptional Circumstances policy.
Q Let’s start with what you know about Community Exceptional
Circumstances… at PHARMAC?
A Well not very much. After you asked me to think about this the other
day, I was wondering why I didn’t know much about this. As Minister,
I at least should be, or have been, better aware of it…I think it was
probably too small a budget or just in the mix of all the things that
PHARMAC was doing at the time, but you are right, I should have
known about it. (Interviewee E)
‘E’ was impressed with PHARMAC’s ability to rationalise the various funding
categories and their ability to apply funding criteria to each category. ‘E’
thought this is particularly rare in the New Zealand public health scene. ‘E’ also
alluded to the management of costs with the pharmaceutical companies and
how this was a great advantage to PHARMAC and ultimately the New Zealand
taxpayer.
However, ‘E’ also recognised the position of PHARMAC in relation to the people
who fell outside this rational analytical system of funding. ‘E’ described
Community Exceptional Circumstances policy as an “escape valve” for
managing these demands.
57 New Zealand has a mixed Member Proportional Representation electoral system. At elections in New Zealand eligible
people have two votes to cast; an Electorate Vote and a Party Vote. Approximately one half of the Members of
Parliament are called Electorate Members and are elected by winning the most number of Electorate Votes in an
electorate. The other half of the Parliament are called List Members and are elected by the political party gaining a
proportion of the Party Vote. List Members are elected in proportion to the party vote gained and their place on the Party
List.
176