District Health Board Elections

DHBs and the New Zealand health and disability sector

District Health Boards (DHBs) are Crown entities responsible for providing and funding health and disability services in 21 districts. You can view maps of DHBs here.

Who makes up the health and disability sector?

The Minister of Health and the Government set the overall strategic direction for the health and disability sector. This direction is outlined in the New Zealand Health Strategy, the New Zealand Disability Strategy and a number of other strategies (eg, He Korowai Oranga: Māori Health Strategy).

View the Strategies.

A wide range of advocacy and consumer groups, health care providers and health professional groups make significant contributions to the sector, as do many non-government and voluntary groups. The primary government organisations in the sector are the 21 DHBs, working with the Ministry of Health. Other government organisations and agencies also play important roles. These include:

other health Crown entities: the Alcohol Advisory Council of New Zealand (ALAC), the Crown Health Financing Agency, the Health and Disability Commissioner, the Health Research Council, the Health Sponsorship Council, the Mental Health Commission, the New Zealand Blood Service and the Pharmaceutical Management Agency (PHARMAC)
the Accident Compensation Corporation (ACC)
the Ministry of Social Development, including:
- Child, Youth and Family
- Office for Disability Issues
- Work and Income
the Ministry of Agriculture and Forestry and the Ministry for the Environment (who have biosecurity functions).

More detailed information on the New Zealand health and disability sector is available in the Ministry of Health publication, New Zealand Health and Disability Sector Overview.

What legislation governs the sector?

While the health and disability sector is subject a large number of acts and regulations, the sector is largely structured through the:

New Zealand Public Health and Disability Act 2000 (the NZPHD Act)
Crown Entities Act 2004 (the CE Act)
Health Act 1956.

View New Zealand legislation on www.legislation.govt.nz.

The NZPHD Act outlines the responsibilities of the Minister of Health and the role and functions of DHBs. In addition, the NZPHD Act creates several ministerial committees including the National Health Committee, and outlines the roles and functions of the Crown Health Financing Agency, the New Zealand Blood Service and PHARMAC.

The CE Act provides a consistent framework for the establishment, governance and operation of Crown entities. It also clarifies accountability relationships and reporting requirements between Crown entities, board members, responsible Ministers (on behalf of the Crown) and the House of Representatives.

The Health Act is focused on public health. It sets out the role of the Ministry of Health in relation to public health, and contains provisions for sanitation, pollution, quarantine and infectious diseases, trading in blood and controlled substances, and screening programmes. An updated Health Act is currently being considered by Parliament.

What are DHBs’ objectives?

DHBs’ objectives are clearly set out in law (see section 22 of the NZPHD Act). These include:

improving, promoting and protecting the health of people and communities
promoting the integration of health services, especially primary and secondary health services
promoting effective care and support for those in need of personal health services or disability support services
promoting the inclusion, participation in society and independence of people with disabilities
reducing health disparities by improving health outcomes for Māori and other population groups
reducing (with a view to eliminating) health outcome disparities between various
population groups within New Zealand by developing and implementing (in consultation with the groups concerned) services and programmes designed to raise their health outcomes to those of other New Zealanders
exhibiting a sense of social responsibility by having regard to the interests of the people for whom it provides (or arranges the provision of) services
fostering community participation in health improvement and in planning for the provision of services and for significant changes to the provision of services
upholding ethical and quality standards commonly expected of providers of services and of public sector organisations
exhibiting a sense of environmental responsibility by having regard to the environmental implications of its operations
being a good employer in accordance with section 118 of the CE Act.

DHBs are required to pursue their objectives in accordance with their District Strategic Plans, District Annual Plans and Statements of Intent. DHBs also have to comply with any formal directions given to them by the Minister of Health (see sections 32 and 33 of the NZPHD Act. DHBs also have to follow ‘whole of government’ directions issued by the Minister for State Services and the Minister of Finance under the CE Act).

What are DHBs’ functions?

A DHB has certain defined functions in order to achieve its objectives (see section 23 of the NZPHD Act). These include:

ensuring the provision of services for its resident population and for other people as specified in its Crown funding agreement
actively investigating, facilitating, sponsoring, and developing co-operative and collaborative arrangements with persons in the health and disability sector (or in any other sector) to improve, promote, and protect the health of people, and to promote the inclusion and participation in society and independence of people with disabilities
issuing relevant information to the resident population, persons in the health and disability sector, and persons in any other sector working to improve, promote, and protect the health of people for the purposes of the two preceding functions
establishing and maintaining processes to enable Māori to participate in, and contribute to, strategies for Māori health improvement
continuing to foster the development of Māori capacity for participating in the health and disability sector and for providing for the needs of Māori
providing relevant information to Māori for the purposes of the two preceding functions
regularly investigating, assessing, and monitoring the health status of its resident population, any factors that the DHB believes may adversely affect the health status of that population, and the needs of that population for services
promoting the reduction of adverse social and environmental effects on the health of people and communities
monitoring the delivery and performance of services by it and by persons engaged by it to provide or arrange for the provision of services
participating, where appropriate, in the training of health practitioners and other workers in the health and disability sector
providing information to the Minister of Health for the purposes of policy development, planning, and monitoring in relation to the performance of the DHB and to the health and disability support needs of New Zealanders
providing, or arranging for the provision of, services on behalf of the Crown or any Crown entity within the meaning of the CE Act
collaborating with preschools and schools within its geographical area on the fostering of health promotion and on disease prevention programmes
performing any other functions it is for the time being given by or under any enactment, or authorised to perform by the Minister of Health by written notice to the board of the DHB after consultation with it.

How are DHBs accountable?

DHBs are accountable, both to the Government and the House of Representatives, through a framework set out in statute and in Cabinet decisions.

Accountability to the Government is achieved through the following documents.

District Strategic Plan: Sets out the DHB’s strategic objectives and or desired DHB population outcomes for a five- to ten-year period. DHBs must consult their resident populations when forming their District Strategic Plans.
District Annual Plan: Sets out in greater detail how the DHB intends to work towards the intermediate outcomes or strategic objectives identified in its District Strategic Plan, for a particular financial year.
Crown Funding Agreement: Specifies the funding to be supplied to the DHB by the Crown in return for the broad outputs expected of DHBs and specific outputs set out in the DHB’s District Annual Plan.

The following documents form the main lines of accountability to the House of Representatives.

Statement of Intent (SOI): The SOI is the DHB’s key accountability document to the House, and through the House to the public. The SOI provides a high-level focus on the DHB’s key financial and non-financial objectives and targets. It is a relatively brief and concise document and is intended to be easily understood by the general public. The SOI is prepared before each financial year and covers the period of the financial year and at least the following two years.
Annual Report: The Annual Report covers the year’s activities, against the SOI, including financial performance and the DHB’s Statement of Service Performance.

Page last updated: 9 August 2007