Health boards questioned
New Zealand's unique system of elected health boards has been found wanting in a just launched book Democratic Governance and Health (Otago University Press).
Professor Robin Gauld: "… a much more restricted number of elected members should be the way forward and those elected members should have a specific objective of representing the public."
The book, co-authored by Professor of Health Policy Robin Gauld (Preventive and Social Medicine) and Assistant Professor Miriam Laugesen, at Columbia University Mailman School of Health, looks back at the history and performance of elected health boards in New Zealand, the only country in the world with such a model across an entire health-care system.
Gauld says the system doesn't necessarily produce boards with the skills to drive complicated organisations with budgets, in some cases, in the realm of billions of dollars.
"They should have a really solid brief and knowledge and understanding of the practice of health-care quality improvement and patient safety which internationally is a number one issue in health-care services."
Currently, four of the 11 members are appointed, providing the government with a way to get the necessary skill mix.
Gauld also questions whether the public are interested, given the low voter turn out, and points out that the boards are there to serve the government first and foremost – the public is a secondary concern.
"We believe a much more restricted number of elected members should be the way forward and those elected members should have a specific objective of representing the public. Their job would be to act as a conduit for members of the public wanting to have issues voiced at the board table."