8. On 9 March 2000 the Ad Hoc Ministerial Committee on Health Sector Change (the Ad Hoc Committee) considered advice on the high level governance structure for DHBs and agreed on a number of key points. Subsequently, Cabinet also directed Officials to undertake further work on the roles, membership and relationships of the DHB Committees [CAB(00)M11/1A(3) refers]. This paper presents the results of that work.

DHB COMMITTEES

9. DHB Boards will have the overall responsibility for working within allocated resources to achieve positive health and disability outcomes for a defined population and will provide the strategic direction to ensure that these gains are made. The Board will appoint a Chief Executive who will be responsible for the management of all the DHB's functions including the delivery of services by publicly owned hospitals.

10. Within this framework, Cabinet has agreed that DHBs will be required to form, as a minimum, a Hospital Governance Committee and a Primary Care Advisory Committee [refer CAB(00)M2/4]. The requirement to form these committees and the ability to form other committees (if desired by DHBs) will need to be reflected in legislation.

    Purpose of DHB Committees

11. Officials understand that there are three reasons for establishing the committees:
    1. to facilitate the Board in undertaking its business and providing 'head room' for it to focus on its governance responsibility as opposed to management of service delivery (and in particular, the day-to-day management of the hospital). This also recognises that the Boards' new role is complex, challenging and new
    2. to ensure that there are internal mechanisms within the DHB structure to minimise the risk that either of the 'interests' in the DHB (in particular the management of the hospital) predominates over its over-riding responsibility for improving the health of its population (which will include agreements with a wide range of providers not necessarily owned by the DHB); and
    3. to recognise the distinct ownership and purchase interests the Government has within the DHB.

12. Subsequently, the Minster of Health has clarified that there will be only one acceptable model for senior-level management within DHBs "this model provides for a single Chief Executive for each DHB and Primary Health and Hospital Governance sub-committees as a minimum (as is set out in Labour Party policy). The Chief Executive will be responsible for the management of all of the DHB's functions, including delivery of services by publicly owned hospitals" DHBs will, however, be free to develop their own structures for management below the Chief Executive level.

13. The Ministers' letter is designed to ensure that Officials do not provide advice beyond a managerial separation between the hospital and the rest of the operations of the DHB. The letter does not seek to clarify the purpose and options for the two DHB committees.

14. This paper clarifies the purposes of the committees and their relationship with the DHB Board and Chief Executive within the broad structural parameters defined by the Minister.