Democratic Governance & Health: Hospitals, Politics and Health Policy in New Zealand

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New Zealand is the only country in the world where elected health boards have long been a core feature of the health care system. These boards are conceptually important and aspirational for policy-makers and communities across the world grappling with issues of how to increase public participation in health care. The influence of the district health boards is vast. In 2011, they were responsible for much of the $12 billion in public expenditure directly funded by taxpayers via the Ministry of Health. They also made all major decisions as to how health services were configured in the areas they serve, including which services were to be funded, and for whom and where they should be located. This book traces the development of New Zealand's elected health boards, from the 1930s to the present District Health Board structure, analysing the history of democratic governance of health care, how boards have functioned, the politics surrounding their reform, and the idea of local democracy in health care decision-making. Based on extensive primary research, it assesses the capacity of elected boards to effectively govern the allocation of public expenditure on behalf of taxpayers and patients. Are there alternatives to the existing District Health Board model How might the electoral model be improved upon The concluding chapter provides some suggestions.

Author Bio

Miriam J. Laugesen is an Assistant Professor in the Department of Health Policy and Management at Columbia University's Mailman School of Public Health in New York. Robin Gauld is Professor of Health Policy in the Department of Preventive and Social Medicine, University of Otago, Dunedin, and Director of the Centre for Health Systems that spans the Otago Medical and Business schools.