EXECUTIVE SUMMARY

2. Cabinet agreed [CAB (00) M 2/4 refers] to establish DHBs and that, working within allocated resources, their fundamental objectives will be to improve, promote, and protect the health of a defined population and to promote the independence of people with disabilities within a defined population.

3. Cabinet requested a report back by 30 June 2000 on the process for establishment of DHBs.

4. There is a significant work programme associated with the process of DHB establishment. Attachment One provides an overview of the programme. There is also considerable continuing input from Cabinet and/or Ministers in the policy design, the operating environment, the establishment of criteria which will be used to assess DHB readiness to take on the roles assigned to it and the approval of DHB plans.

5. A key element of DHB establishment will be the Transition Plans which will be completed by HHS Boards by 1 September. As requested by Cabinet, the Ministry of Health will provide advice to Ministers of Health and Finance by 30 November on "the advantages and disadvantages of the DHB transition plans as well as the specific health and disability services funding responsibilities that might be undertaken by collaborative DHB arrangements, and which by the Ministry of Health". The report will also include how planning and/or funding for all other health and disability services will be devolved to DHBs following their establishment. This advice will be based on a paper currently being prepared for Cabinet (for consideration on 3 July) on rules for devolution of services to DHBs.

6. To ensure that there is strong direction and oversight of the process of DHB establishment, and good engagement of central agencies, the Ministry of Health has established a District Health Board Establishment Support Unit (the Unit) within the Performance Management Branch of the Ministry. This is an interagency team with senior staff seconded from the Ministry, HFA and Crown Health Association at this stage. There is also a liaison person participating in the process from each of key central agencies.

7. The brief of the unit includes:
   1. ensuring HHS Boards have appropriate processes in place to manage establishment of DHBs

   2. supporting the development of DHB Transition Plans due on 1 September 2000

   3. assessing DHB Transition Plans and advising Ministers

   4. ensuring that all tasks for DHB organisational establishment are identified and carried out i.e. a co-ordinating and facilitating role

   5. identification and engagement of stakeholders

   6. communicating operational policy design related to DHB establishment

   7. HHS and DHB director appointments and induction

8. The key areas of DHB establishment currently being undertaken in the sector include:
   1. Board appointments and induction

   2. Development by HHS Boards of their Transition Plans for DHB establishment

   3. Development of operational policy

9. The DHB establishment process is part of a larger health sector change process which includes a number of other elements. Whilst this paper does not address the other change processes, these changes are strongly linked in with the DHB establishment process which are also being led by the Ministry of Health in line with decisions made by Cabinet and Ministers.

10. This report recommends that the Cabinet Social Policy and Health Committee be provided with a six weekly update report on DHB establishment. This will include progress and risks and will also identify any issues that need to be resolved.

BACKGROUND

11. Cabinet agreed [CAB (00) M 2/4 to establish DHBs and that, working within allocated resources, their fundamental objectives will be to improve, promote, and protect the health of a defined population and to promote the independence of people with disabilities within a defined population.

12. Officials were required to report back by 30 June 2000 on the process for establishment of DHBs.

13. This paper outlines:
    1. management and oversight of the process of DHB establishment

    2. the timeframe for DHB establishment

    3. the tasks and processes to be completed

    4. risk management

    5. further report backs on DHB establishment

14. The DHB establishment process is part of a larger health sector change process which also includes:
    1. development of a New Zealand Health Strategy and New Zealand Disability Strategy

    2. HFA disestablishment

    3. changes to the Ministry of Health

    4. changes to the organisational arrangements for other agencies such as PHARMAC, NZ Blood Service etc.

15. This paper does not address the other change processes, but they are strongly linked in with the DHB establishment process and are also being led by the Ministry of Health in line with decisions made by Cabinet and Ministers.

16. There is a significant work programme associated with the process of DHB establishment (see attached chart for an overview of this programme). There is also considerable continuing input from Cabinet and/or Ministers in the policy design, the operating environment, the establishment of criteria which will be used to assess DHB readiness to take on the roles assigned to it and the approval of DHB plans.

17. It should be noted that the timeframe for establishment of DHBs is very much dependent on timing of the new legislation. This paper assumes that the legislation will be passed in November.