Research Paper Role of District Health Board and Local Government

Abstract

Local government today is a multi faceted organisation and is responsible for the administration of many local matters with the aim of improving the community well being. Local government has long been recognised in New Zealand as the proper and competent institution to look after the infrastructure and needs of its communities. This was evident from successive governmental support for retaining local authorities as the preferred organisations to oversee local amenities, including local environmental health and safety. The provision and funding of health and disability services is the responsibility of the District Health Boards (DHB). In recent times the DHBs’ ability to provide health care and the management of funding for health care services has increasingly come into question from various quarters, including politicians, clinicians and health care recipients. The debate ranges from the lack of effective coordination within the primary health care organisations to the complexity of the DHB administration. This paper promotes the case for local authorities to take over the provision of the health and disability services currently undertaken by the local DHBs. The support for this is that local authorities already have the necessary infrastructure and administrative experience to deal with the current DHBs’ roles and functions and there are no significant statutory impediments against the proposal. The idea may be against the traditional historical philosophy that the provision of health services should be the responsibility of the central government. There are examples where local authorities have successfully provided health care services on behalf of central governments. They include the Australian Government’s Public Health Outcome Agreements with the States and Territories and the implementation of a universal health care scheme by the American State of Massachusetts. The issue remains whether any political party is brave enough to implement this new idea.