A paper considered in secret by Otago and Southland district health boards in October recommended the boards begin joint meetings before the outcome of consultation on a possible merger.
Records of the two boards' private discussions about the possible merger, released to the Otago Daily Times under the Official Information Act, show that Southland members, while reaching consensus about consultation, stated they did not believe the boards should meet jointly in the interim as this would be pre-determining the outcome of the consultation process.
The minutes of the Otago board's private session are confined to recording the decision made on supporting the consultation and do not include any discussion of the joint meeting idea.
Both boards voted to consult the community and staff about a single Otago-Southland district health board, but Southland's decision made it subject to the boards not meeting jointly for their monthly meetings before the completion of the consultation process.
Public consultation meetings are being held around the provinces this month with submissions closing on December 11, and the boards making a decision on their futures at their February meetings.
Staff consultation is also taking place.
The management paper considered by the boards, "Proposal to consult on one DHB across the Otago Southland region," suggested that "concurrent with the consultation, the boards could agree to meet together" as three of their other committees already did.
Commencing joint meetings would "demonstrate the proactive approach for change while assisting the current structures to reduce duplication and costs", the report said.
At such meetings, the boards would still have been separate legal entities as are those committees which already share membership.
The report noted that a one board approach would avoid increasing bureaucracy associated with cost sharing and accounting functions of the two boards.
It was estimated that the full cost of a board meeting, including time and report preparation, was $46,000, with committee meetings averaging about $11,000.
Having one hospital advisory committee could present some initial challenges until the regional services plan was further introduced, but one committee was likely to be able to drive this strategy, the report said.
Under a section on potential financial benefits, the report breaks down the estimated $531,000 direct savings envisaged annually.
The report stated that under one board structure it was likely "management layers can be simplified".
This might be needed to support the expectation of a reducing cap on management and administration staff.
The report also suggested moving the advisory committees to six-weekly meetings rather than monthly to lower costs and workload.
On organisational culture, the report said the lack of a clearly-stated joint governance vision was resulting in confusion and frequent misunderstandings for staff.
The Southland board minutes of the discussion show that members saw a need for a system that ensured fair representation across the combined region.
Chief executive Brian Rousseau is recorded as advising that board members were not representatives of the people, "but are directly accountable to the Minister of Health".
If the boards decide in February to proceed with a merger, a boundary change will be sought from the Minister of Health, and the two boards will meet jointly until the local body elections in October when a new Otago-Southland board will be elected.
