District Health Boards (New Zealand)

District health boards (DHBs) in New Zealand are organisations established by the New Zealand Public Health and Disability Act 2000, responsible for ensuring the provision of health and disability services to populations within a defined geographical area. They have existed since 1 January 2001 when the Act came into force. There are 20 DHBs (fifteen in the North Island and five in the South Island). Initially there were 21 DHBs, and this was reduced to the current 20 organisations in 2010. DHBs receive public funding from the Ministry of Health on behalf of the Crown, based on a formula which takes into account the total number, age, socio-economic status and ethnic mix of their population. DHBs are governed by boards, which are partially elected (as part of the triennial local elections) and partially appointed by the Minister of Health.

District health boards were first introduced as an idea in the 1970s in the Green and White Paper suggested by the then Labour government. This was part of a plan to nationalise primary health care as the Social Security Act of 1938 had originally intended. Labour subsequently lost the election to Robert Muldoon's National Party in the 1975 election. Muldoon's government chose however to slowly implement these reforms in trial "area health boards", which can be seen as early predecessors of the district health boards.

The more direct predecessors were the Crown health enterprises (CHEs) and subsequent Hospital and Health Services (HHS) management structures of the 1990s; these were responsible for managing the hospitals under business ethos, albeit, with the expectation that the former would return a profit to the shareholders (i.e. the government).

In the 1990s "regional health authorities" (RHAs) were formed. These RHAs were amalgamated in 1997 to form the Health Funding Authority (HFA). The election of the Labour-Alliance government in the 1999 election saw the New Zealand Public Health and Disability Act 2000 passed by parliament, this led to the merging of the HFA with the Ministry of Health. Part of the HFA's funding capacity combined with the hospital management elements of the Hospital and Health Services board to form the DHBs.

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