Guidelines for Capital Investment

Guidelines for Capital Investment
Date of publication: October 2003

HP 3698

The delivery of health services required to meet the New Zealand Health and Disability Strategies requires building and maintaining high-quality, well-located and safe public health facilities. There is a significant stewardship responsibility for all who are responsible for public health infrastructure.

To meet this responsibility requires tools to build community trust and deal with conflicting community expectations. It also requires clear requirements for business cases and a stable, trusted and transparent framework for capital decision-making that is appropriate for the DHB environment.

Much knowledge regarding the efficient allocation of capital expenditure resides in DHBs. What is required, therefore, are sound structures for inter-DHB decision-making and collaboration, and incentives for the sector to prioritise capital expenditure and to adhere to agreements. There is much potential for peer-led decisions and peer review to provide these incentives. This maximises local and regional contributions to the capital allocation process and avoids as much as possible decisions being removed from DHBs.

In order to best deliver defensible decisions on how to spend a limited budget, this Capital Investment Framework sets out a process to maximise the service and efficiency gains achievable from collaboration and the incentives from peer review.

Any peer process, however, must not undermine the individual accountability of DHBs. It should also not diminish the obligation of central agencies to take responsibility for final major capital allocation recommendations and discharge their duty to enable the health system to function as a coherent system.

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