Each District Health Board (DHB) has up to 11 members, either elected or appointed by the Minister of Health by notice in the Gazette for terms of up to three years. Appointed members of the Board are eligible for reappointment unless they have served consecutively for six years, in which case they must not be reappointed immediately without consent from the Minister of Health. Such reappointment must only be for another three years.
The Minister decides who to appoint as a DHB Board member by considering the mix of skills and backgrounds of the elected members to the Boards, identifying the gaps, and endeavouring to fill these with people known to have the required attributes and backgrounds. The Ministry may also use the appointment process to balance ethnicity, gender and age on the Board. The Minister of Health appoints one member as Chairperson and one member as Deputy Chairperson. These people may have been either elected or appointed to the Board.
Once a candidate to a DHB Board is elected (or appointed) they are required to disclose any interests in transactions of the Board, and in some circumstances not to take part in the deliberations of the Board in relation to the conflict of interests (Clause 36, Schedule 3 of the New Zealand Public Health and Disability Act 2000). The disclosure of this conflict must be recorded in the minutes of the Board and entered in a separate interests register.
The BoardBoard members are responsible for the governance of the District Health Board (DHB). They must together work in a financially responsible manner and in the best interest of the health of the whole population of the DHB to achieve the objectives of the DHB and to meet the requirements of the Minister of Health. Governance, as executed by the DHB Board, is strategic oversight of the management of the entity to ensure it delivers on its fundamental objective of working within allocated resources to improve, promote and protect the health of a defined population, and to promote the independence of people with disabilities within a defined population. Board members do not manage the DHB. The DHB Board is required, under the Act, 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 and by law cannot interfere in matters relating to individual employees.
DHB Board members are accountable to the Minister of Health, (through the Chairperson of the Board) for the performance of the DHB.
Boards fees are set by the Minister of Health and are publicly available on the Ministry of Health website www.health.govt.nz.
Board meetings are open to the public, who are able to observe but not participate in meetings. The rules around when the public is able to attend DHB Board meetings are similar to those that apply to Local Government meetings. Although some parts of the meeting may need to be closed to the public, this occurs only for specific reasons.
DHBs are required under the NZ Public Health and Disability Act 2000 to have three advisory committees. These committees provide a key means for community voices to be heard.
They are the:
Community and Public Health & Disability Support Advisory Committee – The Community and Public Health Advisory Committee and the Disability Support Advisory Committee (delivered through the same body of membership) provide the Board with advice on the health and disability needs of our population, assess how the services we fund or provide and the policies we adopt will impact on our population and promote the inclusion, participation and independence of people with disabilities.
Hospital Advisory Committee – A statutory governance role in monitoring the financial and operational performance of the hospitals the Canterbury DHB owns, as well as assessing strategic issues relating to the provision of hospital services; gives the Board advice and recommendations on that monitoring and assessment.
The DHB has also established three additional committees to assist the Board to meet its responsibilities:
Quality, Finance, Audit and Risk Committee – enhances the Board’s governance function by monitoring and providing advice on the financial operation of the DHB and monitoring quality and clinical risk issues.
The Remunerations and Appointments Committee - manages the employment of the Chief Executive and other specific industrial and employment matters.
The Facilities Development Project Committee - monitors and reviews the
overall planning, progress and direction of the Canterbury DHB Facilities
DHB Boards appoint members to their committees. The committees comprise both
Board members and members of the public. The members of the public are usually
appointed following publicly invited nominations.
The Chief Executive and Executive Management TeamThe Chief Executive and Executive Management Team are responsible for the management matters of the District Health Board (DHB). They must together work in a financially responsible manner and in the best interest of the health of the whole population of the DHB to achieve objectives of the DHB and to meet the requirements of the Board. The Board does not have a role in employment decisions beyond the appointment of the Chief Executive and by law cannot interfere in matters relating to individual employees.
The Executive Management Team report directly to the CEO, who in turn is accountable to the Chair of the District Health Board.
Our Clinical Board is a multidisciplinary clinical forum, whose membership includes representatives from the primary, secondary and community sectors. There are 26 members on the Clinical Board, 17 of whom are elected, and the Board is chaired by the DHB’s Chief Medical Officer.
The Clinical Board oversees the DHB’s clinical activity, provides advice to the Chief Executive on clinical issues and takes a proactive role in setting clinical policy and standards and encouraging best practice and innovation. Members support and influence the DHB’s vision and values and play an important clinical leadership role, leading by example to raise the standard of patient care.
The Treaty of Waitangi places obligations on the DHB as a Crown Entity. The three principles of partnership, participation and protection apply in managing the Board.
We engage informally at many levels with Māori providers and community groups to facilitate genuine participation in the planning and delivery of health and disability services, particularly as they affect Canterbury’s Māori population. The Board also has a formal Memorandum of Understanding with Manawhenua Ki Waitaha (representing the seven Ngāi Tahu Rūnanga) as a further step to enhance Māori participation in decision making.
Our Māori Health Plan commits us to establishing formal relationships with other Māori representative groups. We continue to explore mechanisms to facilitate these formal relationships and greater participation of Māori at an executive and governance level, as a pathway to shared decision making.
We also have links with a number of consumer and community reference groups, advisory groups and working parties. Their advice and input assists in developing DHB plans and strategies to improve the delivery of health and disability services and to reduce inequalities in health status within our population.
Our Consumer Council provides input into decision making as a permanent advisory group for the Chief Executive and supports a partnership model that provides a strong and viable voice for the community and consumers in health service planning and service delivery.
The Council consists of 15 representatives nominated by consumers and consumer lobby and advocacy groups and covers 10 key areas: family health, older persons’ health, disabilities, Māori health, Pacific health, long-term conditions, mental health, rural communities, primary health care and refugees. Networks support each representative in their role and facilitate wider communication across the Canterbury community.