Ban on DHB members making political comment may prevent criticism of health reforms

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Canterbury District Health Board's executive team fell apart last year, with seven of the 11-strong team resigning as the board faced budget challenges and potential cuts. (Video first published August 20, 2020)

A new code of conduct banning health board members from making “political comment” may have been timed to dull criticism of imminent changes to the health system, an expert says.

The code of conduct for board members of Crown enterprises was published on the State Services Commission website on March 18 and came into force on Monday.

Responsibilities in the code included acting in a “politically impartial manner” both as a board member and in a private capacity.

New Zealand's health system is in line for a massive shake-up – but there are concerns that health board members are being gagged from making any criticisms.
Christel Yardley/Stuff
New Zealand's health system is in line for a massive shake-up – but there are concerns that health board members are being gagged from making any criticisms.

Members must also consult with the board chair on any “proposal to make political comment or to undertake any significant political activity”.

But Public Service Commissioner Peter Hughes said it was “totally and utterly untrue” to suggest the new code of conduct was linked to any government announcement.

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Each district health board (DHB) has up to 11 members, with up to four appointed by the Minister of Health and the rest elected in three-yearly local body elections.

The code notes elected members have “a relationship with their constituency in addition to their accountability to the responsible minister”.

“Elected board members must consider how to maintain that relationship while, as for all members, ensuring their actions do not jeopardise the effective governance of the entity.”

Minister of Health Andrew Little has announced a radical overhaul of the health sector
ROBERT KITCHIN/Stuff
Minister of Health Andrew Little has announced a radical overhaul of the health sector

On Wednesday, Health Minister Andrew Little will announce far-reaching reform of the health system in response to a review completed in March 2020.

The review, by a team of experts led by health economist Heather Simpson, recommended culling the country’s 20 DHBs by about half.

Otago University professor Robin Gauld​ said the code confirmed long-held expectations of members under the Health and Disability Act, but may have been timed to reinforce their responsibility was “first and foremost to the government”.

“With the announcement coming on Wednesday it might be that they are seeking to get people understanding that it’s their job to just put their head down, listen and respond collectively in a way the government won’t see as being embarrassing.”

Professor Robin Gauld, co-director of the University of Otago’s Centre for Health Systems and Technology, says the national airline’s expertise in developing a world-leading app for air travel services could be put to good use in the health sector, where Covid-19 accentuates the need for better technology systems.
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Professor Robin Gauld, co-director of the University of Otago’s Centre for Health Systems and Technology, says the national airline’s expertise in developing a world-leading app for air travel services could be put to good use in the health sector, where Covid-19 accentuates the need for better technology systems.

Gauld said DHB members had been expected to act in unison and in line with the government for many years, despite a majority being elected to their positions.

“I think a lot of members when they actually get elected and are inducted by the Ministry of Health are surprised that they are not there to represent the public, they are there to implement government policy.”

Gauld said he believed DHBs should have been abolished a long time ago.

“Many people are very good, some are very competent, very knowledgeable but it’s a model that doesn’t work, so let’s see what happens on Wednesday.

“They may serve notice they are going to disestablish the current board arrangements.”

A Canterbury DHB member – who did not want to be named – said the CDHB, under former chairman John Wood, developed its own code of conduct in 2018.

That code said members had the right to “freely and publicly express a personal view on any aspects of government or public policy without interference”.

He believed the new code was “definitely” a gagging order on members, which denied them personal rights to express opinions under the New Zealand Bill of Rights.

Hughes​ said the commission had been working on the development of the code with 80 Crown entity boards for “some time”, and most recently before Christmas.

“It has nothing new that board members were not already required to uphold under applicable laws or existing expectations.

“The code is issued under my authority independently of government, as the law requires.

Hughes said the code “recognises that some board members are elected and their particular situation is provided for in the code”.