Building a Healthy New Zealand

Size: px

Start display at page:

Download "Building a Healthy New Zealand"

Logan Perkins
5 years ago
Views:

1 Building a Healthy New Zealand Becoming a DHB board member Released August

2 Citation: Ministry of Health Building a Healthy New Zealand: Becoming a DHB board member. Wellington: Ministry of Health. Published in August 2013 by the Ministry of Health PO Box 5013, Wellington 6145, New Zealand ISBN (print) ISBN (online) HP 5691 This document is available at

3 Our district health boards The country s 20 district health boards (DHBs) are large organisations. They have a combined budget of over $11 billion, representing 75 percent of the government s total health budget. Combined, they employ nearly 60,000 full-time equivalent staff. They account for most of the day-to-day business of the health system. Their basic function is to plan, manage, provide and purchase health services for their communities so that New Zealanders have access to quality services when and where they need them. DHBs own and run our public hospitals, but their reach extends even further. GP visits, disability services, pharmacy prescriptions, laboratory tests and mental health and addiction services all come under the DHBs jurisdiction. DHBs also fund community and residential care and deliver health promotion programmes to improve the overall wellbeing of the communities they serve. In addition, DHBs are required to deliver on specific health targets set each year by the government. The current health targets are: shorter stays in emergency departments; shorter waits for cancer treatment; improved access to elective surgery; increased immunisation; better help for smokers to quit; more heart and diabetes checks. DHBs don t work in isolation. They have to work with service providers, their neighbours and other DHBs in their region together as a national collective to determine the best way to deliver health and disability services to their residents. Building a Healthy New Zealand: Becoming a DHB board member 1

4 DHB districts 2 Building a Healthy New Zealand: Becoming a DHB board member

5 DHB budgets and staff numbers 2012/13 DHB Budgets 2012/13 $ million* Number of staff 2012/13^ Northland Waitemata 1, Auckland 1, Counties Manukau 1, Bay of Plenty Waikato Lakes Tairawhiti Taranaki Hawke s Bay Whanganui MidCentral Hutt Valley Wairarapa Capital & Coast Nelson Marlborough West Coast Canterbury 1, South Canterbury Southern Total 10, ,302 *Devolved funding from the Ministry of Health ^Based on accrued full-time equivalents (FTEs) as at 30 April 2013 Building a Healthy New Zealand: Becoming a DHB board member 3

6 Being a DHB board member DHB boards comprise up to 11 members. Seven are elected every three years, and elections are taking place in Up to a further four are appointed by the Minister of Health. This helps ensure that each board has the kind of skills, perspectives and experience it needs to operate effectively. Like company directors, DHB board members are there to govern the organisation. They set the overall strategic direction for the DHB and monitor its performance. How much time is involved? The amount of time board members are required to spend on DHB business varies from DHB to DHB. In general, board members should be prepared to commit the equivalent of around 30 days a year to board business. This includes time to prepare for each meeting. As well as board meetings, members often serve on the board s committees (eg, the hospital advisory committee or the audit committee). Generally, DHB board members will serve for a three-year term. Appointed members can be reappointed to the board at the end of their term, subject to an upper limit of nine consecutive years service. Will I get paid? Board members are paid an annual fee for their service on the DHB board; the level varies depending on the size and assessed complexity of the DHB. Fees currently range from just over $16,000 to around $26,000 per annum, with the board chair and deputy chair receiving a higher fee. Members are also covered for reasonable expenses associated with board and committee business, such as travel costs. 4 Building a Healthy New Zealand: Becoming a DHB board member

7 Personal experiences People who have served on DHB boards have found it an interesting and challenging experience that has contributed to their personal and professional development. Graeme Milne is an experienced professional director and management consultant. He is Chair of Synlait Milk Ltd and was appointed to chair the Waikato DHB board in May DHBs are large, complex organisations. There aren t too many companies in New Zealand that have an annual turnover of more than a billion. As a board member, you can have an impact on just about every aspect of the health service. This is a sector where there are always new demands, new diagnostics and treatments, changing population dynamics and decisions to be made around investing in prevention versus the need to treat today s waiting lists. It s a job that requires the very best people we can get, and I believe it s a role some of the better directors in the land would find attractive. True, the remuneration is not as high as it is for private sector directors, but this is a chance to put something directly back into the community and really make a difference to people s lives. The rewards that brings are immeasurable. Building a Healthy New Zealand: Becoming a DHB board member 5

8 Sandra Alofivae is a lawyer with the firm KAM Legal Chambers. She was appointed to the Counties Manukau DHB board in December This is my first foray into the health sector and after the first couple of months, the fog lifted and I came to grips with the enormity and complexity of the DHB s business. It felt challenging but not insurmountable. I love the work and really enjoy the breadth and depth of it all. It s exciting when you see strategies adopted that prove successful. It s also rewarding to know that when tough decisions have to be made as a board, we can stand together as a collective and forge a robust way forward. As a board member, you become deliberate in focusing on strategic governance and adopting a helicopter view of all the issues. Asking the right questions is also critical to the success of the organisation, and this challenges management as well as the board to be constantly alert to doing our best for those out there in our communities. Greg Gent, a Northland farmer and experienced director in the dairy industry, has served as a Northland DHB board member since July My role is certainly a very challenging one. Funds are limited, and demand is ever increasing, so ensuring each dollar is spent well is a very high priority. Health also has a complexity to it that I ve found fascinating. The public health system attracts people who are motivated to improve the lot of others, and I have enjoyed being a part of that. This is in sharp contrast to boards that are motivated purely by commercial aspirations. I ve also found the role avoids the public politics often associated with other community-related roles. I believe very strongly that there comes a time in one s life when it is important to give something back. For me, this role is a great vehicle for that. 6 Building a Healthy New Zealand: Becoming a DHB board member

9 David Warburton is Chief Executive of Auckland Transport and a current appointed member of the Whanganui DHB board, first joining in November My involvement in DHBs has concentrated on putting something back into the community. Coming from a commercial background, I can contribute my knowledge of what s required to run a large organisation like a DHB. The health sector gets a huge spend from the public purse, so anything you re able to do to improve the outcome nationally or regionally is cause for satisfaction. There s also the personal satisfaction of contributing to the community s health. No matter what project the board s working on, be it patient safety or faster responses in the emergency department, members are continually trying to raise the bar, and someone benefits every time you do that. Sharon Shea (Ngāti Ranginui, Ngāti Hauā, Ngāti Hine, Ngāti Hako) began her career as a lawyer before moving into the health sector, where she is now a consultant specialising in Māori health and development. She was appointed to the Northland DHB board in December I ve developed some key skills in my time as a DHB member, especially when it comes to financial literacy and strategic planning. I ve also expanded my network of personal friends and professional colleagues. There s the satisfaction of realising the difference you can make by contributing new ideas and strategies that can make a real difference to people s health and result in a high-performing health sector. Being on the DHB board has also given me the opportunity to partner with iwi and Māori organisations to reduce Māori health inequalities. Reducing disparities across all communities and promoting new thinking about partnering with Māori are so important for a better New Zealand in terms of our cultural, social and economic wellbeing. Building a Healthy New Zealand: Becoming a DHB board member 7

10 Gay Shirley, a Hamilton chartered accountant with her own practice and experience as a director and trustee, first joined the Waikato DHB board in September Being a board member is an opportunity to make a contribution to the community, but it s also an opportunity to learn and develop skills. Personally, I ve learnt a great deal from the experience. Everyone has a point of view and a contribution to make. I ve learnt more about what actually happens in our hospitals and the community to support our health services. Overall, I think we can all be pretty proud of, and grateful for, what we ve got. The board doesn t work independently though it s a real team effort to achieve positive results, and the board needs to support its chief executive, senior management and all the clinical and operational staff who keep the health system running effectively. Wendy Lai is a partner in the consulting arm of Deloitte New Zealand, focusing on strategy alignment and operations improvement. She s been a member of the Waitemata DHB board since January A curiosity about health care and our health care system drew me to this role in particular, what makes the system work and what the levers are to drive better patient experiences at improved costs. Commercial acumen is critical, and this can come from a variety of work experiences. A passion for people and their families and communities is also needed and is the moral compass that members need to guide their work. It does take a lot of time to reflect on the information you re getting in order to make sense of it all and get to the heart of the issues, but I ve gained real insights into the roles of governance and management and the responsibility of balancing large public sector budgets. I also have a much better understanding of mental health issues and the needs of our elderly the generosity of our staff and the dignity of our patients and their families is very humbling. 8 Building a Healthy New Zealand: Becoming a DHB board member

11 Jan Dawson is a chartered accountant and former Chair and Chief Executive of KPMG. She is a director of Meridian Energy and was appointed as Deputy Chair of the Counties Manukau DHB board in December Boards need members with a variety of skills and experiences. To really succeed, you need an enquiring mind, good communication skills, positive working relationships with other board members, an understanding of the principles of good governance and a desire to add value to the DHB. I really admire the people who are in the health system dealing with the effects of poor choices or circumstances and trying to change the methods of delivering on health needs so that services will remain affordable in the long term. The learning curve shouldn t be underestimated, but if you think you can make a positive contribution and can commit to the role, then go for it. Tim Ward of Invercargill is a partner in chartered accountancy firm BDO New Zealand. He was first appointed to the Southland DHB board in September 2009 and is now a member of the combined Southern DHB board. Challenging is the word that best describes the experience of being a DHB member. It reflects the diverse nature of health care, the need to ensure equity of access across the community and the need for the DHB to carry out its business in a financially sustainable way. A prospective board member needs to be prepared to make a considerable commitment in time and energy in order to deliver on their governance duties and, because of the range of DHB responsibilities, to be well informed on a diversity of issues. Health is a subject of intense public interest, and people expect accountability from those governing the health sector. In return, there s the satisfaction of being involved in governing a large and complex organisation that helps people live healthier lives and honing skills that are transferrable to other community and business situations. Building a Healthy New Zealand: Becoming a DHB board member 9

12 To find out more Visit the Ministry of Health s website at: This webpage includes more detailed information about the board appointment process, with DHB-specific information provided in the My DHB section. Expressions of interest, with a current CV attached, can be ed directly to: appointments@moh.govt.nz 10 Building a Healthy New Zealand: Becoming a DHB board member

Performance audit report. District health boards: Availability and accessibility of after-hours services

Performance audit report. District health boards: Availability and accessibility of after-hours services Performance audit report District health boards: Availability and accessibility of after-hours services Office of of the the Auditor-General PO PO Box Box 3928, Wellington 6140 Telephone: (04) (04) 917