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

expert committees in the 1990’s. The Ministry of Health could not, or would not,
provide me with the names of doctors who had been appointed to such expert
committees. This however was not a sufficiently strong basis on which to
impede my research on the fairness and equity of PHARMAC’s decision
making.
My study could not have been conducted utilising a phenomenological
approach because it would be necessary to have close association with the
lived experiences of the PHARMAC decision makers when they make their
decisions. This implies that it would have also been necessary to be in
PHARMAC and experience the decision making process by shadowing a group
of CEC panellists and living with them through the experience of deciding
onCommunity Exceptional Circumstances claims. Given my experiences with
PHARMAC discussed above, a phenomenological approach would not have
been possible.
An ethnographical methodology would have required me to experience the
culture of PHARMAC and see how this culture impacted on the decision making
process. Again, I was denied access to the decision makers. I encountered a
polite but obstructive culture. The effect of this culture was referred to many
times in the collected data especially through the media study and the key
informant interviews.
A critical social theory approach might have been utilised to elucidate the power
differentials between PHARMAC and Community Eceptional Circumstances
claimants as well as between PHARMAC and the pharmaceutical industry.
Whilst this might be an interesting study into the dissected interests which were
being served in the decision making process, it would not provide sufficient
opportunity to develop understanding of how the policy was being
operationalised.
Similarly, remembering that this research was a study of decisions and not
applications, discourse analysis might have been instructive. However the
operationalisation of the PHARMAC policy was heavily impacted by PHARMAC
decision makers and the reasons for their determinations. Such outcomes
impacted both on PHARMAC (and its budgets) and the successful and
unsuccessful claimants. These outcomes were also impacted by legal
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