Partnership and Managed Care: A Way Forward 

Abstract
As the programme of health reform in New Zealand gains momentum the number of new concepts and terms used to describe them is increasing to an extent where it would be easy for nurses, on whom the changes have major impact, to become overwhelmed.  Most prominent and influential among the current ideas are managed care, evidence based practice, critical pathways and cultural safety.  Al these are permeated by the change process.  In this paper critical issue surrounding aforementioned terms are discussed from both a professional and a consumer viewpoint, with reference to both the literature and media sources.  The purpose is clarification, with the aim of assisting nurses to be more engaged in the debate.

Introduction
This paper is an edited version of a keynote address given at the Australasian Nurse Educators' conference in Christchurch, New Zealand, October 1997.  Included are comments on managed care, the change process, evidence based practice, critical pathways and cultural safety as these constructs focus the subsequent paper streams and discussion.  I decided to highlight critical issues surrounding these terms from both a professional and consumer viewpoint, using recent literature and media sources.  With the health reforms gathering momentum it is easy for colleagues to feel overwhelmed by these new concepts and terminology.  This paper addresses these concerns.