The case against electing district health boards

Abstract

In this paper, I argue that elections to District Health Boards (DHBs) should be abolished. This argument comprises the first half of the paper. My argument has two broad steps. The first focuses on the elections themselves. It shows that most voters are uninterested in and uninformed about DHB elections. The second step focuses on the powers and limitations of DHBs. It shows that DHBs’ primary function is to implement health policy set by central government, not to implement the wishes of or represent their electors. The combined force of these steps provides a sufficient reason to abolish DHB elections. In short, the lack of public interest and the degree of ministerial oversight means there is no real scope for democracy. Accountability mechanisms should focus on the responsible Minister. The second half of the paper determines what the alternative should be. It canvasses a number of possibilities. I conclude that the best alternative is that DHB Boards should be entirely appointed and that their consultation function should be carried out by a committee of a local authority.