Robin Gauld
Waning interest in district health board elections may
reflect a growing awareness DHB members are servants of the
Government rather than the people, says University of Otago
health policy specialist Associate Prof Robin Gauld.
Prof Gauld's article, "Are elected health boards an effective
mechanism for public participation for health service
governance?" is to be published in British journal Health
Expectations.
The article questions how elections had performed in giving
the public a say, and suggests other measures could be needed
to increase participation.
Prof Gauld told the Otago Daily Times DHB elections were
accompanied by less "noise" than the first elections in 2001,
when the public seemed interested in who was standing, and
high-profile candidates' meetings were held.
Voter turnout dropped from 50% in 2001 to 43% in 2007,
compared with 49% in 2007 for district councils.
Prof Gauld said DHB members were in an unusual position
because, unlike local body politicians, they were legally
accountable to the Government, rather than electors.
New members were firmly instructed of their responsibilities
to implement Government policy during training they received
at the beginning of their term, Prof Gauld said.
He believed many candidates did not understand their primary
responsibility would be to the Government rather than the
people.
Many realised they were "ham-strung" after they were elected.
Prof Gauld believed remuneration was a factor in why there
was still a healthy number of candidates. Undoubtedly, some
skilled and articulate people put themselves forward for
DHBs, he said.
The best thing about DHBs had been increased transparency of
local health decision-making through open monthly meetings of
boards and committees.
New Zealand was the only country in the world with a
comprehensive elected health board system surviving a number
of electoral cycles, Prof Gauld said.
Prof Gauld would like to see more training of DHB members in
health best practice, particularly in how overseas health
systems were run.
He expected the Government to place greater emphasis on
financial training for DHB members after October's election.
Prof Gauld said another option for public representation was
to have far fewer elected members, and appoint an advisory
panel of people with experience of the health system, similar
to drug buying agency Pharmac.
Twenty-two people in Otago and Southland have put themselves
forward for seven elected spots on the Southern District
Health Board.
DHB pay
DHB member: $23,000.
DHB chairman: $50,000.
Deputy DHB chairman: $36,000.
Advisory committee chairman: $3125.
Advisory committee member: $2500.
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