District Health Board Elections

How DHB boards work

How are boards made up?
Each DHB board consists of seven elected members, and up to a further four members appointed by the Minister of Health. This structure allows for a range of perspectives, skills and knowledge on each DHB board.

The Minister of Health also appoints a chair and deputy chair for each board from among the board’s elected and appointed members.

What is the board’s role?
The board of a DHB has all powers necessary for the governance and management of the DHB. However, the board must delegate to the DHB’s Chief Executive the power to make decisions on management matters relating to the DHB (see section 26 of the NZPHD Act). This delegation may be made on such terms and conditions as the board thinks fit.

The board’s role is therefore one of stewardship, direction-setting and monitoring the DHB’s overall performance against its goals. It is not one of day-to-day management (which is the domain of the Chief Executive). The board also has no role in employment decisions, beyond appointing the Chief Executive. By law, the board cannot interfere in matters relating to individual employees (see clause 44(4) of Schedule 3 to the NZPHD Act).

How do representative boards take shape?
DHB boards are made up of elected and appointed members. In electing seven members, the public typically votes for candidates with a range of backgrounds and experience. The Minister of Health is allowed to appoint up to four more people to each board, to balance the skills and representative qualities of the elected members. For example, the Minister may wish to appoint people with financial or other large entity governance experience, or people from groups not represented among the elected members.

Do boards have committees?
Yes. Under the NZPHD Act, a DHB board has three statutory advisory committees: the hospital advisory committee; the community and public health advisory committee; and the disability support advisory committee. The board is also able to form its own specialist committees to address particular issues (eg, audit and finance matters, Māori health or rural health).

Committee members are appointed by the DHB board. They can be either board members, members of the public or a mixture of both.

What are board members’ duties?
The CE Act sets out DHB board members’ duties. Every board member must comply with the CE Act and the NZPHD Act, act with honesty and integrity, act in good faith and not at the expense of the DHB’s interests, and act with reasonable care, diligence and skill (see sections 53 to 56 of the CE Act). Board members also have a duty not use information received in their capacity as a member that would otherwise not be available to them, unless it is for board purposes (see section 57 of the CE Act).

The board also has a number of collective duties. It must ensure that the DHB:

acts in a manner consistent with the DHB’s District Strategic Plan, District Annual Plan, and any directions under section 33 of the NZPHD Act, or section 103 or 107 of the CE Act (see section 27(1) of the NZPHD Act)
acts in a manner consistent with its objectives, functions, current Statement of Intent, and Crown Funding Agreement
performs its functions efficiently and effectively and in a manner consistent with the spirit of service to the public
operates in a financially responsible manner and, for this purpose, that it prudently manages its assets and liabilities and endeavours to ensure its long-term financial viability and that it acts as a successful going concern (see sections 49 to 51 of the CE Act).

The board must also ensure that the DHB complies with sections 97, 98, 99 and 101 of the CE Act in respect of any subsidiary entities it may have (see section 52 of the CE Act and section 21 of the NZPHD Act).

The Minister has the power to remove one or all board members for breaching their duties, in addition to other reasons (eg, that an elected member was not entitled to be elected in the first place) (see clause 8 of Schedule 3 to the NZPHD Act).

What happens at board meetings?
At board meetings, members discuss a range of matters to do with the DHB’s business. These include reports from various operating parts of the DHB (eg, finance, mental health, elective services) and from subsidiary companies and trusts the DHB might have an interest in. Board members are asked to make decisions on the DHB’s strategic direction and monitor the Chief Executive’s performance, among other things.

Decisions taken by the board are formalised as resolutions, voted on by members after the board has debated and has discussed the matters at hand. Looking at board agendas, minutes and papers is a good way of seeing what is discussed at a typical meeting. These are available directly from the DHBs or on their websites.

Board meetings are held in public, and both the meeting agenda and the minutes of the meeting are available to the public. Under some circumstances, parts of the meeting may need to be closed to the public (see clause 32 of Schedule 3 to the NZPHD Act).

DHB boards are free to regulate their own procedures at meetings and establish their own policies so long as these aren’t inconsistent with the NZPHD Act. Board members are expected to treat all confidential business before the board as strictly confidential (see ‘What are board members’ duties?’ above). Members are also expected to comply with all relevant legislation concerning privacy, especially with regards to individuals. The board may also have a media policy which guides members’ dealings with media organisations.

Who are board members responsible to?
While most board members are elected by the public, all board members (both elected and appointed) are directly responsible and accountable to the Minister of Health. This is because DHBs are funded by the Government, using taxpayer dollars. It is acknowledged though that elected members provide an important community voice on DHB boards.

Board decision-making is highly transparent. Meetings, agendas and board papers are normally required to be open and available to the public. The DHB’s District Strategic Plan is also subject to a public consultation process, as are many other decisions DHBs make.

Do board members receive any training?
Yes. Board members who are not familiar with their obligations and duties as members are expected to undertake and complete any necessary training. DHBs fund this training and keep records of it.

Both the Ministry of Health and individual DHBs usually provide induction/refresher sessions for board members, upon their taking office.

How much time does being a board member take up?
Time requirements for board members vary from DHB to DHB, depending on the way the board works, how efficiently members work and on members’ experience.

Board members should be prepared to commit the equivalent of about 60 days per year for board business. This includes preparation time, board meetings, committee meetings, and community liaison activities.

How long do board members serve for?
An elected member serves a three-year term. This term begins on the 58th day after polling day (10 December 2007) and ends on the equivalent date in 2010 when new boards come into office. Board members may stand for re-election every three years.

Appointed members serve at the Minister of Health’s pleasure, and have a term of up to three years. They may, however, be appointed for a shorter time. They may also be reappointed, subject to a upper limit of nine consecutive years on the board. Reappointment is not automatic, and there is no guarantee that any appointed member will be reappointed to a board on the expiry of their term.

Are board members paid for their work?
Yes. The Minister of Health determines board members’ terms and conditions of office and levels of remuneration. Board members are paid an annual fee for their service on the board, and fee levels vary from DHB to DHB (depending on the size and assessed complexity of the DHB). Fees currently range from $16,000 to $26,000 per annum. The board chair and deputy chair receive a higher fee.

Board members are paid an additional fee of up to $2500 per annum for each statutory advisory committee they are a member of. Members serving on certain other committees (eg, audit, risk and finance committees) also receive an additional annual fee.

Members are covered for reasonable expenses associated with board and committee business, such as travel costs.

Page last updated: 2 August 2007