Frequently Asked Questions about District Health Boards

District Health Boards (DHBs) are responsible for providing (or funding the provision of) Government funded health care services for the population of a specific geographical area. There are 21 DHBs in New Zealand and they have existed since 1 January 2001.

The statutory objectives of DHBs include improving, promoting and protecting the health of communities, promoting the integration of health services, especially primary and secondary care services, and promoting effective care or support of those in need of personal health services or disability support.

Other objectives include promoting the inclusion and participation in society and independence of people with disabilities, reducing health disparities by improving health outcomes for Maori and other population groups, and to reduce toward elimination, health outcome disparities between various population groups.

DHBs are expected to show a sense of social responsibility, to foster community participation in health improvement, and to uphold the ethical and quality standards commonly expected of providers of services and public sector organisations.


1. What is a DHB?

2. How many DHBs are there?

3. How long have DHBs existed?

4. What do DHBs do?

5. How is a DHB different to a Hospital and Health Service (HHS), Crown Health Enterprise (CHE), Area Health Board, or Hospital Board?

6. How big are DHB’s budgets?

7. What are the populations served by DHBs?

8. How do DHB boards know that they are doing what they are required to do?

9. What guidance does the Government give to DHBs?

10. How can I find out more information about my local DHB?

11. How many board members does a DHB have?

12. How long do board members serve for?

13. How much do DHB board members get paid?

14. What do DHB board members do?

15. How much time are board members expected to DHB business?

16. Is the public entitled to attend board meetings?

17. What are statutory advisory committees?

18. How are people appointed to statutory advisory committees?

19. Can board members have a say in who is employed within the DHB?

20. Is it necessary to be an experienced director or to have particular qualifications to be a DHB board member?

21. How does the Minister decide who to appoint as DHB board members?

22. How are the board's chairperson and deputy chairperson decided?

23. What provision is made for Maori membership of DHB boards?

24. How are balanced boards achieved?

25. What provision is there for the community to have a say on DHB boards?

26. Who are DHB board members responsible and accountable to?

27. Where can I get information on DHB elections?

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1. What is a DHB?

The organisation responsible for ensuring the provision of publicly funded health and disability support services for the population of a specific geographic area.

2. How many DHBs are there?

There are 21.



3. How long have DHBs existed?

Since 1 January 2001.



4. What do DHBs do?

The statutory objectives of DHBs (as set out in the New Zealand Public Health and Disability Act 2000, and slightly abbreviated) are as follows:

• to improve, promote and protect the health of communities
• to promote the integration of health services, especially primary and secondary care services
• to promote effective care or support for those in need of personal health services or disability support
• to promote the inclusion and participation in society and independence of people with disabilities
• to reduce health disparities by improving health outcomes for Maori and other population groups
• to reduce, with a view to eliminating, health outcome disparities between various population groups
• to exhibit a sense of social responsibility by having regard to the interests of the people to whom they provide, or for whom they arrange the provision of, services
• to foster community participation in health improvement, and in planning for the provision of health services and for significant changes to the provision of health services
• to uphold the ethical and quality standards commonly expected of providers of services and public sector organisations
• to exhibit a sense of environmental responsibility by having regard to the environmental implications of their operations
• to be good employers.

5. How is a DHB different to a Hospital and Health Service (HHS), Crown Health Enterprise (CHE), Area Health Board, or Hospital Board?

Hospital Boards had a strictly hospital focus and were publicly elected(the Department of Health ran non-hospital public health and some mental health services).

Area Health Boards (AHBs) combined hospital and public health services. Their boards were partly publicly elected and partly appointed by the Government.

Crown Health Enterprises (CHEs) took over from AHBs. They were publicly owned companies, with boards appointed by the Government.

Hospital and Health Services (HHSs) were publicly owned companies with responsibilities for a wider range of health and disability service provision than CHEs. Their boards were appointed by the Government.

DHBs have very wide responsibilities for publicly funded health and disability services, including purchasing of services. They are bodies corporate owned by the Crown and are required to operate in a transparent manner.


6. How big are DHBs’ budgets?

As examples, the annual budget for one of the largest DHBs is $870 million and funding for one of the smaller DHBs is $48 million.



7. What are the populations served by DHBs?

DHB populations are approximately:

DHB	Population (000s)
Northland	154
Waitemata	516
Auckland	439
Counties Manukau	468
Waikato	355
Bay of Plenty	204
Lakes	102
Tairawhiti	45
Taranaki	107
Hawke's Bay	153
MidCentral	165
Whanganui	63
Hutt	141
Capital & Coast	282
Wairarapa	39
Nelson Marlborough	135
West Coast	32
Canterbury	491
South Canterbury	55
Otago	185
Southland	110

Source: Statistics NZ population projections, Sep 2007.



8. How do DHBs know that they are doing what they are required to do?

The New Zealand Public Health and Disability Act 2000 sets out quite clearly DHBs’ obligations and objectives. In addition, the Minister of Health makes the expectations and requirements of the Government clear through approval of required accountability documents.



9. What guidance does the Government give to DHBs?
The Government's overall vision for the health sector is contained in the New Zealand Health Strategy. This document sets out the goals and objectives the Government has for the health of New Zealanders.

The New Zealand Disability Strategy works to help create an inclusive society and sets the high level direction for the delivery of disability, policies, practices and services across Government - including disability support services provided within the health and disability sector.

The Ministry of Health provides guidance through a number of documents such as He Korowai Oranga (the Maori Health Strategy) , and the Primary Health Care Strategy, on how to achieve those goals and objectives set by Government.

The Government, through the Ministry of Health, also sets out clear accountability documents. The Ministry of Health, acting for the Government, works with DHBs to make sure that these are understood and that requirements are met.



10. How can I find out more information about my local DHB?

Here is a link to DHBs’ contact details.




Boards


11. How many board members does a DHB have?

Up to 11 board members sit on each DHB board. Seven members are elected every three years at the time of local government elections. In addition to the elected members, up to four members can be appointed by the Minister of Health.



12. How long do board members serve for?

Elected members serve a three year term and can then stand for re-election at the next DHB elections.

Appointed members are appointed for up to three years. Members may be appointed for a shorter time. The Minister may also reappoint members for a further term in office. Appointed members can serve a maximum of three consecutive terms (nine years in total).



13. How much do DHB board members get paid?

This varies from DHB to DHB depending on the size and assessed complexity of the DHB.

In recognition of the additional work required of them, DHB chairpersons receive twice as much as members and deputy chairpersons are paid 1.25 times as much as members.

The Minister of Health determines fee levels for DHB board members, in accordance with the Fees Framework (www.dpmc.govt.nz). Board members are also reimbursed for reasonably incurred expenses, such as costs for travelling to meetings. Current fee levels can be seen in the files below:

Current DHB fee levels (Word, 103 KB)
Current DHB fee levels (PDF, 26 KB)




14. What do DHB board members do?

Board members are responsible for the governance of the DHB. They must work together in a financially responsible manner and in the best interests of the health of the DHB's whole population. In doing so, they seek to achieve the DHB's objectives to meet the requirements of the Minister of Health.

Governance, as carried out by the DHB board, is strategic oversight of the DHB's management. This is to ensure it delivers on its fundamental objective of working within allocated resources to:
- improve, promote and protect the health of those within its district
- promote the independence of people with disabilities within its district

Board members do not manage the DHB. That is the responsibility of the chief executive (who is appointed by the board) and the staff who report to the chief executive.



15. How much time are board members expected to DHB business?

Time requirements will vary from board to board, depending on the way the board works, the amount of time for further involvement each member has, how efficiently members work, and how much time is spent in community consultation and similar activities.

Members should expect to commit the equivalent of about 60 days per annum on board business. This includes preparation time, board meetings, committee meetings and community liaison. The workload for board chairpersons is estimated at about 100 days per annum.



16. Is the public entitled to attend board meetings?

Yes. Board meetings are generally held in public. The rules around when the public are able to attend DHB board meetings are similar to those that apply to local government meetings. Some parts of the meeting may need to be closed to the public, and this occurs only for specific reasons.



17. What are statutory advisory committees?

DHBs are required, under the New Zealand Public Health and Disability Act 2000, to have three statutory advisory committees. They are, the community and public health advisory committee, the disability support advisory committee, and the hospital advisory committee.



18. How are people appointed to statutory advisory committees?

DHB boards appoint members to their statutory advisory committees. The committees can be made up of both board members and members of the public.



19. Can board members have a say in who is employed within the DHB?

No. DHB boards are required, under the New Zealand Public Health and Disability Act 2000, to appoint a chief executive to take responsibility for management matters.

The board does not have a role in employment decisions beyond the appointment of the chief executive. By law, it cannot interfere in matters relating to individual DHB employees.



20. Is it necessary to be an experienced director or to have particular qualifications to be a DHB board member?

No, it is not essential. All boards need a mix of skills, backgrounds and experience. This includes people with governance and finance experience.



21. How does the Minister decide who to appoint as DHB board members?

The Minister considers the mix of skills and backgrounds of the board's elected members, identifies any gaps which exist, and endeavours to fill these with people known to have the required attributes and backgrounds. The Minister may also use the appointment process to balance ethnicity, gender, age and geographic representation on the board.

Similar rules regarding eligibility for elected membership apply to appointed members as well.



22. How are the board's chairperson and deputy chairperson decided?

The Minister of Health appoints one member as chairperson and one member as deputy chairperson of the board. These people may be elected or appointed members.



23. What provision is made for Maori membership of DHB boards?

Section 29(4) of the New Zealand Public Health and Disability Act 2000 requires the Minister to:

"...endeavour to ensure that –

(a) Maori membership of the board is proportional to the number of Maori in the DHB's resident population (as estimated by Statistics New Zealand); and

(b) in any event, there are at least 2 Maori members of the board."



24. How are balanced boards achieved?

In making appointments to DHB boards, the Minister recognises the importance of an appropriate balance and mix of cultures, bearing in mind the cultural backgrounds of the communities those boards serve.



25. What provision is there for the community to have a say on DHB boards?

The DHB election process ensures that a community voice is present in board decision-making. The Government also recognises the importance of ensuring a balance of community views when appointments to boards are considered.

In addition to the board, each DHB has three statutory advisory committees which typically consist of both members of the public and DHB board members. These committees provide a key means for community voices to be heard.

The DHB must also consult with its district's population when it writes its District Strategic Plan.



26. Who are DHB board members responsible and accountable to?

The DHB board is accountable to the Minister of Health for achieving the expectations of the Minister and the Government. Members are expected to have a clear understanding of the issues of importance and the views of the people in their district as a whole, and be able to contribute to board-room discussion. However, they remain directly accountable to the Minister for the DHB's performance.



DHB Elections


27. Where can I get information on DHB elections?

Further information on DHB elections is available on the DHB elections section of the Ministry's website.

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Related information:

District Health Boards home

DHB elections

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Page last updated: 23 April 2008