DHB Governance Debate Around Fit for Purpose
Date: 6 December 2012
DHB Governance Debate
Around Fit for Purpose
The extent to which District Health Board governance was ‘fit for purpose’ was robustly debated in an evening meeting of the NZ Institute of Health Management this week in Auckland (3 December).
Attended by some 40 health managers, the audience included the Minister of Health Honourable Tony Ryall, the Associate Minister of Health Honourable Jo Goodhew and MP Dr Paul Hutchison.
In a session chaired by Stuart Francis, chairman of Francis Group International, Dr Lee Mathias, Deputy Chair of the Auckland District Health Board, Dr Tim Tenbensel of the University of Auckland and Graeme Milne, chair of the Waikato District Health Board shared their research, experience and opinions.
There was general
agreement on a number of fronts:
• Public interest in transparency is not well served in the current model
• The current model of having a majority of elected board members is a problem
• Only few DHB board members have qualifications to manage billion dollar organisations
• Evolving the model to a majority of appointed members would lift board performance
Dr Mathias’ research in her doctoral thesis pointed strongly to a much reduced number of elected board positions. One of the most important attributes of successful board members is the skill of ‘metaliteracy’ – the ability to assimilate multiple viewpoints as part of a board’s decision making process.
She found far too few DHB directors possessed the necessary skills for the job.
Dr Tenbensel’s research, conducted in collaboration with colleagues from two other New Zealand Universities raise some issues around the value of existing democratic mechanisms. He advocated for more consistent and formal clinical leadership within DHBs and likewise found the skill of ‘versatility’ of juggling different imperatives a critical skill for board members.
Mr Milne, an experienced corporate leader and professional director, plainly stated that the level of performance he has seen in the DHB sector simply would not be tolerated in the commercial sector let alone of billion dollar organisations with thousands of employees. He pointed to the need for boards to act as coaches for managers grappling with strategic issues, the lack of talent and the negative consequences on performance of the current systems for ensuring public transparency over DHBs.
The President of the NZ Institute of Health Management, Jenni Coles, thanked Francis Group for their continued support and facilitation of the meeting. NZIHM has been the professional association for promoting health management in New Zealand since 1946. Francis Group is a leading health performance improvement consultancy in England with practices in New Zealand and Australia.