HON ANNETTE KING, MINISTER OF HEALTH
MEMORANDUM TO CABINET SOCIAL POLICY AND HEALTH COMMITTEE
GOVERNANCE OF DISTRICT HEALTH BOARDS: ELECTORAL PROCESS AND RELATED ISSUES
APPENDIX THREE: Definition of DHB constituencies
| DHB DISTRICT |
DHB CONSTITUENCIES |
NO OF MEMBERS |
RESIDENT POPULATION |
ELECTORAL ROLL |
| Northland |
Far North District |
2 |
52,900 |
33,400 |
| Whangarei District |
3 |
66,800 |
46,700 |
| Kaipara District |
1 |
17,400 |
11,600 |
| Waitemata |
North Shore City |
3 |
172,200 |
126,200 |
| Rodney District |
1 |
66,500 |
50,700 |
| Waitakere City |
2 |
17,400 |
105,500 |
| Auckland |
Auckland City (Western Bays, Hobson and Hauraki Gulf Islands Wards) |
2 |
96,200 |
71,700 |
| Auckland City (Avondale Roskill and Balmoral Wards) |
2 |
129,600 |
89,600 |
| Auckland City (Eastern Bays and Penrose Wards) |
2 |
120,000 |
82,000 |
| South Auckland |
Manukau City (Pakuranga and Howick Wards) |
1 |
74,500 |
58,200 |
| Manukau City (Mangere, Papatoetoe and Otara Wards) |
2 |
112,200 |
68,900 |
| Papakura District, Manukau City (Manurewa Ward) |
2 |
129,600 |
61,900 |
| Franklin District, Manukau City (Clevedon Ward) |
1 |
97,100 |
39,800 |
| Waikato |
Waikato District, Hauraki District, Thames Coromandel District, Matamata-Piako District |
2 |
111,000 |
75,700 |
| Hamilton City |
2 |
108,400 |
75,200 |
| Waipa District South Waikato District, Otorohanga District, Waitomo District, Ruapehu District (Ohura, Taumaranui and National Park Wards) |
2 |
93,500 |
58,900 |
| Lakeland |
Taupo District |
2 |
30,700 |
20,200 |
| Rotorua District |
4 |
64,500 |
41,100 |
| Bay of Plenty (Pacific Health) |
Tauranga District |
3 |
77,800 |
61,600 |
| Western Bay of Plenty District |
1 |
35,000 |
26,200 |
| Whakatane District, Kawerau District, Opotiki District |
2 |
50,300 |
30,200 |
| Tairawhiti |
Gisborne District (Gisborne Ward) |
4 |
31,800 |
19,400 |
| Gisborne District (all other Wards) |
2 |
14,000 |
7,600 |
| Taranaki |
New Plymouth District (New Plymouth Ward) |
3 |
46,600 |
33,500 |
| New Plymouth District (all other Wards) |
1 |
21,500 |
14,200 |
| Stratford District, South Taranaki District |
2 |
38,700 |
24,900 |
| Hawkes Bay |
Wairoa District, Hastings District (Kaweka and Tutira Wards) |
1 |
14,300 |
33,500 |
| Napier City, Chatham Islands District |
2 |
54,200 |
14,200 |
| Hastings District (Poukawa and Maraekakaho Wards), Central Hawkes Bay District |
1 |
17,900 |
24,900 |
| Hastings District (all other Wards) |
2 |
57,100 |
24,900 |
| Wanganui |
Wanganui District |
4 |
45,000 |
29,400 |
| Rangitikei District, Ruapehu District (Waiouru and Waimarino Wards) |
2 |
22,800 |
13,600 |
| Manawatu District (Health Central) |
Manawatu District |
1 |
28,100 |
19,100 |
| Palmerston North City |
4 |
73,100 |
49,900 |
| Tararua District, Ruapehu District (Waiouru and Waimarino Wards) |
2 |
19,100 |
12,200 |
| Horowhenua District, Kapiti Coast District (Otaki Ward) |
2 |
37,700 |
25,900 |
| Hutt |
Upper Hutt City |
2 |
36,700 |
25,100 |
| Lower Hutt City (Wainuiomata, Eastern and Northern Wards) |
2 |
48,900 |
30,900 |
| Lower Hutt City (Western, Harbour and Central Wards) |
2 |
46,900 |
33,300 |
| Capital Coast |
Kapiti Coast District (Paraparaumu, Waikanae and Paekakariki-Raumati Wards) |
1 |
31,000 |
25,000 |
| Porirua City |
1 |
46,600 |
29,200 |
| Wellington City (Northern, Onslow and Lambton Wards) |
2 |
77,200 |
60,600 |
| Wellington City (Southern, Eastern and Western Wards) |
2 |
80,400 |
58,600 |
| Wairarapa |
Masterton District |
4 |
22,700 |
15,900 |
| Carterton District |
1 |
6,800 |
5,000 |
| South Wairarapa District |
1 |
8,900 |
6,300 |
| Nelson Marlborough |
Tasman District |
2 |
38,000 |
28,000 |
| Nelson City |
2 |
40,200 |
29,500 |
| Marlborough District |
2 |
38,400 |
28,500 |
| West Coast |
Buller District |
2 |
10,500 |
7,000 |
| Westland District, Grey District |
4 |
22,000 |
15,700 |
| Canterbury (Canterbury Health, Healthlink South) |
Kaikoura District, Hurunui District, Waimakariri District |
1 |
45,300 |
35,000 |
| Christchurch City (Papanui, Waimairi, Burwood, Fendalton, Shirley and Pegasus Wards ) |
2 |
154,300 |
111,200 |
| Christchurch City (all other Wards) |
2 |
154,700 |
112,400 |
| Banks Peninsula District, Selwyn District, Ashburton District |
1 |
57,500 |
43,500 |
| South Canterbury |
Timaru District (Timaru Ward) |
3 |
29,800 |
21,700 |
| Timaru District (all other Wards), Mackenzie District |
2 |
16,900 |
12,200 |
| Waimate District |
1 |
7,600 |
5,500 |
| Otago |
Waitaki District |
1 |
21,600 |
15,300 |
| Queenstown-Lakes District (Wanaka Ward), Central Otago District, Clutha District |
1 |
36,600 |
26,000 |
| Dunedin City |
4 |
118,100 |
82,900 |
| Queenstown-Lakes District (Wakatipu, Arrowtown and Queenstown Wards), Southland District (Te Anau, Tuatapere, Five Rivers and Waikaia Wards) |
Waitaki District |
1 |
19,300 |
12,700 |
| Southland District (all other Wards) |
1 |
22,000 |
14,600 |
| Gore District |
1 |
13,300 |
8,900 |
| Invercargill City |
3 |
53,200 |
36,000 |
REGULATORY IMPACT STATEMENT
Objective
- The policy objectives are:
- to ensure sound governance of DHBs commensurate with their roles and responsibilities through processes such as an appropriate remuneration framework, management of conflicts of interest and options for appeal by members dismissed from a board
- to provide a robust framework for the establishment of DHBs.
Statement of the problem and the need for action
Previous advice has proposed that DHB Boards are established with a combination of elected and appointed members. The current paper advises on a process for the election of members and a number of issues related to effective board function.
Given decisions taken to date, it is necessary to set out a process for the election of members to DHB Boards and to ensure that processes are put in place to support the governance function of DHBs.
Feasible options to achieve the desired objectives
Non-regulatory measures
- Non regulatory measures are not applicable.
Regulatory measures
- It is proposed that legislation provide for the governance arrangements for DHBs, and in particular the detail of the composition (including the election of members) and function of the Boards. The proposed arrangements will be included in the New Zealand Public Health and Disability Bill.
Statement of the net benefit of this proposal
Benefits
- The proposals in this paper will allow for the establishment of DHB Boards and will facilitate the effective functioning of the Boards. In particular, it is advocated that, in order to mitigate the risk of factionalising boards, DHB Board members should be elected at-large as opposed to from a constituency within a DHB District.
Costs
- Not having members elected from constituencies within DHB districts will mean that the Minister of Health may need to use the appointments process to ensure rural representation on DHB Boards. However, the Minister will have five members to appoint which provides a degree of flexibility.
Consultation
- The following agencies were consulted: Health Funding Authority, Crown Company Monitoring Advisory Unit, Department of Prime Minister and Cabinet, The Treasury, Te Puni Kökiri, the State Services Commission, and the Department of Internal Affairs.
AT THE MEETING ON 12 JUNE 2000, FOLLOWING REFERENCE FROM THE CABINET SOCIAL POLICY AND HEALTH COMMITTEE, CABINET:
CAB (00) 19/14
GOVERNANCE OF DISTRICT HEALTH BOARDS: ELECTORAL PROCESS AND RELATED ISSUES
NUMBER OF BOARD MEMBERS
- noted that on 3 April 2000 Cabinet agreed in principle that District Health Boards (DHBs) be established with a maximum of nine members, the majority of whom will be elected, and that further work needed to be done on the number of members [CAB (00) M 11/1A(3) refers];
- agreed that all DHB boards be established with seven elected members and up to four members appointed by the Minister of Health, making a maximum of eleven members;
- noted that further work on the equitable representation of Maori on DHB boards will have an impact on the number and type of Maori board members;
MECHANISMS FOR ESTABLISHING A QUORUM
- agreed that a quorum be established at half the number of members of the board (irrespective of any extraordinary vacancies) where that number is even, and a majority of the members where it is odd (i.e. five out of nine or six out of eleven members);
- noted that in determining their meeting procedures DHB boards may choose to establish a 'default quorum' mechanism (i.e. where, following failure of a quorum to be reached, a replacement meeting of the Board could be automatically notified to all members);
REMUNERATION OF BOARD MEMBERS
- agreed that DHB board members be remunerated according to the Cabinet fees framework;
OPTIONS FOR APPEAL BY MEMBERS DISMISSED FROM A BOARD
- noted that the reasons for dismissal of elected members will be included in legislation;
- noted that officials do not consider it necessary for the Minister of Health to be required to Gazette the dismissal of elected members;
- noted that dismissed members will have recourse to the Ombudsman and/or judicial review if they consider they have been dismissed without just cause and can make such a case;
- agreed that establishing an appeal authority for elected members who are dismissed from DHB boards is not necessary;
CONFLICTS OF INTEREST AND ELECTION/APPOINTMENT OF DHB EMPLOYEES
- noted that on 3 April 2000 Cabinet agreed that a member of a board should not vote on, or take part in the discussion of any matter, at any meeting, in which they have, directly or indirectly, any conflict of interest [CAB (00) M 11/1A(3) refers];
- noted that employees of the Ministry of Health are required to comply with the Public Service Code of Conduct and they may therefore be required to resign their employment if they achieve DHB board membership;
- directed officials to undertake further work to define conflicts of interest in the context of DHB membership and report back to the Cabinet Social Policy and Health Committee as soon as possible;
MEDIA ACCESS TO OPEN BOARD MEETINGS
- noted that the sections of the Local Government Official Information and Meetings Act 1987 which refer to open meetings will be used in the DHB legislation;
- noted that, in having open board meetings, there is no distinction between the news media and the public, and that any restrictions on media attendance at board meetings are the same as those on members of the public;
- noted that there are a number of grounds on which a board may exclude the public from meetings;
- noted that boards may hold workshops without the public being present, but no resolutions may be made in such sessions;
ELECTORAL PROCESSES
- noted that on 3 April 2000 Cabinet agreed that DHB elections will be held triennially and concurrently with local body elections [CAB (00) M 11/1A(3) refers];
- agreed that the provisions of the Local Elections and Polls Act 1976 should apply to DHB elections so far as they are applicable and consistent with other Cabinet decisions about DHB elections;
- noted that the proposed electoral process requires the appointment of a DHB supervising returning officer, which may be a role assigned to a local authority returning officer;
- agreed that, in the case of an extraordinary vacancy (of either elected or appointed members), the Minister of Health can decide either to appoint additional members to boards or to allow the position to remain vacant;
- agreed that there be no provision in legislation for DHB by-elections;
- agreed that the electoral provisions in the health sector legislation be contained in a schedule to the Act that can be amended by Order in Council, so that timely amendments can be made, if necessary, following the enactment of local government electoral legislation;
DHB BOUNDARIES
- agreed that DHB boundaries be included in a schedule to the New Zealand Public Health and Disability Services Act with provision for them to be amended by Order in Council;
- noted that draft DHB boundaries have been proposed (see Appendices One and Two attached to the submission under CAB (00) 321) which are aggregations of territorial authority areas, with only three territorial authority areas being divided according to local authority wards;
- noted that individual DHBs will vary considerably in population size;
| aa. |
directed the Ministry of Health to undertake discussions with the relevant Hospital and Health Services (HHS) boards, local authorities and iwi on the draft boundaries; |
| bb. |
noted that submissions on draft boundaries will also be received by the Select Committee as part of the broader consultation process on health sector change legislation; |
DHB CONSTITUENCIES
| cc. |
noted the advice in the paper under CAB (00) 321 that having DHB districts divided into constituencies for voting purposes may result in boards becoming factionalised and operating in a manner which is inconsistent with the overarching intent that DHB boards assume collective responsibility to the Minister of Health for the health services and disability support needs of the total DHB population; |
| dd. |
noted Cabinet's initial preference for a constituency system for the DHB electoral process which may include either single or multiple member constituencies, and, where there are multiple member constituencies, the Single Transferable Vote system would apply; |
| ee. |
directed the Ministry of Health to liaise with both the Department of Internal Affairs (Local Government) and Ministry of Agriculture and Forestry (Rural Affairs) officials and provide advice as soon as possible to the Cabinet Social Policy and Health Committee on the voting systems for DHBs described in paragraph (dd) above and on associated issues of implementation, including time and costs. |
