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  • to require the creation of the New Zealand Health Strategy and the New Zealand Disability Strategy with an annual report to Parliament on the progress of these strategies;

  • to foster co-operation between the health care agencies; and

  • to encourage local community input to decision-making about health and disability support services.

The DHBs are charged with responding and giving effect to health related policy from government. The elected and government appointed boards are answerable to the Minister of Health for the appointment and tracking of the performance of the Chief Executive, the strategic direction of the board, and the compliance with the law and the Crown expectations relating to health service. The Minister of Health is accountable to Parliament for the outcomes in the health and disability sector. The main focus of each district is on their region’s population, working within the apportioned resources to improve, advance and safeguard the health of their population. The DHB has dual functions, as both funder and provider of services.

The DHB where this research was conducted is directed by three central advisory committees one of which is a Hospital Advisory Committee. This advisory committee monitors the performance of its hospital and related services. There are a range of responsibilities which the DHB must meet, including but not limited to, making public their District Strategic Plan and their Annual Plan, both of which include their strategic direction and intentions (New Zealand Public Health and Disability Act, 2000). The Strategic Plan of 2002 - 2011 was developed to deliver on the community’s perception of their health needs and the systematic health needs analysis relating to the region’s population. The then Chief Executive Officer (CEO), in introducing the Strategic Plan, stipulated that the strategy needed to have a strong focus on the community and involve providers and consumers in decision-making. This focus arose from extensive consultation about the way the providers, consumers and staff wanted their health organisation to operate. The Strategic Plan addressed issues that the community and needs assessment deemed important and identified five specific regional health needs priorities. Nurses have

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