District health board

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District health boards (DHBs) in New Zealand are organisations established by the New Zealand Public Health and Disability Act 2000, responsible for ensuring the provision of health and disability services to populations within a defined geographical area. They have existed since 1 January 2001 when the Act came into force.[1] There are 20 DHBs (15 in the North Island and 5 in the South Island). From their creation until 1 May 2010, there were 21 DHBs. At that date, Otago DHB and Southland DHB amalgamated their boards to form the new Southern DHB.[2] DHBs receive public funding from the Ministry of Health on behalf of the Crown, based on a formula which takes into account the total number, age, socioeconomic status and ethnic mix of their population.

History[edit]

District health boards were first introduced as an idea in the 1970s in the Green and White Paper suggested by the then Labour government. This was part of a plan to nationalise primary health care as the Social Security Act of 1938 had originally intended. Labour subsequently lost the election to Rob Muldoon's National Party in the 1975 election. Muldoon's government chose however to slowly implement these reforms in trial "area health boards", which can be seen as early predecessors of the district health boards.

The more direct predecessors were the Crown health enterprises (CHEs) and subsequent Hospital and Health Services (HHS) management structures of the 1990s; these were responsible for managing the hospitals under business ethos, albeit, with the expectation that the former would return a profit to the shareholders (i.e. the government).

In the 1990s "regional health authorities" (RHAs) were formed. These RHAs were amalgamated in 1997 to form the Health Funding Authority (HFA). The election of the Labour-Alliance government in the 1999 General Election saw the New Zealand Public Health and Disability Act 2000 passed by parliament, this led to the merging of the HFA with the Ministry of Health. Part of the HFA's funding capacity combined with the hospital management elements of the Hospital and Health Services board to form the DHBs.

Organisation[edit]

The district health boards are given a set of objectives by the Ministry of Health, but have a degree of autonomy in how they choose to achieve these. In contrast to their predecessors, the regional health authorities, the DHBs are non-profit providers. The performance of individual DHBs is monitored by the DHB Funding and Performance Directorate.[3] DHBs provide funding to primary health organisations (PHOs).

The DHBs are governed by boards, which consist of up to 11 members: seven elected by the public every three years, and up to four appointed by the Government's Minister of Health. These appointments are largely to balance the board's expertise as deemed necessary.[4] Voting for public-elected DHB board members occurs through the single transferable vote system, and elections take place at the same time as local body elections.

Taranaki and Wairarapa District Health Boards maintain their own ambulance services, with St John and the Wellington Free Ambulance covering the rest of the country.[5]

On 1 May 2010, the Otago and Southland DHBs were merged to form a new Southern DHB, with elected members coming from two constituencies, Otago and Southland, and the remainder, appointed members of the Minister of Health, with the change taking effect from the 2010 local body elections. From 1 July 2010, a unified primary health organisation covers the entire new Southern DHB region with PHO centres in Alexandra, Dunedin and Invercargill with the mandate of providing PHO resources and services, replacing the previous nine PHOs.

Locations[edit]

There are 20 DHBs, organized around geographical areas, of varying population sizes, though they are not coterminous with the Regions of New Zealand:

Name Acronym/short name Website Area covered Population[6]
Auckland ADHB http://www.adhb.govt.nz/ Auckland City 441,100
Bay of Plenty BOPDHB http://www.bopdhb.govt.nz/ Tauranga City, Western Bay of Plenty District, Whakatane District, Kawerau District 207,700
Canterbury CDHB http://www.cdhb.govt.nz/ Christchurch City, Kaikoura District, Hurunui District, Waimakariri District, Selwyn District, Ashburton District 502,000
Capital and Coast CCDHB http://www.ccdhb.org.nz/ Wellington City, Porirua City, Kapiti Coast District (excluding Otaki) 288,100
Counties Manukau CMDHB http://www.cmdhb.org.nz/ Manukau City, Papakura District, Franklin District 481,700
Hawke's Bay HBDHB http://www.hawkesbaydhb.govt.nz/ Napier City, Hastings District, Wairoa District, Central Hawke's Bay District, Chatham Islands 153,900
Hutt Valley Hutt Valley DHB http://www.huttvalleydhb.org.nz/ Upper Hutt City, Hutt City 142,700
Lakes http://www.lakesdhb.govt.nz/ Rotorua District, Taupo District 101,800
MidCentral MDHB http://www.midcentraldhb.govt.nz/ Palmerston North City, Manawatu District, Horowhenua District, Otaki 166,000
Nelson Marlborough NMDHB http://www.nmdhb.govt.nz/ Nelson City, Tasman District, Marlborough District 136,800
Northland NDHB http://www.northlanddhb.org.nz/ Far North District, Whangarei District, Kaipara District 155,800
South Canterbury SCDHB http://www.scdhb.health.nz/ Timaru District, Waimate District 55,600
Southern Southern DHB http://www.southerndhb.govt.nz/ Dunedin City, Waitaki District, Central Otago District, Queenstown Lakes District, Clutha District, Invercargill City, Gore District, Southland District 300,400
Tairawhiti http://www.tdh.org.nz/ Gisborne District 46,200
Taranaki TDHB http://www.tdhb.org.nz/ New Plymouth District, Stratford District, South Taranaki District 108,300
Waikato Waikato DHB http://www.waikatodhb.health.nz/ Hamilton City, Waikato District, Matamata Piako District, Thames Coromandel District, Hauraki District, Waipa District, South Waikato District, Otorohanga District, Waitomo District, Ruapehu District north of the Makatote Viaduct 365,700
Wairarapa Wairarapa DHB http://www.wairarapa.dhb.org.nz/ Masterton District, Carterton District, South Wairarapa District 39,900
Waitemata Waitemata DHB http://www.waitematadhb.govt.nz/ North Shore City, Waitakere City, Rodney District 528,500
West Coast WCDHB http://www.westcoastdhb.org.nz/ Buller District, Grey District, Westland District 32,600
Whanganui WDHB http://www.wdhb.org.nz/ Wanganui District, Rangitikei District, Ruapehu District south of the Makatote Viaduct 63,200

References[edit]

  1. ^ District health boards from Ministry of Health, last updated January 2005
  2. ^ Ryall, Tony. "New Southern DHB roles announced".
  3. ^ DHB Funding and Performance from Ministry of Health.
  4. ^ DHB Elections from Ministry of Health, last updated 21 January 2005
  5. ^ "Ambulance Communications Centres Today". NZ Government 111 website. Retrieved 2009-02-20. 
  6. ^ "Subnational population estimates at 30 June 2009: local government areas". Statistics New Zealand. Retrieved 2010-08-22. . Population based on Statistics New Zealand population projections in September 2007.

External links[edit]