Roy Heather: Estimates Debate — In Committee 
Roy Heather: Estimates Debate — In Committee 
[Volume:640;Page:10437] 
HEATHER ROY (Deputy Leader—ACT) 
: 
 It is a great pleasure to stand tonight on behalf of the ACT party to talk of health issues. Unfortunately my slot does not allow me to touch on even a fraction of the real issues that exist in the health sector but I do want to talk about the upcoming elections of district health boards in conjunction with the local body elections in October this year. District health boards of course came into being in about 2001 and were set up with quite impressive cost. They continue to cost this country around $25 million a year once all the contributing factors come into account. 
 Despite the set-up of district health boards and an extra $4.5 billion a year being spent on health in actual fact we are seeing no extra health services—nothing extra contributed to patients requiring health care in this country. In fact when we take into account population growth we have failed not even to tread water but have moved backwards in terms of outcomes in the health sector. 
The district health boards as governance boards do need to shoulder some of the responsibility although I should point out that in many respects they are just the meat in the sandwich. In fact a pertinent point I would like to make is that a cynic might well be tempted to say that district health boards were put in place to put in an extra layer of bureaucracy to separate the Minister of Health and the patient at the bottom of the queue. It is very important that when we have governance boards that take a significant share of the health funding—funding that could be spent for example on people requiring hip operations or knee operations or on children requiring grommets—they do take money out of the equation. 
We need to take into account just what happens with these elections. People put forward their names in good faith to stand for district health boards thinking that they are there to represent the needs of their local populations. People vote for these people who are often pillars of the community and who are well known. The people who do cast their votes sadly not enough of them do so thinking that these people will represent their local needs. That sadly is not the case. At the first meetings of the district health boards those members—those people who think that they are in fact going to contribute to the health needs of their local populations—are told that they are there to implement the health policy of the Minister of Health and the Government of the day. So they are there under a misapprehension having participated in a completely phoney election and I question whether this process should continue at all. 
These governance boards are in fact phoney democratically elected boards. I would contend that they really have no place in our process. Many board members being very frustrated when they realise what their actual function is have tried to speak out and have been stymied. They have been silenced by their chairs and by people further up the chain and that is very regrettable. 
Each board contains seven elected members and four appointees. In many cases although the people who put their names forward and who are elected are well meaning frequently a combined board often does not have all the collective skills necessary to fulfil all the roles expected of it by the Minister and the Ministry of Health. When that happens the appointees are chosen to fill those gaps. But all too often as we have seen of late those people are chosen more for their political affiliation and the favours that they have bestowed upon the Government of the day than they are for the necessary skills that a good governance board brings forward. That again is quite regrettable. 
We have seen any number of examples—not just the most recent example in the Hawke’s Bay that was spoken about in the House today but also a number of other examples—where people have been found to have had quite terrible conflicts of interest and have used those quite inappropriately not to further the needs of their local populations but too often sadly to meet their own needs and feather their own nests. One does have to ask whether the function fulfilled by these governance boards—the elected district health boards—would not be just as well fulfilled by a small and very good well-functioning team.