ACCOUNTABILITY FRAMEWORK

1. agreed that the Government's goals for the Public Sector and the Government's health and disability strategies will provide the strategic context for the development of each District Health Board's (DHB) accountability documents, and that the DHB accountability documents will give effect to these strategies;

   agreed that the Minister of Health provide annual planning information, including funding levels and specific performance expectations, to guide the development of each DHB's accountability documentation;

   agreed that the following DHB planning and reporting documents be provided for in the enabling legislation:

   Planning

   a Strategic Plan, developed in consultation with the community to be endorsed by the Minister of Health;

   an Annual Plan to be agreed with the Minister of Health incorporating an annual funding schedule and their Statement of Intent as a schedule (in accordance with the requirements of the Public Finance Act);

   Reporting

   regular performance reports, including monthly financial and quarterly performance reports against their Annual Plan, to the Minister of Health;

   an Annual Report including audited financial statements to be tabled in Parliament;

   agreed that the Annual Plan (incorporating all schedules) will detail the Funding Agreement between the Board of the DHB and the Minister of Health, and will be the formal negotiated DHB/Crown accountability document;

   noted that where there are inconsistencies between a DHB's Strategic Plan and Annual Plan, the Minister of Health will require the DHB to ensure that its Strategic Plan, and the Annual Plan formed in line with it, are consistent;

   agreed that the enabling legislation will require each DHB to develop its accountability documents in the form, and within the timeframe, determined by the Minister of Health;

   agreed that the Ministerial power of direction, to be set out in the enabling legislation [CAB (00) M 11/1A(3) refers], will allow for the Minister of Health to use the power to direct on matters related to the development and provision of DHB accountability documents, including to direct the Board to include certain matters in its Annual Plan;

   agreed that all formal planning and reporting documents, including financial statements, will clearly and separately detail each of the dimensions of DHB performance: funding of health and disability services, governance and operational management of the DHB and the governance and management of Crown owned hospital and associated health services;

   agreed in principle, subject to the report-back referred to in paragraph 1 (vii) below, that, supporting the Government's desire for greater transparency and availability of information, DHB planning and performance documents will be publicly available; agreed that to facilitate benchmarking, all Boards will be required to use nationally consistent accounting standards for payments, data standards for recording service provision, and standards for ownership issues, all of which will be covered through legislative, regulatory or other accountability mechanisms;

   noted that the accountability and performance management framework set out in the paper attached to CAB (00) 233 will address the risks to Maori on which Cabinet sought advice [CAB (00) M 11/1A(4) refers];

   FURTHER WORK AND REPORT BACKS

   directed officials to report back to the Ad Hoc Ministerial Committee with advice on:

   1. development of the regulatory framework and mechanisms for establishing operational policy requirements for DHBs, by 31 August 2000;
   2. development of a consultation framework for DHBs, by 31 August 2000;
   3. the role of the Minister of Finance in respect of DHBs, including provisions to be made in the enabling legislation, by 8 May 2000;
   4. the proposed content requirements of the DHB Strategic and Annual Plans, and the mechanisms by which these are communicated to DHBs, by 30 November 2000;
   5. detailed developmental framework for DHBs setting out the criteria for DHB progression between five different modes of autonomy, and associated rewards, by 30 November 2000;
   6. development of specific rewards and sanctions for application by the Ministers, and the criteria for their application - report back for those to be incorporated into legislation by 8 May 2000, and on the complete framework by 31 August 2000;
   7. development of a monitoring framework for DHBs by 30 November 2000;
   8. development of a proposed framework for DHB benchmarking by 30 November 2000;
   9. accountability arrangements for DHBs during the transitional phase of establishment by 31 August 2000;
   10. ccountability arrangements related to the Ministry's funding role by 8 May 2000;

agreed that the enabling legislation will provide for a regulation-making power to be established to cover such matters as the financial operating environment, nationwide service coverage and nationwide standards;

agreed that DHBs be added to the fourth, fifth, sixth and seventh schedules of the Public Finance Act 1989;

agreed that the provisions of section 26 of the Health and Disability Services Act 1993, allowing the Minister of Finance to request financial forecasts and financial information, be included in the new legislation;

agreed that the provisions of section 26 of the Health and Disability Services Act 1993, as referred to in paragraph (o) above, be extended to include broad powers for the Minister of Health to request information (that does not compromise patient confidentiality) in relation to any DHB aspect of the DHB's performance;

OTHER MATTERS

agreed to a review of the DHB accountability arrangements two years following implementation, that is, in 2003.

Hon Annette King
Minister of Health