Health Boards

 

The Health Board

The health board consists of a number of elected representatives from the particular community or geographic area according to what is specified in the health service constitution. The board is the employing body; it makes high-level policy decisions for the health service and ensures that it remains accountable to the community. In some communities health boards are less formal structures that do not have legal control of the service. For instance, in some communities serviced by NTDHCS efforts have been made to establish health boards, but these are only advisory bodies.

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Role of Health Boards

The role of health boards as the board of a legal entity include:

• The oversight of health service activities to ensure that they operate within the aims and objectives of the organisation as defined in the constitution.
• The responsibility for the legal, financial and industrial relations obligations of the organisation, including funding agreements, employment, defining appropriate delegation of authority (eg signing of cheques) and the oversight of reporting requirements
• The meetings of the board and the AGM are organised and conducted in a way consistent with the health service constitution and the Act of Parliament under which the service is incorporated.

Consult the health service constitution and review the Act under which the health service is established to refine board legal responsibilities for the local service.

Health boards usually have other roles and responsibilities that are not defined by law. The board may take direct responsibility for these issues, and/or delegate responsibility to other staff or community members. These include:

• ensuring that the health service operates appropriately and respectfully within the jurisdiction of Aboriginal Law and culture
• establishing policies of the health service
• representing the community on issues affecting the running of the service
• selecting new staff members and providing them with orientation and support
• determining the way in which the health service will operate (eg outstation/homeland visits).

So health boards staddle both non-Aboriginal legal requirements and community and cultural values including Aboriginal Law. This often involves difficult contradictions (see figure below). This manual provides a guide to the legal requirements and does not attempt to suggest how Aboriginal culture and Law should be addressed. This is the prerogative of Aboriginal leaders.

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Health Board Responsibilities

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Board Members and Office Bearers

At every annual general meeting (AGM), health board members and office bearers are elected by the community. The health service constitution will determine:

1. The number of board members to be elected, and if there are any restrictions on how many can come from which areas.
2. What executive office bearers are to be determined and how this should be done (eg by the AGM or the newly elected board). Common office bearers in health services are president, vice-president, secretary and treasurer. In some services holders of these offices form an executive, which has certain defined powers between board meetings.
3. How many signatories are required on financial documents and cheques, and who they will be.
4. Frequency of meetings.

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Health Board and Staff Relationships

Health boards and employed staff should have mutual respect and cooperate to provide an effective health service.

To achieve this both health board members and staff must:

• Accept that the role of health board members is to represent the community interests and provide leadership in health matters.
• Accept that the role of health service staff is to do their job as specified in duty statements.
• Not publicly criticise individuals in a way that casts doubt on their competence and integrity.
• Not use the position to improperly influence an individual to gain an advantage to themselves, their family or others.
• Not communicate information of a confidential nature.
• Declare at any relevant meeting or interview any interests that may conflict with public and professional duties.
• Follow any grievance processes set down by the health service/awards/agreements.
• Use the health service’s property entrusted to them effectively and economically.
• Not use property for private purposes.

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Role of Health Service Staff

Health service staff must act in compliance with the decisions of the health board, the Policies and Procedure manual and their job description.

Aboriginal authority generates from complex sources, and decisions are often made through processes outside formal meetings that may lack transparency to observers outside the process. Aboriginal decision making is often consensual in nature, and this demands often widespread discussions over time or discussions in larger community meetings. This process may appear to health service staff to be in breach of confidentiality rules. However, staff are advised to be flexible and respectful of these community dynamics and accept the decisions that result.

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Role of Administrator

The administrator usually attends health board meetings to provide advice and information to the board to assist it in deliberations. S/he provides a report on the operations of the service, including outcomes achieved, future plans and any issues that need to be considered by the board. There may be times that the health board wishes to meet without the administrator and this should be complied with. Other staff members may also be required to provide reports and meet with the board regularly or from time to time.

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Administrator’s Report

The administrator should prepare a monthly report to the health board that includes the following information:

• finances/funding
• staffing information
• current activities
• plans/major activities for the next month
• other issues for consideration by the health board.

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Health Board Orientation/Training

Health Boards require ongoing orientation and training regarding their responsibilities. The administrator should maintain an orientation/training package for new health board members that includes:

• the constitution
• health board roles and responsibilities
• organisation history
• organisation overview
• budget
• funding sources
• staff positions and descriptions
• health service policies and procedures and development process
• annual plan
• meeting timetable and arrangements.

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