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Having your say in health and disability: New Zealand communities can have a direct say ...

Why consult: Informed consultation assists DHBs, health service providers, and the public to ...

Plans: Each of the 21 DHBs is required to enter into a funding arrangement ...

"Start here" list of priorities: Given the large amount to do in the health sector, the Minister of Health ...

Understanding consultation: Consultation must take place with the...




Having your say in health and disability

New Zealand communities can have a direct say in the type and mix of health and disability services provided in their local area.
District Health Boards (DHBs) are designed to let communities be heard in decision-making, in line with a philosophy of increasing the community’s voice and access. This makes DHBs an important mechanism for achieving health gains for the entire community.

DHBs’ responsibilities

In 2001 21 DHBs were established in New Zealand. The New Zealand Public Health and Disability Act 2000 sets out their objectives and functions. Board members are either elected by popular vote or appointed by the Minister of Health. Both elected and appointed members have the same responsibilities.

The board’s role is governance, not management. This means that it sets strategies and monitors achievement and performance.

In performing this role, the boards have specific consultation requirements under legislation. They need to give the people in their local communities an opportunity to be heard and have their views considered.
One of the major consultative mechanisms between the public and the board is advisory and consultative committees.

Statutory consultative committees include, among others, disability support advisory, hospital advisory, and community and public health advisory committees. DHBs must have Māori representation on their committees, and this representation have been developed in partnership with local iwi and Māori communities.

Board members and members of the public are appointed by DHBs to serve on the Board’s statutory committees. The committee meetings are all open to the public and agendae and meeting minutes are available.

Disability support

The disability support and advisory committee provides advice to promote ‘the inclusion and participation in society, and maximise the independence of people with disabilities within the DHB’s resident population’. The advice must promote these aims in the kinds of disability support services the DHB has funded or provided, or could provide or fund.

The disability support advisory committees give their DHBs advice on the disability needs of their resident population and priorities for use of the disability support funding provided.


The hospital advisory committees assess strategic issues relating to the provision of hospital services by or through the DHB. Part of the committee’s role is to monitor the financial and operational performance of the hospitals and related services of their DHBs.

Community and public health

DHB community and public health advisory committees provide advice to the board on the ‘needs, and any factors that the committee believes may adversely affect the health status of the resident population of the DHB’. They also advise on priorities for use of the health funding provided for community and public health services.

Consultation principles

Consultation is a key ingredient in quality decision-making and policy development in health. Board members and committees can present community views.

DHBs are also required by legislation to establish consultation processes, seeking the views of the community on specific issues so that providers and users of services as well as the community can have input into major decisions taken by the boards.
Another important aspect of the consultation process is that DHBs should use culturally appropriate ways to communicate with population groups. Consulting with Māori is particularly important as it reflects the principles of the Treaty of Waitangi. Pacific peoples, other ethnic groups and people with disabilities also should be consulted with.

Consultation is more effective when built on relationships of trust, one part of the ongoing process of community engagement.

Director-General of Health, Dr Karen Poutasi, says ‘consultation is commonsense. We do it because it is pragmatic, and good management practice. It leads to better decisions and therefore more appropriate services, which in turn contribute to improving the health of all New Zealanders.’

In July 2003 parts of the Local Government Act (LG Act) will come into force. The new sections will include parts on public consultation that are similar to the requirement that DHBs operate under. The key ideas of the LG Act are:

  • to improve local democracy
  • to provide a broad mandate to enhance community wellbeing
  • to provide for community governance
  • for a sustainable development approach.

The LG Act requires councils to take a community leadership role and to listen to community values and priorities. In this, it is similar to the way DHBs provide a community voice in matters relating to health and disability services. Another implication of the LG Act is that links and co-ordination between the public, health and disability sector and local government will be improved.

Government strategies

These consultation principles were applied in developing a number of overarching strategies released by the Minister of Health to provide guidance to DHBs. The overarching strategies are the New Zealand Health Strategy and the New Zealand Disability Strategy. These strategies ensure national consistency and focus DHBs and providers on priority areas. They have been developed in consultation with experts, practitioners and other interested parties.

Before releasing a strategy a discussion document is developed. The discussion document is produced by the Ministry of Health, with input from sector reference groups, expert advisory groups, focus groups and DHBs. Submissions are sought from those in the health and disability sector, Māori, Pacific peoples, other ethnic groups disabled people and other interested groups.

Once a national strategy has been agreed by Government, the Ministry, DHBs and the sector, board members work to implement it in a manner appropriate to relevant populations.

Find out more!

A list of strategies and those under consultation can be found on the Ministry of Health website



Former Minister of Health, Annette King, believes in community consultation.

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