From the Minister's Desk

Devolving Funding to DHBs

Indicative Timetable for Transition

Select Committee Submissions

One of the main objectives of the changes to the public health and disability sector is to involve communities much more in decision making on their local health and disability services. The establishment of District Health Boards (DHBs) is a major step towards this.

The DHBs will be responsible for the health and independence of their populations, and will be expected to take a population health focus, prevent disease, close the gaps in health outcomes, promote collaboration in the sector and ensure community voice and leadership.

Over time, planning and funding responsibilities for health and disability support services will be devolved to DHBs. There is an indicative timetable, but devolution will not be automatic. DHBs must be able to demonstrate they have the required level of competency ahead of the timetable.

This issue of Health Moves looks at the rules and timetable for devolving funding to DHBs as detailed in a recently released Cabinet paper entitled Rules for Devolving Funding to District Health Boards. The paper can be found on my web site: www.executive.govt.nz/minister/king

The New Zealand Public Health and Disability Bill will soon begin its passage through Parliament. An important part of that process will almost certainly be a call from the Health Select Committee for submissions on the Bill. You can find more details on that process in this issue of Health Moves.

Hon Annette King
Minister of Health

Responsibility for funding and planning most health and disability support services will be devolved to DHBs once they have met a detailed set of criteria. The first assessment will occur in November, on the basis of the establishment plans that I have asked the current HHS boards to prepare.

The criteria will help Ministers determine whether or not DHBs are ready to take on responsibility for planning, funding and managing particular health and disability support services, such as primary health care, public health, Mäori health and Pacific health services. A number of services will continue to be funded nationally by the Ministry. (A comprehensive list of criteria is included in the Cabinet paper which is on the Minister's web site.)

The transfer of funding responsibilities first from the HFA to the Ministry of Health, and then to DHBs will be planned, staged and managed. The Ministry of Health's DHB Establishment Support Unit will work closely with DHBs during the transition to co-ordinate the implementation of the new arrangements.

Ministers will have final sign-off before funding and planning responsibilities are devolved to individual DHBs. Some funding responsibilities will not be devolved whilst others may be devolved ahead of the suggested timeframe if DHBs can demonstrate that they have the infrastructure, processes, people and relationships in place to meet the criteria. This may well be the case, for example, for DHBs that have well-developed relationships with local Pacific communities and health service providers.

The intention is that from 1 July 2001, and subject to having met the specific requirements, the DHBs will take over responsibility for funding a baseline set of local personal and mental health services. These would be primary/community-based services and secondary health services that are mainly delivered within their own districts and for their own populations.

The exact list of baseline services will be determined over the next few months, as a result of further work occurring as part of the establishment planning process by the HFA, the HHSs and the DHB Establishment Support Unit.

Responsibility for the funding and planning of services that carry significant quality, health or financial risks, or rely on scarce planning and funding expertise is not expected to be devolved to DHBs until July 2002.

Indicative date	DHBs planning and funding responsibilities	Comment
to 30 June 2001	None (but provision of hospital and related health services)	Transitional stage
July 2001	Local personal health services (primary and secondary care)· Local mental health services· Local Mäori health services	These 'baseline' services present no extraordinary risks· Scope to bring forward devolution dates for other services if requirements met
July 2002	DSS, public health, Pacific health services· Regional and national personal and mental health services Tertiary services	Opportunity to monitor performance on baseline services Time to set up collaborative arrangements, frameworks and protocols· Some services identified by Government will remain in the Ministry of Health

Select Committee Submissions

As part of its passage through the House of Representatives the New Zealand Public Health and Disability Bill is expected to be referred to the Health Select Committee. The Committee's job is to consider the Bill and to decide what, if any, amendments it wishes to recommend.

As part of its consideration, the Select Committee will almost certainly call for written submissions from the public as well as hearing witnesses who wish to present their submissions in person.

When the Committee is ready to receive submissions an advertisement will be placed in the 'Public notices' columns of all major newspapers with details of the deadline for sending in submissions.

Individuals and organisations who have already considered the Bill and wish to comment on it might find it helpful to begin working on their submissions before the Committee's advertisements appear.

More information on this process can be found at:-