E22 A4 Annual Report 2010 FP.indd - Northland District Health Board

2009 2010

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READING OUR
ANNUAL REPORT
The annual report presents an account of
Northland District Health Board’s performance
for the year from 1 July 2009 to 30 June 2010.
The annual report is a key report to stakeholders
as it sets out what the district health board
committed to do in the year, and how it delivered
on that commitment.
The key components of the report are outlined
below.
The Board has a vision for its district and a long
term strategy (10 years) as to how this vision will
be achieved. This is documented in the District
Strategic Plan.
Each year, the Board reviews progress on its
vision and long term strategy, and identifi es what
will be achieved over the next 12 months. This is
documented in the District Annual Plan.
A Statement of Intent is also prepared annually
and is the formal accountability document
between Northland DHB and Government. It
provides a concise summary of Northland’s
intentions for the year ahead, and covers both
long term and annual planning objectives. It also
covers the day-to-day operational performance of
the Board.
This document, the Annual Report, tells you
how Northland DHB performed against the
Statement of Intent. It also provides the reader
with a detailed account of how the health dollars
allocated to this Board were managed.
INTRODUCTION NORTHLAND DISTRICT
HEALTH BOARD
A brief overview of Northland DHB’s role, the district
it covers, and resources it manages.
2009/10: THE YEAR IN REVIEW
A report from the Board Chair and Chief Executive
in the past year. Includes staff matters and DHB’s
fi nancial performance.
GOVERNANCE AND PARTNERSHIPS
A report on how the Board of Northland DHB is
structured and operates.
FINANCIAL AND AUDIT REPORTS
The annual fi nancial accounts for the organisation as
at 30 June 2010
STATEMENT OF SERVICE PERFORMANCE
A report on Northland DHB’s performance against
the targets set by the Board, and agreed by the
Minister of Health.

Contents
INTRODUCTION NORTHLAND DISTRICT HEALTH BOARD
Our Role....... ............................................................................................................................................. 4
Our Communities ........................................................................................................................................ 5
Our Health Profi le ....................................................................................................................................... 6
Our Vision, Mission & Values ....................................................................................................................... 8
2009/10: THE YEAR IN REVIEW
Message From The Board Chair and Chief Executive .................................................................................... 10
Where The Money Goes ............................................................................................................................ 12
Each Day In Northland .............................................................................................................................. 13
Our Services ............................................................................................................................................. 14
Our People .............................................................................................................................................. 16
Some Highlights ........................................................................................................................................ 20
GOVERNANCE AND PARTNERSHIPS
Governance And Partnerships .................................................................................................................... 28
Our Health Priorities .................................................................................................................................. 30
Our Strategies........................................................................................................................................... 30
FINANCIAL AND AUDIT REPORTS
For the year ended 30 June 2010 .............................................................................................................. 32
STATEMENT OF SERVICE PERFORMANCE
For the year ended 30 June 2010 .............................................................................................................. 72
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4
INTRODUCTION
NORTHLAND DISTRICT HEALTH BOARD
“A brief overview of Northland DHB’s role,
the district it covers and resources it manages.”

Our Role
Northland DHB, established under the New Zealand Public
Health and Disability Act (2000), is categorised as a Crown
Agent under section 7 of the Crown Entities Act 2004.
Responsible for providing, or funding the provision of, health and
disability services for the people of Northland, the district health
board covers a large geographical area from Te Hana in the
south to Cape Reinga in the north.
It serves a projected population for 2010 of 157,420 and
employs around 2,628 staff.
Acute services are provided through the district health board’s
four hospitals, based at Whangarei, Dargaville, Kawakawa
and Kaitaia, with elective surgery performed at Whangarei
and Kaitaia. These services are supplemented by a network of
community-based outpatient and mental health services, a range
of allied health services and a public health unit.
Some specialist services like radiation treatment and rheumatology
services are provided from Auckland or through visiting specialists
travelling to Northland.
The district health board’s funding arm allocates funding across the
health sector in Northland, contracting with a range of communitybased
service providers such as primary health organisations
(PHOs), dentists, pharmacies and non-government organisations
(NGOs).
Our Communities
Population
Northland’s projected population for 2010 is 157,420, 3.6%
of New Zealand’s population. Just over half live within the
Whangarei District Council area, 37% live within the Far North
District Council area and 12% live within the Kaipara District
Council area.
Maori
Nga Iwi o Te Tai Tokerau comprises 30% of Northland’s
population. Out of the total Maori population, about half live in
the Far North District, 40% in Whangarei, and 10% in Kaipara.
Iwi in Northland include Ngati Kuri, Te Aupouri, Ngaitatoko, Te
Rarawa, Ngati Kahu, Whaingaroa, Ngapuhi, Ngati Wai and
Ngati Whatua.
Aging population
Northland’s population is ‘ageing’ because the number of children
is decreasing while the older population is increasing signifi cantly.
The child section of the population (0-14 years), is projected to
drop from 23.1% in 2006 to 21.1% by 2016. Northland’s
older population (65+ years) is projected to grow from 14.5% to
18.9% over the same period.
Northland not only has a higher proportion of older people than
the national average, but it is projected to grow at a faster rate.
Socio-economic status
Northland has one of the most deprived populations in the country.
While 20% of New Zealand’s population is in the lowest quintile
of the deprivation index, the equivalent measure for Northland is
35%.
The most deprived local authority area is the Far North District
Council with 51% of the population in the lowest quintile; within this
district the most deprived areas are Hokianga 83%, Whangaroa
41% and north of the Mangamukas 55%.
Rurality
The only true urban area in Northland is Whangarei, which
contains about one-third of the region’s population. Kaitaia,
Kerikeri, Kaikohe and Dargaville are rural centres with populations
of about fi ve thousand each. The Northland population is
distributed across a region which takes over fi ve hours to travel
from its northern to southern extremities and up to two hours west
to east. Northland has the highest proportion of unsealed roads in
New Zealand and public transport is very limited.
Northland DHB District Map
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Our Health Profi le
Maori
Maori experience low levels of health status across a whole
range of health and socioeconomic statistics. They comprise
30% of Northland’s population, but 52% of the child and
youth population, a key group for achieving long-term gains.
Maori experience early onset of long term conditions like
cardiovascular disease and diabetes, presenting to hospital
services on average about 15 years younger than non-Maori.
Child and Youth
The child and youth population in Northland is projected to
decline over the coming years, but it remains a priority because
healthy children make for healthy adults and because children
are more vulnerable than adults.
The 2006 deprivation index, which scores New Zealander’s on
a ten point deprivation scale, placed 70% of Northland adults
and 85% of Northland children on the most deprived half of the
index.
Older People
Our ageing population is placing signifi cant demands on health
services provided specifi cally for older people (residential care,
home based support services, day care). It also affects the
prevalence of long term conditions which become more common
with age.
Long Term Conditions
The ‘big 3’ are diabetes, cardiovascular disease and cancer.
Thirty six percent of Northlanders die from cardiovascular
disease (heart disease and stroke). Twenty two percent of adult
Northlanders have been told they have high blood pressure and
fourteen percent told that they have high cholesterol, both known
risk factors for cardiovascular disease.
While diabetes is not a major killer in itself, it is a primary cause
of heart disease and a great deal of unnecessary illness
and hospitalisations are related to poor management of the
condition.
Thirty nine percent of Northlanders die from cancer. The four
most common sites are; trachea-bronchus-lung, colorectal,
prostate and breast.
Oral Health
Northland’s 5-year olds have repeatedly had the country’s
highest average score of damaged (decayed, missing or
fi lled) teeth and one of the lowest percentages of teeth without
tooth decay (33% compared with the national 41%). Data for
adolescent oral health is scanty, but it suggests a similar, if not
worse, picture.
Lifestyle Behaviours
The way people live their lives and the behaviours they exhibit
have an enormous infl uence on health status. There are a wide
range of infl uences, but key ones are smoking, diet and physical
activity.
Mental Health
Mental health has been a priority since the publication of the
Blueprint for Mental Health Services in NZ in 1998. Since
then increasing amounts of resources have been progressively
invested nationally to work towards a full range of mental health
services.
Social Infl uences
Many of the causes of ill health rest with social and economic
factors such as housing, education and economic prosperity.
The health sector cannot affect these directly, but district health
boards can work on them collaboratively with other government
and local body organisations.
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Our Vision,
Mission & Values
Our Vision:
Creating a healthier Northland
Kai hangahia he hauora mo Te Tai Tokerau
Our Mission:
Working in partnership under the Treaty of Waitangi, creating opportunities for
improving health and wellbeing, and promoting independence of all the people
of Northland.
Mahi tahi te kaupapa o Te Tiriti o Waitangi he whakarapopoto nga whakaaro
o te Whare Tapa Wha me te whakatuturutahi i te tino rangatiratanga te iwi
whanui o Te Tai Tokerau.
Our Values:
People First - Taangata i te tuatahi - People are central to all that we do
Respect - Whakaute (tuku mana) - We treat others as we would like to be treated
Caring - Manaaki - We nurture those around us, and treat all with dignity and
compassion
Communication - Whakawhitiwhiti korero - We communicate openly, safely and
with respect to promote clear understanding
Excellence - Taumata teitei (hiranga) - Our attitude of excellence inspires
confi dence and innovation
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On behalf of the Northland District Health Board, we are pleased to present our Annual Report for the 2009/10 fi nancial year. This is
our principal accountability document to the people of Northland and describes the progress that we have made in the last year towards
improving the health and well-being of the people in our region.
On 31 December 2009, Lynette Stewart retired as the Northland DHB chair. Mrs Stewart had been chair of the Board for nine years
and as the incumbent chair, I was grateful for her assistance ensuring a smooth transition of leadership and inheritance of Northland DHB’s
sound state of affairs.
Once again, we have continued to demonstrate sound fi nancial management, reporting a modest fi nancial surplus for the year of
$869,000. Refl ective of a sound commitment by the executive and operational teams to achieve our objectives, it is especially pleasing
to see such a result considering the tight fi scal environment in which all district health boards now operate.
Nga Iwi o Te Tai Tokerau comprises 30% of Northland’s population and work continues to strengthen the way we discharge our statutory
obligations to engage with Maori on Maori health issues and strategies.
We have had a busy and demanding year with a number of highlights:
Message
From
• Implementation of the new national health targets has been challenging and providing a focus for action, our results show a solid end
of year achievement with an overall increase of performance in all areas.
• Committed to delivering more surgery for Northlanders, we performed a record number of elective surgical procedures than planned
being 6,675 discharges compared to 6,004 in the previous year, an increase of 11.18%.
• Since late April 2009, we have been involved in responding to the Novel A H1N1 infl uenza pandemic and have successfully
contained and managed it this winter. Sadly we also saw an outbreak of measles in the Hokianga in March 2010. No further
spread occurred, which is a testament to the sound contact tracing and outbreak management by Northland DHB’s public health
unit. This outbreak highlights the importance of continued vigilance and contact with those communities who choose not to immunise
their children.
• To maintain high quality health care for Northlanders, we are committed to working alongside the three other district health boards in
the northern region: Auckland, Waitemata and Counties Manukau, and at a national level with the 20 District Health Boards. We
have taken a leadership role in a number of regional and national initiatives and continue to ensure we fulfi l our leadership requirements.
We will continue to seek support for joint problem solving, prioritisation and necessary service changes.
• This year, over two hundred staff were awarded long service awards, covering service levels of twenty, thirty and forty years.

The Board Chair
and
Chief Executive
• In line with Ministerial expectation, we reached agreement with Northland’s primary health organisations that their number will reduce
from six to two, by 31 December 2010.
• Approval was granted for the planning of the new mental health in-patient unit on site at Whangarei Hospital. This is an important
plank of the new Model of Care being implemented across Northland DHB and includes the establishment of sub-acute units, rehousing
community services off the hospital campus and into community settings, and the further development of alcohol and other
drug services. The commissioning of three inpatient detoxifi cation beds, in the Timatanga Hou ‘New Beginnings’ unit at Dargaville
Hospital in January this year was a signifi cant milestone for Northland DHB.
• We continue to improve the oral health status in the region, building comprehensive service capability with annual oral health checks
for children throughout Northland through a combination of mobile clinics, oral health hubs, and a full complement of staff.
• In conjunction with the Northland Community Foundation, we were delighted to launch ‘Project Promise’ to raise funds for the creation
of a cancer centre at the Whangarei Hospital campus, to provide better fi t-for-purpose facilities for chemotherapy patients of Northland.
Establishment of the centre at Whangarei Hospital will mean many Northlanders will not need to travel to Auckland for this mode of
treatment.
These achievements are the result of a multi-faceted team effort and refl ect the calibre and dedication of our governance and operational
teams.
At this time, we are facing the Board election cycle and we would like to acknowledge the members of the Hospital Advisory Committee,
Community & Public Health Advisory Committee Disability Support Advisory Committee, the Audit & Risk Management Committee and the
Whangarei Hospital Redevelopment Sub-committee for their valued input. We would also like to record the appreciation of the Board to
Kaunihera Kaumatua Council of Elders (Kaumatua and Kuia) for their continuing advice and wisdom on matters of Tikanga Maori.
Our thanks to all Governance Board members for their direction and guidance, and we salute our wonderful volunteers who provide so
much support.
We wish to congratulate our staff and community providers for helping us work towards Better, Sooner, More Convenient health services
for all Northlanders and we look forward to the challenges ahead.
AAnthony th NNorman Karen K Roach R h
Board Chair
Chief Executive
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Where The Money Goes
Whangarei, Dargaville, Bay of Islands and Kaitaia
Hospitals (surgical and medical services, emergency
departments, imaging, laboratories, maternity,
public health, etc) ..................................................$225m
Primary Health (general practitioners, community
dental services, radiology, etc) ....................................$51m
Health of older people
(including residential care, rehabilitation) ......................$41m
Mental health services ...............................................$39m
Maori health services ..................................................$7m
Community pharmacies .............................................$36m
Community laboratory services ......................................$7m
Inter-district fl ows (publicly funded health services paid to
other district health boards and others for services
provided to Northland patients) ...................................$68m
TOTAL ..................................................................$474m
Each Day In Northland
6 Babies are born in hospital
1,480 Hours of home care support is provided to older
people
111 People attend our emergency departments
246 People access mental health care coordination
services
464 People will have had contact with a community or iwi
support worker
219 People attend an outpatient appointment (doctor visit)
16 Schools are visited by a public health nurse
126 People are admitted to our hospitals
6,174 Medicines are dispensed
240 Patients are seen by a dentist or dental therapist
24 Children attend a mobile ear clinic appointment
758 Older people receive subsidised aged residential
care
1,474 People attend an outpatient appointment
10 People are visited by a public health nurse for
communicable disease management
261 People will have had contact with the community
mental health service
2,743 Laboratory tests are processed
19 School children are immunised by a public health
nurse
And we do much more!
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Our Services
Health Portfolio No of Contracts No of Providers
Primary Care 46 15
Oral Health 24 18
Pharmaceuticals
(Pharmacy)
43 33
Laboratory 2 2
Mental Health 27 14
Older People 48 29
Palliative Care 4 4
Maori Health 33 10
Pacifi c People 1 1
Public Health 4 3
Total 232 129
Note: includes contracts with Northland DHB provider arm.
Maori NGOs
NGO Providors and Contracts
Northland PHOs
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Our People
Northland DHB adheres to the Good Employer requirements of the Crown Entities Act
2004, which cover:
• good and safe working conditions
• an equal employment opportunities programme
• the impartial selection of suitably qualifi ed persons for appointment
• recognition within the workforce of the aspirations and needs of Maori,
other ethnic or minority groups, women and people with disabilities
• training and skill enhancement of employees
This year, Northland DHB employed around 2,628 staff.
Workforce development and strong organisational health are central to Northland
DHB ensuring that it provides high quality effective services and meets the continued
challenges of the health needs of its communities.
To attract and grow our workforce to meet service needs, training and development
initiatives include the opportunity to participate in management, leadership and clinical
programmes nationally and internationally.
Staff satisfaction and retention is enhanced because training and development is
aligned to organisational compliance requirements, service needs and staff’s own
professional development.
Northland DHB continues to provide a number of Clinical Training Agency scholarships
for nursing and midwifery and the non-regulated workforce. In addition Northland
DHB pursues “Grow our Own” staffi ng initiatives by providing additional Maori
scholarships for staff and a Pihirau Hauora Maori Scholarship for secondary school
students.
Our relationships with Auckland University, Auckland University of Technology and
NorthTec (Northland’s polytechnic) continues to provide future opportunities for doctors,
nurses, midwives and allied health professionals to join the organisation.
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18
NATIONAL:
Health Workforce New Zealand
The health sector has identifi ed a range of health workforce development
issues - some that already exist and others that are forecast for the future.
The Government has established Health Workforce New Zealand (HWNZ)
to address those issues.
Health Workforce New Zealand has chosen Northland DHB as a pilot
of a new initiative to secure our future workforce. The Special Medical
Engagement Programme has been developed to secure training registrars in
specialties of interest to us for the period of their training regardless of where
their training occurs. This ensures continuity of employment with the purpose
of securing the participants as specialists after their training. Northland
has chosen three registrars in the specialties of orthopaedics, ENT and
psychiatry. The intention is to broaden the programme in the next year.
Health Workforce New Zealand has formally announced the Advanced
Trainee Scheme (ATS) which providers a scholarship to cover the cost of a
period of advanced study overseas. In return, trainees will be bonded to
work in specialty in New Zealand on completion of their training. Initially
six scholarships at three demonstration sites including Northland have been
offered.
Scholarships will be available for up to 50 trainees in any one year and will
lead to HWNZ Fellowship in Advanced Training. Entry to the scheme will
require the trainee to have made a career plan and to have a guarantee of
employment in an appropriate post at the end of their training. Priority, will
be given to doctors in high need specialties such as rural general practice,
renal medicine, rheumatology and psychiatry.
Along with the voluntary bonding scheme, it is expected that this retention
strategy will have a positive affect on the medical workforce.
Health Workforce New Zealand Nursing Education Funding
The continued support of nursing and midwifery education through the
investment, relationships and purchasing arm of Health Workforce NZ, has
provided Nurses and Midwives throughout Northland with opportunities to
advance their knowledge through clinical postgraduate study programmes.
Nurses are divided into two categories for training purposes. The fi rst
category is for the Nursing Entry to Practice (NETP) staff, who are graduate
registered nurses in their fi rst year of practice. For this programme there
were 19 funded trainees during the contract year from January 2010 to
December 2010. The second category is for registered nursing staff, who
are studying for advancement in their chosen fi eld through achievement of
a post graduate certifi cate, postgraduate diploma or a master’s degree. In
semester one of the contract year, which runs from February 2010 to June
2010, Northland had 94 trainees enrolled and funded. For the second
semester, which runs from July 2010 to November 2010, Northland DHB
had 71 trainees enrolled and funded.
National Maori Nursing and Midwifery
Workforce Development Programme
A national Maori nursing and midwifery workforce development programme
that will identify and develop clinical leaders and improve access to
professional development opportunities has been commissioned by the
Ministry of Health and is being developed within Auckland DHB.
The National Maori Nursing and Midwifery Workforce Development
Programme – Nga Manukura o Apopo – is being designed to support
the retention, recruitment and continuous development of Maori nurses and
midwives practising in New Zealand with a particular focus on clinical
leadership and professional development.
Key programme work streams include clinical leadership, recruitment and
professional development. The programme is being led out of Auckland
DHB and will be implemented nationally by professional Maori organisations
selected in a request for proposal process.
Nurse Practitioner Innovation Fund
Te Tai Tokerau PHO and Tihewa Mauriora PHO were successful in securing
one of the twelve one-off $15,000 packages through DHBNZ (District
Health Boards New Zealand) to enable the creation of nurse practitioner
development positions within Te Tai Tokerau.

NORTHLAND:
Whakapiki Ake Programme
Whakapiki Ake is a Ministry of Health initiative, and it is operated as
a partnership scheme between the University of Auckland and Northland
DHB. The programme is in its seventh year and it exists to encourage young
Maori students to pursue a career in medical and health sciences.
The programme’s primary focus is to increase the Maori workforce, by
exposing Maori secondary students to health careers and University study
pathways within the Auckland Faculty of Medical and Health Sciences
.This is a key event of the programme and it is held during the secondary
school holidays in July. Since 2008, over sixty Northland secondary school
students have participated in this programme.
Incubator Programme
The Northland Incubator Programme was launched in June 2009 and is a
workforce development initiative for secondary school students to nurture
an interest for a vocation in health. The programme is franchised through
Hawke’s Bay District Health Board and is a targeted approach to workforce
development that nurtures the passion for a vocation in health through
experience and knowledge of people in the health sector.
Currently the programme is available to year 12 and 13 students in fi fteen
schools in various district health boards throughout New Zealand. In
Northland, the programme has commenced within Kamo and Tikipunga
High Schools and work is underway to identify health professionals, from a
wide range of disciplines within the health and disability sector, to support
the programme in the schools.
Pihirau-Te Tai Tokerau Hauora Maori Scholarship
One of the barriers to success for many Maori wishing to pursue undergraduate
qualifi cations has been the lack of funding support for costs of
completing tertiary education and training as noted in the report He Tipu
Hareke.
Northland DHB is committed to growing workforce capacity and capability
to serve the growing needs of the population of Northland and operates an
internal annual scholarship fund for current Maori employees.
The district health board has established a scholarship fund to support and
enable Maori entering the health and disability workforce to successfully
complete tertiary studies, through minimising one of the barriers to successful
recruitment - affordability.
The scholarship also compliments other health workforce recruitment
programmes such as Whakapiki Ake and Incubator.
Approved Training Organisation (ATO)
Northland DHB’s application to the New Zealand Institute of Chartered
Accountants to renew Northland DHB’s registration as an ‘Approved
Training Organisation’ was successful.
The ATO’s function is to provide an environment in which a trainee can
develop the necessary skills and attributes to become a competent Chartered
Accountant or Associate Chartered Accountant.
As an ATO approved organisation, Northland DHB is recognised as being
capable of offering the type of work experience that fulfi ls the practical
experience requirements for admission to the College of Chartered
Accountants or College of Associate Chartered Accountants.
Oral Health Scholarship
In 2008, Northland DHB introduced the Oral Health Scholarship, offering
fi nancial support to those either wishing to train, or currently training, as
dental therapists or dental surgeons at Otago or Auckland Universities, and
who intend to work within oral health services in Northland on completion
of their training.
Two scholarships were awarded to students in 2008 for therapist hygienist
training. In 2009 and 2010, there were four scholarships awards. Three
of the scholarship recipients are completing a Bachelor of Health Science
(Oral Heath) and another is studying for entrance into dentistry. They are
at varying stages in their studies and are funded for the following year, on
passing of the previous year’s exams.
The fi rst Northland DHB scholarship student will graduate from the Auckland
University of Technology with a Batchelor of Health Science (Oral Health)
degree at the end of this year, and is expected to be working in Northland
from 2011 onwards.
19

National Health Targets
Health Targets 2009/10 end of year results showed solid progress for Northland DHB, with an overall
increase of performance in all areas.
86% of Northland DHB patients were admitted,
discharged, or transferred from our emergency
departments within six hours.
77% of Northland two-year olds were fully immunised.
Northland DHB increased its electives surgery volume to
118% of its delivery target.
20

100% of Northland DHB patients needing radiation
treatment received it within six weeks of their fi rst specialist
assessment.
An average of 70% of the eligible adult population of
Northland had either: their cardiovascular disease risk
assessed; attended a free diabetes annual check; and/
or were able to better manage their diabetes.
55% of Northland DHB inpatients were provided with
advice and help to quit smoking.
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22
ASSOCIATED HEALTH TARGET ACTIVITIES
Cancer Control
A stock-take and gap analysis of cancer services within Northland was
conducted during the 2005-2006 fi nancial year and identifi ed signifi cant
barriers for Northland patients diagnosed with cancer. In the Northern
Cancer Control Strategic Action Plan, Northland DHB identifi ed that
there were gaps in accessing available cancer services for the Maori
population.
The analysis found that cancer treatment services provided in Northland
were chemotherapy and surgery treatment options. Complex chemotherapy
and radiation therapies services are Auckland based and form part of a
regional cancer service. Northland patients are required to travel for their
complex care and are provided with accommodation and travel assistance
through the New Zealand Cancer Society and Northland DHB.
The Northland Cancer Control Strategic Action Plan 2006-2011 identifi ed
breast cancer, lung and colorectal cancer as the top priorities for the
fi ve year period. In July 2004, the eligibility for publicly funded breast
screening was extended to 45-69 years’ thereby addressing the breast
screening priority.
In May 2007, the Northland Cancer Control Steering Committee agreed to
establish cancer care coordination roles within the secondary care setting.
It was agreed that two cancer care coordinators be appointed to assist in
reducing the inequalities between Maori and non-Maori, and improve the
access to cancer care services for Northland Maori patients diagnosed
with lung and colorectal cancer.
The two cancer care coordinator roles have now been in place for more
than twelve months.
Cardiovascular Disease Screening for Maori and Pacifi c Men
Te Tai Tokerau PHO has been funded to coordinate and facilitate a process
to ensure that the population at high risk from cardiovascular disease –
Maori and Pacifi c men from 35 years – is risk assessed and receives
appropriate management, through seamless follow up and referral systems.
This project runs in parallel with a contract between Northland DHB and Te
Hauora o Te Hiku o Te Ika that aims to extend the successful cardiovascular
and diabetes awareness raising campaign across other Maori providers in
Northland.
In a nine month period, 5170 Maori have been screened within the
programme, with 50% presenting with 15% or more high risk factors.
One hundred and ninety seven Pacifi c men have been screened with 43%
presenting with high risk factors. This work continues to expand as Te
Tai Tokerau PHO plan and coordinate outreach screening programmes
possibly going into work place not previously accessed across Northland.
This acknowledges that Maori and Pacifi c men do not ordinarily access
general practices until extreme health issues arise.
While challenges have presented in the smooth running of the programme,
these are not insurmountable and are being addressed through training
on the use of the web-based clinical decision support programme for
cardiovascular disease PREDICT-CVD, improving its functions and clarifying
referral pathways and follow ups with practice nurses and Maori NGOs.
Elective Surgery
Northland DHB’s elective services have once again been rated gold star
performers by the Ministry of Health. This meant we ensured that the vast
majority of our patients were seen for a First Specialist Assessment within six
months, and also received their treatment within six months of being seen.
The district health board performed elective surgery on 6,675 Northlanders.
This is an increase of more than 671 patients on the previous year.
Emergency Department Length of Stay Programme
Shorter stays in emergency departments is one of three hospital performance
targets and Northland DHB continues to overcome challenges, with 86% of
patients treated within six hours of presenting to an emergency department,
still short of the 95% target.
The ‘length of stay’ programme is ongoing and includes a number of
initiatives such as weekly performance monitoring, the partial establishment
of a short stay unit and meetings with primary care providers to discuss
presentation demands on hospital emergency departments. A new model
of care is also currently under development and will guide the future
development of emergency services.
Smokefree Northland
Smoking is the single greatest preventable cause of illness and early death.
Over 5,000 people die of smoking related disease in New Zealand every
year. Smoking is a major drain on health sector resources, with signifi cantly
increased use of health services and interventions by smokers.
Northland has the second highest smoking rate (25.7%) in the country.
Northland DHB’s recorded smoking rate in our admitted patients is 10.8%.
Hence we have a gap (15%) between what we are recording and what is
likely to be the true prevalence.
In response to the challenge of meeting the required health target, Northland
DHB’s provider arm is working to integrate the ABC approach into the every
day practice of all secondary care workers. Trigger more quit attempts and
improve the likelihood of success of each attempt through treatment.
ABC is a memory aid for health care workers to understand the key steps to
helping people to quit smoking. These steps are as follows:
A. Ask all people about their smoking status and document this
B. Provide brief advice to stop smoking to all people who smoke,
regardless of their desire or motivation to quite
C. Make an offer of, and refer or provide, evidence based cessation
treatment.
The key goal of the ABC approach is – “more supported quite attempts,
more often”.
This year, nearly 500 district health board staff received education about
the use of the ABC smoking cessation intervention and they are now able
to give advice on the benefi ts of quitting and support patients to quit by
offering nicotine replacement therapy and/or referring them to a cessation
support service.
The implementation of new data collections methods for staff, to help
hospitalised smokers quit, saw the health target for smoking prevention leap
from 12% in the fi rst quarter to 55% in quarter four.
Northland DHB has allocated $650,000 over a three year period to
meeting specifi c objectives for supporting more quit attempts across primary
care services. One of the key objects for this funding is to integrate the ABC
into everyday practice of primary health care workers.
Manaia PHO is the lead primary health organisation for this initiative.
Funding arrangements should enable the achievement of agreed quit
attempts targets and ensure that individual patients are managed within
budget.
REGIONAL ACTIVITIES AND ACTIONS
Regional Collaboration
One of the Government’s key responses to the Ministerial Review Group
report, released in 2009, is the expectation of better coordination between
neighbouring district health boards.
Northland DHB is actively seeking a closer relationship with the three
Auckland district health boards and healthAlliance. Mutual cooperation
with other district health boards is also showing benefi ts. This is working
hand-in-hand with a review and refi nement of Northland DHB procurement
methodology and procedures.
A key component to this is the development of a northern regional service
plan and potential establishment of a northern regional shared service. The
Northern DHB Support Agency (NDSA) provides regionally coordinated
support to the metro Auckland and Northland district health boards and is

coordinating the development of the regional service plan for 2010/11.
The plan due at the end of September 2010, will describe the many and
varied streams of work being undertaken across the northern region. This
plan will become the medium-term (5-10 years) accountability document for
northern district health boards, and will have a strategic focus on intended
service confi guration and models of care, and will identify short term
implementation actions.
The intention of the northern district health boards is to work together more
effectively, at a regional level to make better use of available resources
(workforce, funding, capital and IT), strengthen clinical and fi nancial
sustainability, and improve equity of access across the region.
Regional Detoxifi cation Unit
Northland DHB’s Mental Health and Addiction Service recently opened
a new Northland regional detoxifi cation unit called Timatanga Hou or
New Beginnings, to support existing mental health services and addiction
services in the region. Located at Dargaville Hospital, the new three bed
unit provides 24-hour care, counselling and treatment programmes. To
date, the main indicators for admission to this unit are alcohol, followed by
cannabis and methamphetamine addiction.
Regional Sub Acute Inpatient Unit
A new regional sub acute inpatient unit is due to open in Kaikohe on 1
July 2010. The unit will be part of Northland DHB’s Mental Health and
Addictions Service and will provide intensive six week rehabilitation care
and treatment to clients / tangata whaiora, aged between 18 years to 65
years, who reside in the Mid North District.
Based on a similar sub acute unit in Kaitaia, the new facility will support
mental health and addictions clients that need more intensive support than
their usual environment can offer. Northland DHB staff will be on-site to
provide 24 hours a day, seven days a week care and observation, with
visitors permitted, as and when appropriate.
Recidivist Drink Driver Programme
Northland DHB’s Alcohol and Drug Service have been piloting a programme
for Recidivist Drink Drivers since June 2007. The pilot began due to an
increased number of referrals from the Justice Department for Recidivist Drink
Driving offenders to engage in treatment.
The aim of the programme is to reduce recidivist drink driving, address the
level of binge drinking or dependence and provide strategies for reducing
alcohol consumption levels. The programme is psycho-educational and
includes elements of motivational interviewing, cognitive behavioural
therapy, relapse prevention, problem solving theories and victim empathy.
Overall the programme has made an impact, reducing the amount of
alcohol consumed and the rates of re-offending for participants who have
completed the programme. A proposal has been submitted to RoadSafe
Northland for funding to support the extension of the programme across
Northland.
A proposal has also been prepared for presentation to the Northland
Intersectoral Forum (NIF) with the aim of securing facilitators from other
organisations to work in partnership with alcohol and drug counsellors to
deliver the programme.
Northland Intersectoral Forum (NIF)
In early March 2002 a forum was held in Whangarei, chaired by
the Mayoral Forum and run in conjunction with the Ministry of Social
Development. Some 25 representatives from the government and community
attended the meeting which included facilitated workshops.
The fi rst action identifi ed following the meeting was the establishment of a
collaborative networking mechanism that would ensure that the Mayoral
Forum and the government agency representatives worked closely together
on an ongoing basis.
As a result, the Northland Interagency Forum (NIF) was established. The
NIF consists of the chief executive of the Northland DHB and Regional
Managers of Work and Income, Police, Housing, Community Employment,
Te Puni K kiri, Child Youth and Family, Ministry of Education and the chief
executive of Enterprise Northland who provides the link between the
economic and social strategies.
Since the establishment of the group, it has spent time looking at what is
already under way across Northland and has identifi ed where it can add
value. The Forum developed a Strategic Plan for
2010 – 2012, which refl ects the Forum’s collective priorities across four
elements: social, environmental, cultural and economic.
Benefi ts of collaboration include:
• The establishment of the Far North Alcohol Team (FNAT) by Northland
DHB, New Zealand Police and the Far North District Council,
co-locating and integrating working on alcohol in the Mid and Far
North undertaking a wide range of activities. After a focus on
licensed premises, alcohol-fuelled violence where the last drink was at
a licensed premise prior to offending has dropped by over twothirds.
• “The Pulse” located in Raumanga brings government and non
government agencies together to meet the needs of youth in the
Raumanga and wider Whangarei area. The collective approach has
attracted a range of national interest and there is strong agency buy-in
and support. The Pulse is utilised for a range of events, including
Children’s Day 2010.
• Child Youth and Family and Northland DHB are able to discuss mutual
cases, and be proactive in supporting staff to work together better.
Whanau Ora
Earlier this year, Whanau Ora was launched as an inclusive approach
to providing services and opportunities to families across New Zealand.
The primary focus of this new initiative is on achieving best outcomes for
whanau through the development of whanau leadership and integrated
whanau-centred service delivery.
To support the implementation of Whanau Ora, a national governance group
provides strategic advice on policy priorities and ensures coordination across
government agencies and key stakeholders. The governance group’s role is
to facilitate the implementation of Whanau Ora. It does this through advice
to the Minister Responsible for Whanau Ora and providing leadership and
co-ordination across government agencies and stakeholders.
The Northland regional leadership group provide recommendations to
the Whanau Ora Governance Group on the selection of Whanau Ora
service providers and the development and implementation of programmes
and initiatives. The group includes between three and seven community
representatives and offi cials of Te Puni K kiri, Ministry of Social Development
and Northland DHB.
PRIMARY HEALTH CARE ACTIONS
Clinical Director Primary Health Care
Clinical governance at a primary health care level is a necessary requirement
for primary health organisations. In Northland the role of clinical director
primary health care originally sat within the district health board’s service
development and funding team. The opportunity arose to relocate this
position within primary health care with the aim of linking more actively with
those at the frontline of primary care and providing a strong primary health
voice in Northland DHB strategic developments, and to complement the
role of the two general practitioner liaison clinicians.
Te Tai Tokerau PHO agreed to act as the lead primary health organisations
on behalf of the then six Northland primary health organisations. Dr Russell
Smart was appointed as the primary health care clinical director on 1
August 2009. Dr Smart works on four tenths basis, and utilises several
bases around Northland to maximise links with general practitioners in the
various Northland localities.
Shifting Services from Secondary to Primary Care
In March 2009, Government indicated its intention that planning should
23

24
comment to shift some secondary services to primary health care. This
policy direction stems from a signifi cant body of evidence which indicates
that some ambulatory services can be better provide in local community
settings rather than hospitals and that this has the potential to improve
service quality, access and patient outcomes.
Northland DHB had made commitments to secondary to primary devolution
prior to the Government’s announcement, the largest of these being the
introduction of the Primary Options Programme.
Primary Options Programme Northland (POPN) is a scheme to enable
primary care providers to provide treatment for people with selected acute
conditions who would normally have been treated by secondary services.
Primary providers are able to access up to $300 for each patient who
meets POPN access criteria.
Northland DHB has entered into a three year agreement with Manaia
Health PHO, as the lead primary health organisation for the provision of the
POPN programme. Manaia Health PHO has appointed a primary options
coordinator who will coordinate and manage the programme.
In addition, Northland DHB intends to invest in a minor surgery initiative.
Previously piloted within Northland, this initiative involves a review of
secondary services waiting lists to identify patients whose conditions can be
treated in primary care. Patients are then referred to general practitioners
(not necessarily their own) who have previously been identifi ed as skilled
and available for providing the appropriate surgery.
Consolidation of Primary Health Organisations
When primary health organisations were established in Northland, they
formed around historical alliances. This approach led to the formation of
six primary health organisations within Northland, namely Te Tai Tokerau,
Whangaroa, Hokianga, Tihewa Mauriora, Kaipara and Manaia PHOs.
These primary health organisations range in size from 3,000 to 80,000
enrollees.
The collective Northland primary health organisations recognised the
benefi ts of cooperating by sharing resources and infrastructure early after
their formation, and established Northland primary health organisations
(NPHOs) as a separate entity with the purpose of supporting back-offi ce
function around capitation and data requirements.
More recently there has been an increasing recognition within the district of
the need for primary health organisations to merge into larger, more effi cient
organisations. This process of consolidation has already been initiated with
the merger of Tihewa Mauriora PHO into Te Tai Tokerau PHO from 1 April
2010.
Northland primary health organisations have indicated their intent to reduce
the number of primary health organisations further.
Northland DHB has already supported the merger of Tihewa Mauriora PHO
and Te Tai Tokerau PHO, and has applied a process similar to that described
within the Ministry of Health PHO Confi guration Process Requirements and
Timetables. It is Northland DHB’s intent that any merger process should be
made as simple as possible to facilitate ongoing provision of primary care
to enrolled populations with minimal disturbance.
Further devolution currently under consideration includes ultrasound,
orthopaedic steroid injections and rheumatologic primary care management,
outpatient orthopaedic fracture follow-ups and chronic pain primary care
management.
HOSPITAL AND SPECIALIST SERVICE ACTIVITIES
BreastScreen First Digital Mobile Arrives in Northland
New Zealand’s fi rst digital BreastScreen mobile unit arrived in Kaitaia
with a special blessing in February 2010. The arrival of the state of the
art digital mobile technology means Northland women’s images can be
viewed at the time of screening. The technology is not restricted to Kaitaia
and Kerikeri women will be able to access the service from July 2010.
Previously, women in Kerikeri have been offered free breast screening at a
fi xed site utilising analogue technology.
Newborn Hearing Screening Initiative
The fi rst six months of a baby’s life is a critical period for learning
communication. Lack of exposure to language during this time can
affect a child’s development, communication skills, educational and career
achievements. The early detection of hearing loss, and the application of
early interventions, has been demonstrated to signifi cantly improve longterm
language skills and cognitive ability.
Newborn hearing screening is becoming the standard of care internationally,
with programmes being established or already implemented in the United
Kingdom, the United States, Canada, Australia and a growing number of
other countries. As a response to the success of newborn hearing screening
programmes in other countries, the New Zealand Government announced
in 2006, that it would fund a universal newborn hearing screening
programme for all eligible New Zealand children.
Each year, it is estimated that between 135 and 170 babies are born in
New Zealand with mild to profound permanent congenital hearing loss. This
represents a birth incidence of approximately three babies with a hearing
loss per one thousand births. In Northland this translates to approximately
fi ve babies born with mild to profound permanent congenital hearing loss
every year. The universal
Newborn Hearing Screening and Early Intervention Programme (UNHSEIP)
is being progressively rolled out in New Zealand and from May 2010,
Northland DHB began offering newborn hearing screening free of charge,
to every eligible baby born in Northland, whether they are born in hospital
or at home.
Northland DHB commenced newborn hearing screening in May 2010. As
at 30 June 2010 380 babies have been screened, with sixteen referred
for targeted follow up. Four of the sixteen have been referred to specialist
assessment services, with one baby found to have sensory neuronal
(hearing) loss.
Information Services
Much has been happening in the information services division with the
implementation of the clinical workstation and the development of the
Clinical Knowledge Centre.
• Clinical Workstation Project
The aim of the Clinical Workstation Project is to deliver a front-end
user interface to display patient information stored in other systems. It
is a three-year programme of work incrementally adding features to a
new user interface.
The business case to replace our old clinical patient information system
(iHealth) with a new clinical workstation (Concerto) was approved late
last year. Implementation is well underway and we are in the process
of building a new clinical data repository with all the laboratory results
and radiology reports recorded in Northland DHB systems.
• Clinical Knowledge Centre
Launched in June 2010, the Clinical Knowledge Centre (CKC) is
a single portal that allows clinical staff to access clinical resources,
databases and documents. It contains only information relevant to
the delivery of clinical services and it is envisaged that all clinical
documents within the current DHB intranet and all hard copy documents
residing in a collection of folders across various clinical areas will be
available within the CKC by the end of 2010.
• JADE Co-ordinated Care (Access Pilot
JADE Co-ordinated Care (JADE) is an electronic patient record system
used by Northland District Health Board’s mental health service. It
allows authorised clinicians to access a complete health record
from the point of care. It offers an integrated case management
model enabling the delivery of co-ordinated client care within a
multidisciplinary service.
The JADE access pilot has been launched at Northpoint Services Trust,
a non-government organisation (NGO) in the Mid North. The aim of

the pilot is to improve the integration of care between the NGO and
the district health board’s mental health service, and to explore the
potential of NGO reporting to the Ministry of Health being undertaken
by the district health board via JADE.
• Picture Archiving and Communications System (PACS) Expansion
Inpatient and outpatient radiology services are provided at four
Northland DHB’s sites – Whangarei, Dargaville, Bay of Islands and
Kaitaia. Radiological services for patients referred from the community
are also provided at these sites.
PACS was introduced in June 2008 to Whangarei, Dargaville, Bay of
Islands and Kaitaia Hospitals and has seen the use of fi lm processing
becoming obsolete. Recently, the PACS link to the Auckland DHB
was extended to Kaitaia Hospital, improving clinical access to x-rays
for patients transferring to Auckland City Hospital or Starship for
treatment.
• Regional Information Strategy
In December 2009, the northern district health boards, together
with a wide range of sector stakeholders, developed the Regional
Information Strategy for 2010 to 2020 (RIS10-20). The strategy
supports the transformation to new models of care and underpins the
development of a person-centre model to achieve better, sooner, more
convenient health care.
Safe Medication Management Programme
Medication is one of the most common therapeutic interventions used in
the health care system, and medication errors in hospitals or the community
are common. Approximately 1.6% of people admitted to hospital may
experience an adverse medication event. Of these events, the majority are
preventable and occur inside hospitals. Preventable adverse events have a
signifi cant impact on consumers. About 3.1% result in death and 8.3% in
permanent disability.
Northland DHB has introduced strategies proven to be effective for reducing
the rate of errors in medication management. They include: pharmacy
software; reconfi guration of medication rooms and implementation of a
new patient medication chart on 6 April 2010.
Value for Money (VfM) and Productivity Increase
Northland DHB established a VfM steering group to oversee and support
VfM projects, report benefi ts and ensure ongoing benefi ts are imbedded into
the organisation. Launched in 2009, the aim of the group is to encourage
staff to submit cost savings and effi cient project and ideas.
Working through a number of great ideas in areas including electricity
consumption, use of motor vehicles and procurement reviews, the district
health board has saved over $1,200,000.
Violence Intervention Programme
The violence intervention programme screening project is currently being
implemented at Whangarei Hospital’s emergency department and maternity
service and Kaitaia Hospital. During the next two years, the programme
will be rolled out within all areas of the district health board.
Family violence intervention training is now mandatory for all district health
board services and departments.
Whangarei Hospital’s Site Master Plan
Strong progress continues with the Whangarei Hospital development
following the Minister of Health’s approval of our stage one business case
to build a new mental health inpatient unit. Principal consultants for the
multi-million dollar building programme have been selected.
The developed design for the new 25 bed mental health unit at Whangarei
Hospital was approved by the Northland DHB Board at its meeting held
on 21 June 2010.
The main building contractor is expected to be appointed in late September
and works will commence on site at Whangarei Hospital in October 2010.
The building is expected to be completed and operational by December
2011.
PUBLIC AND POPULATION HEALTH POINTS
Emergency Planning and Disease Outbreaks
Following the World Health Organisation declared H1N1 pandemic
infl uenza event, Northland DHB successfully contained and managed
the H1N1 outbreak in Northland during the winter of 2009. Work is
continuing on the development of the Maori component of the Northland
DHB pandemic plan.
A tornado hit Kaitaia Hospital on Saturday, 4 July 2010. It damaged
roofi ng on the old boiler house and shattered glass in the building. The
boiler room roof landed on the main hospital roof, damaging it. The
general practitioner waiting room areas had considerable damage done to
the ceiling tiles. The glass panel in the fi rst exit doors next to the cafeteria
was damaged along with the windows at the front entrance to the hospital.
There were patients and children in the waiting area, but fortunately no one
was hurt.
On 30 October 2009, all theatres were closed as a result of a signifi cant
power cut experienced through out Northland and Auckland. All elective
surgery was cancelled as a consequence and patients were rescheduled.
In January 2010, dry conditions prevailed in Northland causing less
than average monthly rainfall resulting in low river and stream levels and
extreme soil moisture defi cits. Drought conditions continued to worsen
and the Far North District Council placed area water restrictions in Kaitaia
directly affecting Kaitaia Hospital. Northland DHB activated its incident
management team to monitor community health concerns. The team stood
down on 1 June, following the lifting of water restrictions by the district
council.
In March 2010, Northland DHB’s medical offi cer of health notifi ed
Northlanders of a measles outbreak in Northland area. There had been
thirty two reported cases of measles (fi ve laboratory confi rmed) in the
Hokianga since the middle of February 2010.
All cases, except for one, were directly associated with an extended family
group in the Hokianga whose children are largely unvaccinated and are
home-schooled. Most cases were unwell, with one child admitted to
hospital.
High Five for clean hands
In 2007, the Northland District Health Board with support from
representatives from Northland’s schools and early childhood centers
launched a Northland-wide project for children aged 0 – 12 years focusing
on the lifelong importance of good hand hygiene.
The goal of the programme was to effectively spread the message
throughout Northland that thoroughly washing and drying hands is one of
the most signifi cant things that children and their families can do to prevent
the spread of illnesses.
In August 2009, the Ministry of Health adopted the programme and rolled
it out over 6,000 schools and preschools throughout New Zealand to
support hygiene activities in local communities and in response to Novel A
H1N1 09 pandemic.
In response, Northland DHB’s public health promotion unit launched the
second phase of the programme involving the unveiling of vehicle signage
and billboards. Each vehicle and billboard incorporates the vibrant ‘High
5 for Clean Hands’ theme.
SCHOOL AND COMMUNITY FOCUSED ACTIONS
Health Assessment of Year 9 Children in Decile 1 and 2 Schools
The new school based health assessment programme for Year 9 children in
Decile 1 and 2 schools began in May 2010. The overall purpose of the
programme is to identify health issues, improve students’ access to primary
health care and to ensure that appropriate and timely referrals are made in
order to improve youth health and reduce inequalities.
The programme’s objectives are to appropriately plan for, resource and
25

26
implement a comprehensive health needs assessment for all year nine
students attending Decile1 and 2 secondary schools, alternative education
facilities and teen parenting units.
There are three main elements in delivery of the service: universal health,
disability and youth development checks; proactive services such as
promotional health campaigns; and individual health services.
The programme will run for two years with public health nurses conducting
approximately 1500 physical and physiological health assessments at
schools across the region.
Vision and hearing testing for all eligible students will be provided across
Northland by the vision and hearing technician services. Utilisation of
existing Kaiawhina support services in Whangarei and extension of the
Mid-Far North service will also occur.
Oral Health and Fluoridation
Fluoridation of reticulated water suppliers, is one of the cornerstones of
preventing tooth decay and has been identifi ed as one of the top ten public
health measures by The Centres for Disease Control and Prevention (CDC).
It is also one of the most controversial issues as well.
The Far North District Council resolved to fl uoridate Kaitaia and Kaikohe
(2007) for a period of two years. This presented an opportunity to evaluate
the effectiveness of water fl uoridation in reducing dental decay, and a
cross-sectional epidemiological study was conducted with approval from
the Northern Y Regional Ethics Committee and funding from the Ministry of
Health Oral Health Research grant.
The study fi ndings of the results showed that the dental decay rates had
decreased by 5% among 12-13 year olds residing in fl uoridated towns
compared to non-fl uoridated towns. The study has been regarded as
important in the dental scientifi c world.
Child and Adolescent Oral Health Business Case
Good progress has been made on the Oral Health business case over the
last year, which will see an investment of $4.881 million to upgrade child
and adolescent oral health services in the region.
Northland has been allocated funding from the Ministry of Health to provide
seventeen new dental chairs to support the building of an improved, modern,
more integrated and seamless Child and Adolescent Oral Health service
to the 0-17 year age group. All these new dental chairs and facilities are
‘state of the art’ and over time will slowly replace the dental chairs in old
school dental clinics. This will occur in a carefully planned way so that the
current delivery of oral health services to children will not be affected, and
that the provision of care will continue to be delivered at or near where
children go to school or live.
The plan proposes that fourteen of these new dental chairs are strategically
placed in fi xed community clinics across Northland and the remaining three
chairs are placed in two new modern mobile dental units.
The fi rst of the four larger fi xed-site community dental clinics will open
Kaitaia Hospital.
To date we have four of the fourteen fi xed dental chairs and all three mobile
dental chairs operational. Planning is underway for a further ten dental
chairs to be built and become operational during 2011 and 2012, as well
as the construction of concrete pads in selected rural Northland schools, that
do not currently have a suitable site to park visiting mobile dental units.
One of the new diagnostic and screening mobile dental units has been
travelling across Northland for the past year and the new two-chair mobile
dental unit, suitable for providing screening and treatment, arrived in August
2009. These two new mobiles have complimented the already existing
mobile dental unit fl eet, and has further improved access for children and
adolescents to oral health services, especially those living in more rural
areas.
OUR TRUST AND FOUNDATION PARTNERS
Fresh Futures for Northland Kids
Northland’s Fresh Futures campaign launch was held in August 2009. The
appeal saw a variety of fundraising activities taking place to raise funds
for children’s wards in various hospitals around the country. A cheque for
$50,000 was presented to Northland DHB, which was used for paediatric
equipment in the child health unit.
Project Promise Launch
The Minister of Health Hon Tony Ryall, offi cially launched Project Promise,
a joint initiative between Northland Community Foundation and Northland
DHB to provide Northlander’s with their own patient centric ‘cancer-centre’.
The gala event was the fi rst step of a major project to raise $3 million for
the centre, which will be a one-stop-shop that houses all cancer related
information and services, such as chemotherapy and multi-disciplinary
outpatient consultations, providing a venue where education of patients,
family/whanau, and health professionals can occur.
St John Hospital Friends
St John Hospital Friends service was offi cially launched at the Bay of
Islands Hospital on 27 April 2010, as St John commences its celebration
of 125 years service in New Zealand. This new service compliments
clinical services with St John training volunteers to assist in hospital wards,
providing support and comfort to patients, enabling medical staff to focus on
clinical care. St John has also trained nine volunteers to assist at Dargaville
Hospital.

Governance And Partnerships
In accordance with the New Zealand Public Health and Disability Act
2000, the Board has a membership of 11, seven of whom were elected
in October 2007 and four of whom were appointed by the Minister of
Health. In February 2010, the Board combined the committee meetings
for Community & Public Health Advisory Committee and Disability Support
Advisory Committee. The Board now has three committees which provide
a more detailed level of focus on particular issues:
Board Members:
Anthony Norman (Chair from 1 January 2010)
Lynette Stewart (Chair, Term ended 31 December 2009)
MC (Bill) Sanderson (Deputy Chair)
Pauline Allan-Downs
Daniel Bolton
Craig Brown
Debbie Evans
Erima Henare
Peter Jensen
Colin Kitchen
Sally Macauley
Community & Public Health and Disability Support Advisory
Committee:
Sally Macauley (Chair, Board member)
Lynette Stewart (CPHAC Chair, Term ended 31 December 2009)
Craig Brown (Board member)
Debbie Evans (Board member)
Connie Hassan
Erima Henare (Board member)
Peter Jensen (Board member)
Colin Kitchen (Board member, DiSAC member until 2 February 2010)
Noel Matthews
Anthony Norman (Board member)
Kevin Robinson
MC (Bill) Sanderson (Board member)
John Wigglesworth
Beryl Wilkinson
Jonny Wilkinson
Hospital Advisory Committee:
MC (Bill) Sanderson (Chair, Board member)
Maureen Allan
Pauline Allan-Downs (Board member)
Daniel Bolton (Board member)
Scott Cameron
Diane Davis (Resigned 1 April 2010)
Colin Kitchen (Board member, Member from 2 February 2010)
Anthony Norman (Board member)
Lynette Stewart (Board member, Term ended 31 December 2010)
Audit & Risk Management Committee:
Craig Brown (Chair, Board member)
Sally Macauley (Board member, Member from 2 February 2010)
Anthony Norman (Board member)
MC (Bill) Sanderson (Board member)
Lynette Stewart (Board member, Term ended 31 December 2010)
Audit & Risk Management Committee:
Craig Brown (Chair, Board member)
Sally Macauley (Board member, Member from 2 February 2010)
Anthony Norman (Board member)
MC (Bill) Sanderson (Board member)
Lynette Stewart (Board member, Term ended 31 December 2010)
The Chief Executive is the Board’s sole employee and is responsible for
implementing the strategic direction of the Board. The Chief Executive is
supported by a strong senior management team which oversees clinical,
support and advisor services.
Historically, Northland DHB accessed established Ministry of Health
mechanisms for engaging with Maori at both governance and operational
funding and planning levels, through relationships with the two Maori
Advisory Purchasing Organisations (MAPOs), Te Tai Tokerau MAPO
(TTTM) and Tihi Ora MAPO.
Earlier this year, Whanau Ora was launched as an inclusive approach
to providing services and opportunities to families across New Zealand.
At the same time, the Ministry of Health reviewed and altered its MAPO
contracts, refocusing on planning and workforce development associated
with the new Government initiative. Consequently, the Ministry of Health
funding agreement for enabling Maori governance and operational
engagement with the two Northland MAPOs expired.
Northland DHB is now moving to establish relationships directly with iwi,
in order to comply with obligations to Maori as established in the New
Zealand Public Health and Disability Act 2000.
29

Our Health Priorities
Northland DHB’s priorities for 2009/10 arise from a combination of
national strategies, national health targets and priorities listed in the
Minister of Health’s annual Letter of Expectations.
Our priorities this year:
• Cancer
• Cardiovascular Disease
• Children and Youth
• Clinical Leadership
• Diabetes
• Disability Support
• Emergency Department
• Elective Services
• Immunisation
• Improving Service and Reducing Waiting Times
• Maternal Health
• Maori Health
• Mental Health
• Older People
• Oral Health
• Primary Health
• Palliative Care
• Public Health
• Regional Co-operation
• Respiratory Disease
• Shifting Services from Secondary to Primary Care
• Workforce
Our Strategies
Northland DHB has progressively been developing strategies to deal
with these priorities. Each strategy, which has had wide stakeholder
involvement, is a vital driver of our planning activity and collectively
they describe how the district health board intends to raise health status,
improve equity and improve the way services work.
Our strategies adopted this year:
• Disability Strategy Implementation Plan
Strategies yet to be adopted:
• Tobacco
• Mental Health
• Primary Health Care
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32
For the Year Ended 30 June 2010

Financial And Audit Reports Content
Statement of Responsibility .................................................................................................................................... 34
Board Report ....................................................................................................................................................... 35
Audior’s Report .................................................................................................................................................... 38
Statement of Comprehensive Income ...................................................................................................................... 40
Consolidated Statement of Changes In Equity ......................................................................................................... 41
Consolidated Statement of Financial Position .......................................................................................................... 42
Consolidated Statement of Cash Flows ................................................................................................................... 43
Consolidated Statement of Contingent Liabilities ..................................................................................................... 44
Consolidated Statement of Commitments ................................................................................................................ 44
Notes to the Financial Statements .......................................................................................................................... 45
Statement of Accounting Policies ............................................................................................................................ 66
Statement of Service Performance .......................................................................................................................... 72
33

34
Northland District Health Board
Statement of Responsibility
1. The Board and management of Northland District Health Board and group accepts responsibility for the preparation of the Annual
Financial Statements and Statement of Service Performance and the judgements used in them.
2. The Board and management of Northland District Health Board accepts responsibility for establishing and maintaining a system of
internal control, designed to provide reasonable assurance as to the integrity and reliability of fi nancial and non fi nancial
reporting.
3. In the opinion of the Board and management of Northland District Health Board, the Financial Statements and the Statement of
Service Performance for the year ended 30 June 2010 fairly refl ect the fi nancial position and operations of Northland District
Health Board and group.
Signed on behalf of the Board;
AAnthony th NNorman
Chairperson
27 October 2010
Karen Roach h
Chief Executive
27 October 2010
MC (Bill) Sanderson
Board Member
27 October 2010
Robert Paine
General Manager, Finance, Human Resources
and Commercial Services
27 October 2010

Northland District Health Board
Board Report
The Board have pleasure in submitting the Financial Statements and Statement of Service Performance for Northland District Health
Board for the year to 30 June 2010.
Principal Activities
The entity’s principal activities during the period were funding and the provision of health and disability services for the people of
Northland with specialist treatment, community nursing, health promotion and health protection services, most of which were based on
contractual arrangements with the Ministry of Health.
Northland District Health Board operates the following hospitals and related services:
Whangarei Hospital
Kaitaia Hospital
Bay of Islands Hospital (Kawakawa)
Dargaville Hospital
Primary and community health services providing community, district and public health nursing, public health services, health promotion
and health protection services.
2010 2009
Results and Distribution Group $’000s $’000s
Surplus net of Capital Charge 586 295
Financial Position
Equity was represented by:
Current Assets 54,457 93,262
Less Current Liabilities (81,535) (86,671)
Plus Non-Current Assets 126,144 92,531
Less Non-Current Liabilities (32,262) (34,404)
66,804 64,718
Review of the Operations
A review of the entity’s operations accompanies this report under the headings of Chairperson’s Report and Chief Executive Offi cer’s
Report.
Distributions to Owners
The Board have made payments by way of a specifi ed health payment (capital charge) based on net equity which is treated as an
expense not a distribution.
Board Member Fees
No board member of the entity has, since the establishment of the Board, received or become entitled to receive a benefi t, except for
board and committee member fees and travel allowance, as set by the Ministry of Health. Fees paid to Board and Committee members
are detailed in Note 18 of the Financial Statements.
35

36
Northland District Health Board
Board Report
Staff Remuneration
The number of staff with total annualised cost to the entity for senior staff packages including salary and other benefi ts, such as
superannuation, with totals in excess of $100,000 for the year to 30 June 2010 (in $10,000 bands):-
$100,001 - $110,000 28 $110,001 - $120,000 30
$120,001 - $130,000 17 $130,001 - $140,000 9
$140,001 - $150,000 14 $150,001 - $160,000 8
$160,001 - $170,000 5 $170,001 - $180,000 11
$180,001 - $190,000 9 $190,001 - $200,000 10
$200,001 - $210,000 3 $210,001 - $220,000 6
$220,001 - $230,000 9 $230,001 - $240,000 8
$240,001 - $250,000 2 $250,001 - $260,000 5
$260,001 - $270,000 2 $270,001 - $280,000 6
$280,001 - $290,000 2 $290,001 - $300,000 3
$300,001 - $310,000 2 $310,001 - $320,000 2
$320,001 - $330,000 3 $330,001 - $340,000 1
$340,001 - $350,000 1
Of the 196 staff shown above, 141 are or were medical or dental staff.
If the remuneration of part-time staff were grossed-up to an FTE basis, the total number of staff with FTE salaries of $100,000 or more
would be 224, compared with the actual total number of staff of 196.
Statement of Information
There were no notices from the Board Members requesting to use the information received in their capacity as Board Members which
would not otherwise have been available to them.
Interest Register
All relevant and required disclosures relating to Board Members’ interests have been effected during the year and none of the disclosed
interests relate to transactions of the entity that any Board Member has or may have had an interest in.
Board Member’s Insurance
Northland District Health Board and its Board members have taken out liability insurance providing cover against particular liabilities.
Events Subsequent to Balance Date
The Board members are not aware of any matter or circumstance since the end of the fi nancial year (not otherwise dealt with in this
report or the Board’s fi nancial statements) that may signifi cantly affect the operation of Northland District Health Board, the result of its
operations, or the state of affairs of the Board.
Donations
No donations were made for the year to 30 June 2010.
Changes in Accounting Policies
There have been no changes in accounting policies from those adopted in the Northland District Health Board’s last audited fi nancial
statements, other than those required by new standards or amendments adopted as detailed in the accounting policies.
Auditor’s Remuneration
The Controller and Auditor-General is appointed under sections 150 and 156 of the Crown Entities Act 2004. Audit New Zealand
is contracted to provide audit services on behalf of the Auditor-General. Audit New Zealand in their capacity as Auditors are due
$157,200 for audit fees for the group.
In accordance with section 151(1)(g) of the Crown Entities Act 2004 Northland District Health Board is compliant with its obligation
to be a good employer (including its equal employment opportunities programme).

Northland District Health Board
Board Report
Northland District Health Board has a comprehensive range of human resource management policies and procedures in place in
order that it can uphold its good employer status. These include but are not restricted to appointment, orientation, recruitment, leave,
continuing education, credentialing, performance management, disciplinary procedures, harassment protection, impaired staff, work
and family, workplace rehabilitation and equal employment opportunities.
For and on behalf of the Board of Northland District Health Board.
Anthony h
Norman
CHAIRPERSON
37

38
Northland District Health Board
Auditor’s Report
TO THE READERS OF
NORTHLAND DISTRICT HEALTH BOARD AND GROUP’S
FINANCIAL STATEMENTS AND STATEMENT OF SERVICE PERFORMANCE
FOR THE YEAR ENDED 30 JUNE 2010
The Auditor General is the auditor of Northland District Health Board (the Health Board) and group. The Auditor General has appointed
me, John Scott, using the staff and resources of Audit New Zealand, to carry out the audit on her behalf. The audit covers the fi nancial
statements and statement of service performance included in the annual report of the Health Board and group for the year ended 30
June 2010.
Unqualifi ed Opinion
In our opinion:
• The fi nancial statements of the Health Board and group on pages 40 to 71:
• comply with generally accepted accounting practice in New Zealand; and
• fairly refl ect:
- the Health Board and group’s fi nancial position as at 30 June 2010; and
- the results of operations and cash fl ows for the year ended on that date.
• • The statement of service performance of the Health Board and group on pages 72 to 81:
• complies with generally accepted accounting practice in New Zealand; and
• fairly refl ects for each class of outputs:
- its standards of delivery performance achieved, as compared with the forecast standards included in the statement of
forecast service performance at the start of the fi nancial year; and
- its actual revenue earned and output expenses incurred, as compared with the expected revenues and proposed output
expenses included in the statement of forecast service performance at the start of the fi nancial year.
The audit was completed on 27 October 2010, and is the date at which our opinion is expressed.
The basis of our opinion is explained below. In addition, we outline the responsibilities of the Board and the Auditor, and explain our
independence.
Basis of Opinion
We carried out the audit in accordance with the Auditor General’s Auditing Standards, which incorporate the New Zealand Auditing
Standards.
We planned and performed the audit to obtain all the information and explanations we considered necessary in order to obtain
reasonable assurance that the fi nancial statements and statement of service performance did not have material misstatements, whether
caused by fraud or error.
Material misstatements are differences or omissions of amounts and disclosures that would affect a reader’s overall understanding of the
fi nancial statements and statement of service performance. If we had found material misstatements that were not corrected, we would
have referred to them in our opinion.
The audit involved performing procedures to test the information presented in the fi nancial statements and statement of service
performance. We assessed the results of those procedures in forming our opinion.

Northland District Health Board
Auditor’s Report
Audit procedures generally include:
• determining whether signifi cant fi nancial and management controls are working and can be relied on to produce complete and
accurate data;
• verifying samples of transactions and account balances;
• performing analyses to identify anomalies in the reported data;
• reviewing signifi cant estimates and judgements made by the Board;
• confi rming year-end balances;
• determining whether accounting policies are appropriate and consistently applied; and
• determining whether all fi nancial statement and statement of service performance disclosures are adequate.
We did not examine every transaction, nor do we guarantee complete accuracy of the fi nancial statements and statement of service
performance.
We evaluated the overall adequacy of the presentation of information in the fi nancial statements and statement of service performance.
We obtained all the information and explanations we required to support our opinion above.
Responsibilities of the Board and the Auditor
The Board is responsible for preparing the fi nancial statements and statement of service performance in accordance with generally
accepted accounting practice in New Zealand. The fi nancial statements must fairly refl ect the fi nancial position of the Health Board
and group as at 30 June 2010 and the results of operations and cash fl ows for the year ended on that date. The statement of service
performance must fairly refl ect, for each class of outputs, the Health Board and group’s standards of delivery performance achieved
and revenue earned and expenses incurred, as compared with the forecast standards, revenue and expenses at the start of the
fi nancial year.
The Board’s responsibilities arise from the New Zealand Public Health and Disability Act 2000 and the Crown Entities Act 2004.
We are responsible for expressing an independent opinion on the fi nancial statements and statement of service performance and
reporting that opinion to you. This responsibility arises from section 15 of the Public Audit Act 2001 and the Crown Entities Act
2004.
Independence
When carrying out the audit we followed the independence requirements of the Auditor General, which incorporate the independence
requirements of the New Zealand Institute of Chartered Accountants.
Other than the audit and providing specialist assurance for the project management of the Northland Hospital Development Project, we
have no relationship with or interests in the Health Board or any of its subsidiaries.
John Scott
Audit New Zealand
On behalf of the Auditor General
Auckland, New Zealand
39

40
Northland District Health Board
Statement of Comprehensive Income
For the Year Ended 30 June 2010
Budget Group Parent
Notes 2010 2010 2009 2010 2009
$000 $000 $000 $000 $000
Income
Revenue 1 464,456 471,580 442,126 471,957 441,993
Finance Income 4a 4,016 3,307 4,898 3,295 4,883
Total Income 468,472 474,887 447,024 475,252 446,876
Expenditure
Employee Benefi t Costs
Depreciation, Amortisation and Impairment
3 161,617 163,349 145,482 163,349 145,482
Expense 6,7 8,962 12,268 9,611 11,850 9,266
Outsourced Services 10,737 12,752 13,922 12,752 13,922
Clinical Supplies 31,302 34,276 32,415 34,276 32,415
Infrastructure and Non-Clinical Expenses 2 22,475 24,905 25,341 25,405 25,331
Payments to Non-Health Board Providers 227,448 220,041 213,995 220,041 213,995
Finance Costs 4b 1,640 1,694 1,698 1,694 1,698
Capital Charge 5 4,291 5,016 4,265 5,016 4,265
Total Expenses 468,472 474,301 446,729 474,383 446,374
Surplus Before and After Tax 12 0 586 295 869 502
Surplus attributable to:
Northland District Health Board 0 660 334 869 502
Minority Interest 0 (74) (39) 0 0
Other Comprehensive Income
Gains on Property Revaluations
Financial Assets at fair value through other
0 0 8,348 0 6,825
Comprehensive Income 0 433 0 433 0
Total other Comprehensive Income 0 433 8,348 433 6,825
Total Comprehensive Income 0 1,019 8,643 1,302 7,327
Total Comprehensive Income attributable to:
Northland District Health Board 0 1,093 7,982 1,302 7,327
Minority Interest 0 (74) 661 0 0
At the end of the 2010 fi nancial year, there was $0 Mental Health Ring Fence Funding unspent (2009: $0).
Explanations of major variances against budget are detailed in note 25.
The accompanying accounting policies and notes form part of these fi nancial statements.

Northland District Health Board
Statement of Comprehensive Income (Continued)
For the Year Ended 30 June 2010
Supplementary Information
The following table shows the consolidation of the cost of service statements for each output class:
2010 - Actual Provider Governance Funder Kaipara JV Consolidated
2010 2010 2010 2010 2010
$000 $000 $000 $000 $000
Revenue 246,387 4,566 224,299 (365) 474,887
Expenses 250,008 4,333 220,042 (82) 474,301
Surplus/(Defi cit) Before and After Tax (3,621) 233 4,257 (283) 586
2010 - Budget Provider Governance Funder Kaipara JV Consolidated
2010 2010 2010 2010 2010
$000 $000 $000 $000 $000
Revenue 237,063 3,960 227,449 0 468,472
Expenses 237,063 3,960 227,449 0 468,472
Surplus/(Defi cit) Before and After Tax 0 0 0 0 0
Consolidated Statement of Changes in Equity
For the Year Ended 30 June 2010
Budget Group Parent
Notes 2010 2010 2009 2010 2009
$000 $000 $000 $000 $000
Balance at 1 July 53,853 64,718 55,494 62,103 54,091
Total Comprehensive Income 0 1,019 8,643 1,302 7,327
Capital Contribution 5,000 1,171 362 1,171 362
Movement in Trust Funds 0 0 185 0 185
Other Movement 0 0 138 0 138
Balance at 30 June 58,853 66,908 64,822 64,576 62,103
Distributions made to Minority interest 0 (104) (104) 0 0
Balance at 30 June 12 58,853 66,804 64,718 64,576 62,103
Total Comprehensive Income attributable to:
Northland District Health Board 58,853 64,845 62,580 64,576 62,103
Minority Interest 0 1,959 2,138 0 0
Balance at 30 June 12 58,853 66,804 64,718 64,576 62,103
The accompanying accounting policies and notes form part of these fi nancial statements.
41

42
Northland District Health Board
Consolidated Statement of Financial Position
As at 30 June 2010
Budget Group Parent
Notes 2010 2010 2009 2010 2009
$000 $000 $000 $000 $000
Assets
Property, Plant and Equipment 6 88,971 89,616 91,323 85,979 87,268
Intangible Assets 7 424 1,163 1,208 1,163 1,208
Investments 8 1,762 35,365 0 37,127 1,762
Total Non-Current Assets 91,157 126,144 92,531 124,269 90,238
Inventories 9 4,058 4,404 4,291 4,404 4,291
Trade and Other Receivables 10 11,600 9,435 12,972 9,432 12,968
Prepayments 755 366 496 366 496
Cash and Cash Equivalents 11 44,751 29,325 54,769 29,140 54,499
Short Term Deposits 11 15,000 10,194 20,065 10,000 20,000
Trust/Special Fund Assets 271 733 669 733 669
Total Current Assets 76,435 54,457 93,262 54,075 92,923
Total Assets 167,592 180,601 185,793 178,344 183,161
Equity
Crown Equity 12 40,341 40,258 39,012 41,043 39,872
Other Reserves 12 17,772 27,479 27,089 24,987 24,597
Retained Earnings/(Losses) 12 469 (3,625) (4,190) (2,187) (3,035)
Trust/Special Funds
Total Equity Attributable to Northalnd District
12 271 733 669 733 669
Health Board 58,853 64,845 62,580 64,576 62,103
Minority Interest 0 1,959 2,138 0 0
Total Equity 58,853 66,804 64,718 64,576 62,103
Liabilities
Interest-Bearing Loans and Borrowings 13 24,650 20,937 23,650 20,937 23,650
Employee Benefi ts 14 6,932 11,325 10,754 11,325 10,754
Total Non-Current Liabilities 31,582 32,262 34,404 32,262 34,404
Interest-Bearing Loans and Borrowings 13 0 4,076 1,000 4,076 1,000
Trade and Other Payables 16 47,256 49,303 59,082 49,274 59,065
Employee Benefi ts 14 29,901 28,156 26,589 28,156 26,589
Provisions 15 0 0 0 0 0
Total Current Liabilities 77,157 81,535 86,671 81,506 86,654
Total Liabilities 108,739 113,797 121,075 113,768 121,058
Total Equity and Liabilities 167,592 180,601 185,793 178,344 183,161
Explanations of major variances against budget are detailed in note 25.
The accompanying accounting policies and notes form part of these fi nancial statements.
For and on Behalf of the Board
Anthony Norman - Chairperson
27 October 2010
MC (Bill) Sanderson - Board Member
27 October 2010

Northland District Health Board
Consolidated Statement of Cash Flows
For the Year Ended 30 June 2010
Budget Group Parent
Notes 2010 2010 2009 2010 2009
$000 $000 $000 $000 $000
Cash Flows from Operating Activities
Cash Receipts from Ministry of Health and
Patients 464,456 476,704 440,962 477,073 441,339
Cash Paid to Suppliers (291,964) (303,980) (273,547) (304,382) (273,942)
Cash Paid to Employees (161,617) (161,211) (146,188) (161,211) (146,188)
Cash Generated from Operations 10,875 11,513 21,227 11,480 21,209
Interest Received 4,016 2,943 6,944 2,933 6,929
Interest Paid (1,640) (1,699) (1,697) (1,699) (1,697)
Net Taxes Refunded/(Paid)
(Goods and Services Tax) 0 792 360 792 357
Capital Charge Paid (4,291) (4,946) (4,264) (4,946) (4,264)
Net Cash Flows From Operating Activities 11 8,960 8,603 22,570 8,560 22,534
Cash Flows From Investing Activities
Proceeds from Sale of Property, Plant and Equipment
0 182 206 182 206
Acquisition of Property, Plant and Equipment (18,227) (9,714) (11,283) (9,714) (11,283)
Acquisition of Intangible Assets 0 (857) (405) (857) (405)
Acquistion in Investments & Trust Fund Assets 0 (25,192) (734) (25,064) (730)
Net Cash Flows From Investing Activities (18,227) (35,581) (12,216) (35,453) (12,212)
Cash Flows from Financing Activities
Proceeds from Equity Injection 5,000 1,171 362 1,171 362
Borrowings Raised 0 363 0 363 0
Net Cash Flows from Financing Activities 5,000 1,534 362 1,534 362
Net Increase/(Decrease) in Cash and Cash
Equivalents (4,267) (25,444) 10,716 (25,359) 10,684
Cash and Cash Equivalents at Beginning of Year 49,018 54,769 44,053 54,499 43,815
Cash and Cash Equivalents at End of Year 11 44,751 29,325 54,769 29,140 54,499
The GST (net) component of operating activities refl ects the net GST paid and received with the Inland Revenue Department. The GST (net) component
has been presented on a net basis, as the gross amounts do not provide meaningful information for fi nancial statement purposes.
The accompanying accounting policies and notes form part of these fi nancial statements.
43

44
Northland District Health Board
Consolidated Statement of Contingent Liabilities
As at 30 June 2010
Legal Proceedings:
There are no legal proceedings outstanding as at 30 June 2010 (2009: nil).
Personal Grievances:
There are no personal grievance claims outstanding as at 30 June 2010 (2009: nil)
Contingent Assets:
NDHB and group have no contingent assets (2009: nil)
Consolidated Statement of Commitments
As at 30 June 2010
Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Capital Commitments 4,856 2,420 4,856 2,420
Operating Commitments
Not more than one year 18,644 30,970 18,644 30,970
One to two years 13,218 12,729 13,218 12,729
Two to fi ve years 1,701 9,689 1,701 9,689
Over fi ve years 0 0 0 0
33,563 53,388 33,563 53,388
Operating Lease Commitments
Not more than one year 2,096 1,798 2,096 1,543
One to two years 1,345 796 1,345 796
Two to fi ve years 2,167 788 2,167 788
Over fi ve years 551 24 551 24
6,159 3,406 6,159 3,151
Total Commitments 44,578 59,214 44,578 58,959
Northland District Health Board leases a number of buildings, vehicles and offi ce equipment (mainly photocopiers) under operating leases. The
leases run for various lengths of time depending on requirements (for buildings) and typically 5 years (for vehicles and offi ce equipment), with an
option to renew the lease after that date. None of the leases include contingent rentals.
During the year ended 30 June 2010, $3,391,000 was recognised as an expense in the statement of fi nancial performance in respect of operating
leases (2009: $2,625,000).
Fixed Contracts
Northland District Health Board contracts with a wide variety of service providers with whom there are differing contractual terms. These are renegotiated
periodically, refl ecting the general principle that an ongoing business relationship exists with these providers. Included in the commitments
total is only the actual contracted amount.
Demand-driven Contracts
Total commitments does not include demand-driven contracts as this expenditure is ultimately paid to individual consumers on a population or
needs basis.

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
1 Revenue Group Parent
2010 2009 2010 2009
Notes $000 $000 $000 $000
Health and Disability Services (MoH Contracted Revenue) 454,420 424,588 454,420 424,588
ACC Contract 3,109 3,206 3,109 3,206
Inter District Patient Infl ows 7,824 8,500 7,824 8,500
Other Revenue 6,227 5,832 6,604 5,699
471,580 442,126 471,957 441,993
Revenue for Health Services includes all revenue received from the Crown (via the Ministry of Health), Accident Rehabilitation and Compensation
Insurance Corporation (ACC), and other sources.
2 Infrastructure and Non-Clinical Expenses Group Parent
2010 2009 2010 2009
Included in Infrastructure and Non-Clinical Expenses: Notes $000 $000 $000 $000
Impairment of Trade Receivables (Bad and Doubtful Debts) 10 47 97 47 97
Loss on disposal of Property, Plant and Equipment (37) 45 (37) 45
Audit Fees (Audit of Financial Statements) 157 114 157 114
Audit Fees (Audit of Financial Statements additional 2009) 29 0 29 0
Fees paid to Auditor for Other Services (Internal Audit) 80 75 80 75
Fees paid to Auditor for Other Services (Provider Audits) 63 94 63 94
Board and Committee Member Fees and Expenses 304 324 324
Operating Lease Expenses 3,391 2,625 3,391 2,625
3 Employee Benefi t Costs Group Parent
2010 2009 2010 2009
Notes $000 $000 $000 $000
Wages and Salaries 161,211 145,937 161,211 145,937
Increase/Decrease in Employee Benefi t Provisions 2,138 (455) 2,138 (455)
4 Finance Income and Finance Costs
163,349 145,482 163,349 145,482
4a Finance Income Group Parent
2010 2009 2010 2009
Notes $000 $000 $000 $000
Interest Income 3,307 4,898 3,295 4,883
4b Finance Costs Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Interest Expense 1,694 1,698 1,694 1,698
5 Capital Charge
Northland District Health Board pays a monthly capital charge to the Crown based on the greater of its actual or budgeted closing equity
balance for the month. The capital charge rate for the period ended 30 June 2010 was 8% (2009: 8%).
45

46
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
6 Property, Plant and Equipment
(a) Group
Freehold land (at
valuation)
Freehold buildings
(at valuation)
Plant, equipment
and vehicles
Work in progress Total
Cost $000 $000 $000 $000 $000
Balance at 1 July 2008 10,227 67,410 50,330 1,270 129,237
Additions 0 5,411 5,493 0 10,904
Disposals (150) (52) (462) 0 (664)
Reclassifi cation (2,850) 2,817 33 0 0
Movement due to Revaluation 1,187 (5,883) 0 0 (4,696)
Movement in Work in Progress 0 0 0 111 111
Balance at 30 June 2009 8,414 69,703 55,394 1,381 134,892
Balance at 1 July 2009 8,414 69,703 55,394 1,381 134,892
Additions 0 2,577 4,752 0 7,329
Disposals (65) (53) (2,830) 0 (2,948)
Movement in Work in Progress 0 0 0 2,478 2,478
Balance at 30 June 2010 8,349 72,227 57,316 3,859 141,751
Freehold land (at
valuation)
Freehold buildings
(at valuation)
Plant, equipment
and vehicles
Work in progress Total
Depreciation and Impairment Losses $000 $000 $000 $000 $000
Balance at 1 July 2008 0 8,941 39,295 0 48,236
Depreciation Charge for the year 0 4,296 4,655 0 8,951
Disposals 0 (14) (423) 0 (437)
Movement Due to Revaluation 0 (13,181) 0 0 (13,181)
Reclassifi cation 0 (33) 33 0 0
Balance at 30 June 2009 0 9 43,560 0 43,569
Balance at 1 July 2009 0 9 43,560 0 43,569
Depreciation Charge for the year 0 5,955 4,762 0 10,717
Impairment charge for the year 0 652 0 0 652
Disposals 0 (16) (2,787) 0 (2,803)
Balance at 30 June 2010 0 6,600 45,535 0 52,135
Freehold land (at
valuation)
Freehold buildings
(at valuation)
Plant, equipment
and vehicles
Work in progress Total
Carrying amounts $000 $000 $000 $000 $000
At 1 July 2008 10,227 58,469 11,035 1,270 81,001
At 30 June 2009
8,414 69,694 11,834 1,381 91,323
At 1 July 2009 8,414 69,694 11,834 1,381 91,323
At 30 June 2010 8,349 65,627 11,781 3,859 89,616

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
6 Property, Plant and Equipment (continued)
(b) Parent
Freehold buildings
(at valuation)
Plant, equipment
and vehicles
Fixtures
and fi ttings
Work in progress Total
Cost $000 $000 $000 $000 $000
Balance at 1 July 2008 9,927 64,140 50,330 1,270 125,667
Additions 0 5,411 5,493 0 10,904
Disposals (150) (52) (462) 0 (664)
Reclassifi cation (2,850) 2,817 33 0 0
Movement due to Revaluation 1,013 (6,194) 0 0 (5,181)
Movement in Work in Progress 0 0 0 111 111
Balance at 30 June 2009 7,940 66,122 55,394 1,381 130,837
Balance at 1 July 2009 7,940 66,122 55,394 1,381 130,837
Additions 0 2,577 4,752 0 7,329
Disposals (65) (53) (2,830) 0 (2,948)
Movement in Work in Progress 0 0 0 2,478 2,478
Balance at 30 June 2010 7,875 68,646 57,316 3,859 137,696
Freehold land (at
valuation)
Freehold buildings
(at valuation)
Plant, equipment
and vehicles
Work in progress Total
Depreciation and Impairment Losses $000 $000 $000 $000 $000
Balance at 1 July 2008 0 8,249 39,295 0 47,544
Depreciation charge for the year 0 3,951 4,655 0 8,606
Disposals 0 (14) (423) 0 (437)
Movement due to revaluation 0 (12,144) 0 0 (12,144)
Reclassifi cation 0 (33) 33 0 0
Balance at 30 June 2009 0 9 43,560 0 43,569
Balance at 1 July 2009 0 9 43,560 0 43,569
Depreciation Charge for the year 0 5,537 4,762 0 10,299
Impairment charge for the year 0 652 0 0 652
Disposals 0 (16) (2,787) 0 (2,803)
Balance at 30 June 2010 0 6,182 45,535 0 51,717
Freehold land (at
valuation)
Freehold buildings
(at valuation)
Plant, equipment
and vehicles
Work in progress Total
Carrying Amounts $000 $000 $000 $000 $000
At 1 July 2008 9,927 55,891 11,035 1,270 78,123
At 30 June 2009 7,940 66,113 11,834 1,381 87,268
At 1 July 2009 7,940 66,113 11,834 1,381 87,268
At 30 June 2010 7,875 62,464 11,781 3,859 85,979
47

48
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
6 Property, Plant and Equipment (continued)
Impairment
Impairment losses of $652,000 (2009:$nil) have been recognised in the current year in respect of the Mental Health Inpatient Unit and other
relocatable buildings used for delivering Mental Health services. The impairments are a result of the redundancy of the existing inpatient unit
due to the imminent replacement of this building with a new facility and in respect of the relocatable buildings due to services having been
moved off site and the need for these buildings to be physically relocated once alternative uses are identifi ed. The impairment expense has
been recognised in the Statement of Comprehensive Income in the line item “Depreciation, Amortisation and Impairment Expense”.
Revaluation
Current Crown accounting policies require all crown entities to revalue land and buildings in accordance with NZIAS 16, Property, Plant and
Equipment. Current valuation standards and guidance notes have been developed in association with the Treasury for the valuation of hospitals
and tertiary institutions.
The revaluation of land and buildings was carried out as at 30 June 2009 by Diana Koomen, an independent registered valuer with DTZ
Limited and a member of the New Zealand Institute of Valuers. The valuation conforms to International Valuation Standards and all land and
buildings excluding work in progress have been valued at fair value. The total fair value of property valued amounted to $78,108,000 at 30
June 2009. The valuer was contracted as an independent valuer. The next valuation will be completed by 30 June 2012.
Restrictions
Northland District Health Board does not have full title to crown land it occupies but transfer is arranged if and when land is sold. Some of
the land is subject to Waitangi Tribunal claims. The disposal of certain properties may be subject to the provision of section 40 of the public
works Act 1981.
Titles to land transferred from the Crown to Northland District Health Board are subject to a memorial in terms of the Treaty of Waitangi Act
1975 (as amended by the Treaty of Waitangi (State Enterprises) Act 1988). The effect on the value of assets resulting from potential claims
under the Treaty of Waitangi Act 1975 cannot be quantifi ed.
No fi xed assets of Northland District Health Board are pledged as security for liabilities.
7 Intangible Assets
Parent and Group
Software 2010 2009
Cost $000 $000
Balance at 1 July 4,254 3,586
Additions for the Year 854 668
Balance at 30 June 5,108 4,254
Amortisation
Balance at 1 July 3,046 2,386
Amortisation Charge for the Year 899 660
Balance at 30 June 3,945 3,046
Carrying Amounts
Balance at 1 July 1,208 1,200
Balance at 30 June 1,163 1,208
There are no development costs accounted for as intangible assets.
There are no restrictions over the title of Northland District Health Board’s intangible assets, nor are any intangible assets pledged as security
for liabilities.

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
8 Investments Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Investment in Subsidiary (at cost) 0 0 1,762 1,762
Bonds 35,365 0 35,365 0
Balance at 30 June 35,365 0 37,127 1,762
Investment in Subsidiary
General Information
Interest
Held
Interest
Held Balance
Name of Entity Principal Activity 2010 2009 Date
Kaipara Total Health Care Joint
Venture
Bonds
Medical Centre Delivering
Health Services 54% 54% 30 June
Bonds are recognised at fair value. Fair value has been determined using quoted market prices in an active market.
Interest rates on the Bonds range from 4.775% to 7.5%
9 Inventories Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Pharmaceuticals 220 246 220 246
Surgical and Medical Supplies 4,184 4,045 4,184 4,045
Balance at 30 June 4,404 4,291 4,404 4,291
Write-down of Inventories to net realisable value amounted to $12,347 for 2010 (2009: $10,556).
No Inventories are pledged as security for liabilities.
10 Trade and Other Receivables Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Trade Receivables from Non-related Parties 3,615 2,822 3,612 2,818
Ministry of Health Receivables 6,032 10,315 6,032 10,315
Less: Provision for Impairment (212) (165) (212) (165)
Balance at 30 June 9,435 12,972 9,432 12,968
The carrying amount of receivables approximates their fair value.
49

50
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
10 Trade and Other Receivables (Continued)
As at 30 June, all overdue receivables have been assessed for impairment and appropriate provisions applied, as detailed below:
Parent Parent
Gross
Receivable Impairment
Gross
Receivable Impairment
2010 2010 2009 2009
$000 $000 $000 $000
Not past due 9,287 95 12,822 107
Past due 0-30 days 206 14 34 2
Past due 31-60 days 22 8 45 23
Past due 61-90 days 30 16 26 3
Past due >91 days 99 79 206 30
Total 9,644 212 13,133 165
The provision for impairment has been calculated based on expected losses for the Northland District Health Board’s pool of debtors. Expected
losses have been determined based on an analysis of the Northland District Health Board’s losses in previous periods, and review of specifi c
debtors.
Movements in the provision for impairment of receivables are as follows:
Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Balance 1 July 165 68 165 68
Additional/(reduced) Provision during the year 66 151 66 151
Receivables written off during the period (19) (54) (19) (54)
Balance at 30 June 212 165 212 165
11 Cash and Cash Equivalents and Short Term Deposits Group Parent
2010 2009 2010 2009
(a) Cash and Cash Equivalents $000 $000 $000 $000
Cash On Hand and at Bank 4,325 20,270 4,140 20,000
Short Term Deposits with maturities less than 3 months 25,000 34,499 25,000 34,499
Total Cash and Cash Equivalents in the Statement of Cash Flows 29,325 54,769 29,140 54,499
(b) Short Term Deposits with maturities 4-12 months
Short Term Deposits with maturities 4-12 months 10,194 20,065 10,000 20,000
Total Cash and Cash Equivalents and Short Term Deposits 39,519 74,834 39,140 74,499

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
11 Cash and Cash Equivalents and Short Term Deposits (Continued)
The maturity dates and effective interest rates of short term deposits are as follows:
2010 2009
Effective fi xed
interest rate Actual
Effective fi xed
interest rate Actual
% $000 % $000
Short Term Deposits with maturities of 0-3 months: 4.30% 15,000 3.95% 34,500
3.88% 10,000
Short Term Deposits with maturities of 4-12 months: 5.00% 10,000 4.55% 15,000
4.80% 194 4.10% 5,000
2.85% 65
Total Short Term Deposits 35,194 54,565
There were no impairment provisions for cash and cash equivalents.
The carrying amounts of short term deposits approximate their fair value.
(c) Reconciliation of surplus for the period with net cash fl ows from operating activities:
Group Parent
2010 2009 2010 2009
Notes $000 $000 $000 $000
Surplus for the Period
Add back Non-cash Items:
12 586 295 869 502
Depreciation and Assets Written Off 12,268 9,611 11,850 9,266
Add back items classifi ed as Financing Activity:
Movements in Working Capital:
(Increase)/Decrease in Trade and Other Receivables 3,537 1,375 3,536 1,375
(Increase)/Decrease in Inventories (113) (406) (113) (406)
Increase/(Decrease) in Trade And Other Payables (9,813) 12,402 (9,720) 12,504
Increase/(Decrease) In Employee Benefi ts 2,138 (455) 2,138 (455)
(Decrease)/Increase in Provisions 0 (252) 0 (252)
Net Movement in Working Capital (4,251) 12,664 (4,159) 12,766
Net Cash Infl ow from Operating Activities 8,603 22,570 8,560 22,534
In the Consolidated Statement of Cash Flows the prior year opening and closing cash and cash equivalents have been restated to ensure
consistency of this classifi cation between current and prior years.
51

52
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
12 Equity Group Parent
2010 2009 2010 2009
General Funds $000 $000 $000 $000
Balance at 1 July 41,150 40,892 39,872 39,510
Distributions made (104) (104) 0 0
Capital Contribution 1,171 362 1,171 362
Balance at 30 June 42,217 41,150 41,043 39,872
Made up of:
Parent 40,258 39,012 41,043 39,872
Minority Interest 1,959 2,138 0 0
Retained Earnings/(Losses)
Balance at 1 July (4,190) (4,653) (3,035) (3,705)
Surplus 586 295 869 502
Sale of Property 43 138 43 138
Transfer to Trust Funds (146) (39) (146) (39)
Transfer from Trust Funds 82 69 82 69
Balance at 30 June (3,625) (4,190) (2,187) (3,035)
Reserves
Revaluation Reserve
Balance at 1 July 27,089 18,741 24,597 17,772
Revaluations 0 8,486 0 6,963
Other Movements (43) (138) (43) (138)
Balance at 30 June 27,046 27,089 24,554 24,597
Revaluation Reserve consists of:
Land 6,869 6,922 6,632 6,685
Buildings 20,177 20,167 17,922 17,912
Total Revaluation Reserve 27,046 27,089 24,554 24,597
Fair value through other Comprehensive Income Reserve
Balance at 1 July 0 0 0 0
Net Revaluation gains(losses) 433 0 433 0
Balance at 30 June 433 0 433 0
Total Reserves 27,479 27,089 24,987 24,597
Trust/Special Funds
Balance at 1 July 669 514 669 514
Revaluation of Land
Transfer from Retained Earnings in respect of:
0 185 0 185
Funds received 136 26 136 26
Interest received
Transfer to Retained Earnings in respect of:
10 13 10 13
Funds spent (82) (69) (82) (69)
Balance at 30 June 733 669 733 669
Total Equity at 30 June 66,804 64,718 64,576 62,103
All trust funds are held in bank accounts that are separate from Northland District Health Board’s normal banking facilities.

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
13 Interest-Bearing Loans and Borrowings Group Parent
2010 2009 2010 2009
Non-current $000 $000 $000 $000
Secured Bank Loans 20,650 23,650 20,650 23,650
Crown Energy Effi ciency Loan 287 0 287 0
20,937 23,650 20,937 23,650
Current
Secured Bank Loans 4,000 1,000 4,000 1,000
Crown Energy Effi ciency Loan 76 0 76 0
4,076 1,000 4,076 1,000
Total Interest-bearing Loans and Borrowings 25,013 24,650 25,013 24,650
Secured Bank Loans
Northland District Health Board has secured bank loans with the Crown Health Financing Agency. The details of terms and conditions are as
follows:
Interest Rate Summary 2010 2009
Actual Actual
Crown Health Financing Agency $1m facility 3.92% 5.93%
Crown Health Financing Agency $4m facility 6.41% 6.41%
Crown Health Financing Agency $4.5m facility 7.47% 7.47%
Crown Health Financing Agency $7m facility 7.26% 7.26%
Crown Health Financing Agency $8.15m facility 6.60% 6.60%
Energy Effi ciency and Conservation Authority $0.363m 0.00%
Repayable as follows: Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Within two years 9,653 5,000 9,653 5,000
Two to fi ve years 15,360 11,500 15,360 11,500
Six to nine years 0 8,150 0 8,150
Total 25,013 24,650 25,013 24,650
14 Employee Benefi ts Group Parent
2010 2009 2010 2009
Non-current Liabilities $000 $000 $000 $000
Liability for Long-service Leave and Retirement Gratuities 9,797 9,458 9,797 9,458
Liability for Sabbatical Leave 663 626 663 626
Liability for Sick Leave 865 670 865 670
11,325 10,754 11,325 10,754
53

54
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
14 Employee Benefi ts (continued) Group Parent
2010 2009 2010 2009
Current Liabilities $000 $000 $000 $000
Liability for Long-Service Leave and Retirement Gratuities 1,388 1,435 1,388 1,435
Liability for Annual Leave 12,432 11,017 12,432 11,017
Liability for Sick Leave 195 110 195 110
Liability for Sabbatical Leave 24 26 24 26
Liability for Continuing Medical Education Leave 6,154 6,249 6,154 6,249
Salary and Wages Accrual 5,743 5,506 5,743 5,506
ACC Levy Payable 1,254 1,245 1,254 1,245
ACC Partnership Programme Liability 966 1,001 966 1,001
28,156 26,589 28,156 26,589
Total Employee Benefi ts 39,481 37,343 39,481 37,343
The long service leave, retirement gratuities, sick and sabbatical leave were valued by an independent actuary.
The present value of the retirement and long service leave obligations depend on a number of factors that are determined on an actuarial
basis using a number of assumptions. Two key assumptions used in calculating this liability include the discount rate and the salary
infl ation factor. Any changes in these assumptions will impact on the carrying amount of the liability.
The discount rates used were obtained by fi nding weighted averages of returns on government stock of different terms. The salary
infl ation factor has been determined after considering historical salary infl ation patterns.
15 Provisions Group Parent
2010 2009 2010 2009
Restructuring Provision $000 $000 $000 $000
Balance at 1 July 0 252 0 252
Provision made during the year 0 0 0 0
Provision used during the year 0 (252) 0 (252)
Total Provisions 0 0 0 0
16 Trade and Other Payables Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Trade Payables to Non-Related Parties 3,583 4,310 3,583 4,310
GST and PAYE Payable 5,702 4,644 5,673 4,627
Income in Advance relating to contracts with specifi c performance
obligations 2,110 746 2,110 746
Capital Charge due to the Crown 1,268 1,118 1,268 1,118
Other Non-Trade Payables and Accrued Expenses 36,640 48,264 36,640 48,264
Total Trade and Other Payables 49,303 59,082 49,274 59,065
Trade and Other Payables are at fair value and payable within 12 months.

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
17 Financial Instruments
Northland District Health Board is party to fi nancial instruments as part of its everyday operations. These include instruments such as bank
balances, investments, accounts receivable, accounts payable and loans.
Credit Risk
Financial instruments, which potentially subject Northland District Health Board to concentrations of risk, consist principally of cash, short-term
deposits, bonds and accounts receivable.
Northland District Health Board places its cash and short-term deposits with high quality fi nancial institutions and has a policy that limits the
amount of credit exposure to any one fi nancial institution.
Concentrations of credit risk from accounts receivable are limited due to the large number and variety of customers. Northland District Health
Board receives 95% of its income from the Ministry of Health, who is also the largest single debtor. It is assessed to be a low risk and highquality
entity due to its nature as the government funded purchaser of health and disability support services.
The status of trade receivables at the reporting date is shown in note 10.
The table below analyses the Northland District Health Board’s Financial Instruments maximum credit exposure. The amounts disclosed are the
contractual undiscounted cashfl ows.
Carrying
Amount
Contractual
Cashfl ows
Group Parent
Notes 2010 2009 2010 2009
$000 $000 $000 $000
Cash on Hand and at Bank 11 4,325 20,270 4,140 20,000
Cash Equivalents - Short Term Deposits 11 35,194 54,564 35,000 54,499
Bonds 8 35,365 0 35,365 0
Trade and Other Receivables 10 9,435 12,972 9,432 12,968
Total 84,319 87,806 83,937 87,467
At balance date there were no signifi cant other concentrations of credit risk. The maximum exposure to credit risk is represented by the
carrying amount of each fi nancial asset in the statement of fi nancial position.
Liquidity Risk
Liquidity risk represents the Northland District Health Board’s ability to meet its contractual obligations. The Northland District Health Board
evaluates its liquidity requirements on an ongoing basis. In general, the Northland District Health Board generates suffi cient cash fl ows from its
operating activities to meet its obligations arising from its fi nancial liabilities.
The table below analyses the Northland District Health Board’s fi nancial liabilities into relevant maturity groupings based on the remaining
period at the balance sheet date to the contractual maturity date. The amounts disclosed are the contractual undiscounted cashfl ows.
Less than 1
year
2-5 years 6-9 years
$000 $000 $000 $000 $000
Parent & Group 2010
Secured Bank Loans 25,013 29,573 5,541 24,032 0
Trade and Other Payables 49,303 49,303 49,303 0 0
Total 74,316 78,876 54,844 24,032 0
Parent & Group 2009
Secured Bank Loans 24,650 30,840 1,045 18,528 11,267
Trade and Other Payables 59,082 59,082 59,082 0 0
Total 83,732 89,922 60,127 18,528 11,267
55

56
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
17 Financial Instruments (continued)
Market Risk
The interest rates on Northland District Health Board’s Investments and Cash and Cash equivalents are disclosed in note 11 and 8.
The Board has a series of policies providing risk management for interest rates and the concentration of credit. The Board is risk averse and
seeks to minimise exposure from its treasury activities.
Its policies do not allow any transactions which are speculative in nature to be entered into.
Interest Rate Risk
Interest rate risk is the risk that the fair value of a fi nancial instrument will fl uctuate or the cash fl ows from a fi nancial instrument will fl uctuate,
due to changes in market interest rates.
Northland District Health Board does not consider there is any signifi cant exposure to the interest rate risk on its investments. They are limited
to bank deposits and bonds, which are held over various terms. All borrowings are at fi xed interest rates for the term of the loan.
Foreign Currency Risk
Foreign exchange risk is the risk that the fair value of future cash fl ows of a fi nancial instrument will fl uctuate because of changes in foreign
exchange rates.
Northland District Health Board does not consider there is any signifi cant exposure to foreign currency risk. Only a small amount of purchases
are denominated in a currency other than NZD, none of which were outstanding at 30 June.
Sensitivity Analysis
In managing interest rate and currency risks Northland District Health Board aims to reduce the impact of short-term fl uctuations on its earnings.
Over the long-term, permanent changes in foreign exchange and interest rates would have an impact on consolidated earnings.
At 30 June 2010, it is estimated that a general increase of one percentage point in interest rates would decrease Northland District Health
Board’s surplus before tax by approximately $17,000 (2009: $32,000).
2010 2009
Interest Rate Risk $000 $000
Financial Assets -100 bps +100 bps -100 bps +100 bps
Cash, Cash Equivalents and Bonds (non-current) (33) 33 (49) 49
Financial Liabilities
Secured Bank Loans 17 (17) 17 (17)
Total (16) 16 (32) 32

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
17 Financial Instruments (continued)
Categories of Financial Assets and Liabilities
The classifi cation and fair values together with the carrying amounts in the statement of fi nancial position are as follows:
Group Parent
2010 2009 2010 2009
Loans and Receivables $000 $000 $000 $000
Trade and Other Receivables 9,435 12,972 9,432 12,968
Trust/Special Fund Assets 733 669 733 669
Cash and Cash Equivalents 29,325 54,769 29,140 54,499
Short Term Deposits 10,194 20,065 10,000 20,000
Investment in Subsidiary 0 0 1,762 1,762
Fair Value through other Comprehensive Income
Bonds 35,365 0 35,365 0
Financial Liabilities at Amortised Cost:
Trade and Other Payables 49,303 59,082 49,274 59,065
Interest Bearing Loans and Borrowings 25,013 24,650 25,013 24,650
The following summarises the major methods and assumptions used in estimating the fair values of fi nancial instruments refl ected in the above
table.
Interest-Bearing Loans and Borrowings
Fair value is calculated based on discounted expected future principal and interest cash fl ows.
Trade and Other Receivables / Payables
For receivables / payables with a remaining life of less than one year, the notional amount is deemed to refl ect the fair value. All other
receivables / payables are discounted to determine their fair value.
Fair Value Hierarchy Disclosures
For those instruments recognised at fair value in the statement of fi nancial position, fair values are determined according to the following
hierarchy:
- Quoted market price (level 1) - Financial instruments with quoted prices for identical instruments in active markets.
- Valuation technique using observable inputs (level 2) - Financial instruments with quoted prices for similar instruments in active markets or
quoted prices for identical or similar instruments in inactive markets and fi nancial instruments valued using models where all signifi cant inputs
are observable
- Valuation techniques with signifi cant non-observable inputs (level 3) - Financial instruments valued using models where one or more signifi cant
inputs are not observable.
Northland District Health Board holds Bonds measured at fair value in the statement of fi nancial position, using quoted market prices (level 1).
The fair value is $35.365m (2009: nil).
57

58
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
18 Related Parties
Identity of Related Parties
Northland District Health Board has a related party relationship with its subsidiary and with its board members and key management
personnel.
Key Management Personnel Compensation
The key management personnel compensations are as follows:
Group Parent
2010 2009 2010 2009
$000 $000 $000 $000
Salaries and Other Short Term Employee Benefi ts 1,921 1,907 1,921 1,907
Post-employment benefi ts 0 0 0 0
Other long-term benefi ts 29 29 29 29
Termination benefi ts 0 0 0 0
1,950 1,936 1,950 1,936
Key management personnel costs include any compensation or other benefi ts paid or payable. Key management personnel consist of the
CEO, 6 General Managers, Chief Medical Advisor and Director of Nursing and Midwifery.
Board and Advisory Committee Member Fees
Board Member Fees
For the year to 30 June 2010, fees paid to Board members were:
Current Board Members 2010 2009
Anthony Norman (Chairperson) $35,563 $27,495
MC (Bill) Sanderson (Deputy Chair) $33,125 $34,528
Colin Kitchen $22,250 $24,272
Craig Brown $23,688 $25,254
Daniel Bolton $23,250 $23,477
Debbie Evans $23,000 $24,928
Erima Henare $23,000 $23,252
Pauline Allan-Downs $23,500 $23,877
Peter Jensen $22,750 $22,727
Sally Macauley $23,438 $25,121
Former Board Members
Lynette Stewart (Chairperson, term completed 31/12/09) $25,625 $49,758
Disclosure of Non Board Committee Members
In accordance with Section 152(b) of the Crown Entities Act, the following people are Non Board Committee members:
Current Committee Members 2010 2009
Beryl Wilkinson $2,000 $1,528
Scott Cameron $500 $500
John Wigglesworth $1,250 $3,240
Jonathan Wilkinson $1,250 $1,250
Kevin Robinson $1,250 $3,748
Noel Matthews $1,750 $1,000
Connie Hassan $750 $2,676
Maureen Allan $1,500 $4,383
Dianne Davis (resigned 1/4/10) $1,250 $842

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
18 Related Parties (Continued)
Former Committee Members 2010 2009
Tony Nixon $0 $1,500
Margaret Horsburgh $0 $1,688
Eileen Ace $0 $1,634
Jenny James $0 $1,029
Board and Advisory Committee Members and Key Management Personnel
Services provided to Related Parties 2010
Board and Advisory Committee Member Related Party Relationship Transaction by NDHB
Beryl Wilkinson • Manaia Health PHO Community Committee
Member
Colin Kitchen • Far North District Council Council Member (Northern
Ward) Respresentative
Regional Physical Activity
Strategy and Other Sporting
Activities Group
• Whakawhiti Ora Pai Spouse an employee Laundry and Consumable
Supplies
Erima Henare • NorthTEC Consultant (until
07/04/2010)
Deputy Chair Board (effective
07/04/2010)
• Te Tai Tokerau PHO Chairperson (until
01/03/2010)
John Wigglesworth
Lynette Stewart
(Term ended 31 December 2009)
• Hokianga Health Enterprise
Trust
• University of Auckland Business School Alumni Board
Member
Maureen Allan • Te Tai Tokerau PHO Employee
Member - PHO Clinical
Governance Committee
• Whakawhiti Ora Pai Board Director - Community
Health Services
Pauline Allan-Downs • NorthTEC Putaketanga -Maori Nurse
Advisory Group
Income
$000’s
Due From
$000’s
Room rentals, Relapse
Prevention Programme
18 0
Health Inspection 289 0
Clinical Training, Laundry
Services
Rental of Premises, After Hours
Facilities Use
CEO Pharmacy Supplies, Training
Workshops
17 1
123 33
88 30
163 6
Clinical Training, Study Program 323 25
Rental of Premises, After Hours
Facilities Use
Laundry and Consumable
Supplies
Clinical Training, Laundry
Services
88 30
17 1
123 33
Peter Jensen • Arataki Ministries Ltd Chairperson Room Rentals 2 0
Sally Macauley • Far North District Council Deputy Mayor Health Inspection 289 0
• The Order of St John Spouse a member, Northern Pharmacy, Laundry and
38 4
Regional Trust Board and
Chair of Area Committee -
Kaikohe
Consumable Supplies
• WINZ Northern Regional
Representative on the Benefi ts
Review Committee
Patient Cost Recovery 4 0
Debbie Evans • Kaipara Care PHO Board Member Room Rental, Photocopy
Charges
13 1
• The Kaipara Total Health Committee Member (effective Maintenance and Management 255 0
Care Joint Venture
08/03/2010)
Contract, Distribution
Executive Management Team Related Party Relationship Transaction by NDHB
Robert Paine
• The Kaipara Total Health
Care Joint Venture
Board Member (Chair) Maintenance and
Management Contract,
Distribution
Income
$000’s
Due From
$000’s
255 0
59

60
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
Services provided to Related Parties 2009
Board and Advisory Committee Member Related Party Relationship Transaction by NDHB Income
$000’s
Beryl Wilkinson • Manaia PHO Community Committee
Member
Colin Kitchen • Far North District Council Council Member (Northern
Ward)
• Whakawhiti Ora Pai Spouse an employee Laundry and Consumable
Supplies
Due From
$000’s
Car Rentals 18 0
Health Inspection 309 0
18 0
Craig Brown • NorthTEC Member of Governing Council Clinical Training 80 0
Erima Henare • NorthTEC Consultant Clinical Training 80 0
• The Open Polytechnic of NZ Consultant Clinical Training 0 0
• Te Tai Tokerau PHO Chairperson Rental of Premises 38 0
John Wigglesworth
• Hokianga Health Enterprise
Trust
CEO Pharmacy Supplies 138 0
Lynette Stewart • DHBNZ Member Pay & Employment Equity
Funding
1 0
• University of Auckland Business School Alumni Board
Member
Clinical Training 460 246
Maureen Allan • Te Tai Tokerau PHO Employee Rental of Premises 38 0
• Te Tai Tokerau PHO Member - PHO Clinical
Governance Committee
• Whakawhiti Ora Pai Board Director - Community
Health Services
Rental of Premises 38 0
Laundry and Consumable
Supplies
18 0
MC (Bill) Sanderson • Kensington Private Hospital Shareholder Surgical, Laundry, Sterilisation
and Consumable Supplies
106 0
Pauline Allan-Downs • NorthTEC Maori Nurse Advisory Group Clinical Training 80 0
• Asthma Society Northland Clinical Supervision Consumable Supplies 0 0
• Ki A Ora Ngati Wai Clinical Supervision Maori Health Services and
Personal Health Services
0 0
Peter Jensen • Arataki Ministries Ltd Chairperson Room Rentals 2 0
Sally Macauley • Far North District Council Deputy Mayor Health Inspection 309 0
• Order of St John Spouse a member, Northern
Regional Trust Board and
Chair of Area Committee -
Kaikohe
• WINZ Northern Regional
Representative on the Benefi ts
Review Committee
Pharmacy, Laundry and
Consumable Supplies
52 0
Orthotics and Xray Services 0 0
Debbie Evans • Kaipara Care PHO Board Member Maintenance and Management
Contract, Distribution
• Kaipara Community Health
Trust
Chief Executive Smokefree Health Promotion
Survey
Executive Management Team Related Party Relationship Transaction by NDHB Income
$000’s
18 0
0 0
Due From
$000’s
Nick Chamberlain • Central Family Health Care Part Owner (premises) Course Fees 0 0
Robert Paine
• The Kaipara Total Health
Care Joint Venture
Board Member (Chair) Maintenance and
Management Contract,
Distribution
255 0

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
Services provided from Related Parties 2010
Board and Advisory Committee Member Related Party Relationship Transaction by NDHB Expense
$000’s
Beryl Wilkinson • Age Concern, Whangarei President & Chairperson Health of Older People Care
Services
• DHBNZ Quality & Safety Committee
member
• Manaia Health PHO Community Committee
Member
• Accident Compensation
Corporation
Consumer Advisory Group
Member (General & HOP)
• Whangarei District Council Member - Disability Sector
Reference Group
Colin Kitchen • Far North District Council Council Member (Northern
Ward) Respresentative
Regional Physical Activity
Strategy and Other Sporting
Activities Group
Owed to
$000’s
109 1
DHB Support services 0 3
Clinical Training, Catering 48 0
ACC cover 935 0
Water Rates, Waste Removal,
Building Consents
350 1
Water Rates, Land Rates 130 0
• NZ Fire Service Employee Fire Alarm Call Outs 8 0
• Top Energy Consumer Trustee Car Parking Rental 4 0
Craig Brown • Northland Regional Council Councillor Water Rates and Training
Courses
Daniel Bolton
• Accident Compensation
Corporation
Osteopath accepting
payments for service as
osteopathic practitioner.
Consulting Case Manager
(effective 06/07/2009)
Erima Henare • Te Tai Tokerau PHO Chairperson
(until 01/03/2010)
John Wigglesworth
• NorthTEC Consultant
(until 07/04/2010)
Deputy Chair Board
(effective 07/04/2010)
• Hokianga Health Enterprise
Trust
5 0
ACC cover 935 0
Personal, Public, and Rural
Health Services, Clinical
Training
11589 322
Study Programme 18 42
CEO Personal and Mental Health
Services, Patient Care
Kevin Robinson • Te Runanga O Te Rarawa CEO Maori, Personal and Mental
Health Services
Lynette Stewart
(Term ended 31 December 2009)
7496 567
923 8
• DHBNZ Member DHB Support services 0 3
• University of Auckland Business School Alumni Board
Member
Maureen Allan • Te Tai Tokerau PHO Employee Personal, Public, and Rural
Health Services, Clinical
Training
MC (Bill) Sanderson
• Whakawhiti Ora Pai Board Director - Community
Health Services
• Northland Orthopaedic
Centre Ltd
Study Programme, Course Fees 52 0
Maori Health Services, Clinical
Training Fees
11589 322
604 49
Director Clinical services 31 0
Peter Jensen • Arataki Ministries Ltd Chairperson Mental Health Services 1626 300
• Northland Regional Council Councillor Water Rates and Training
Courses
5 0
Sally Macauley • Far North District Council Deputy Mayor Water Rates, Land Rates 130 0
Debbie Evans
• The Order of St John Spouse a member, Northern
Regional Trust Board and
Chair of Area Committee -
Kaikohe
• The Kaipara Total Health
Care Joint Venture
Committee Member (effective
08/03/2010)
Venue and Equipment Hire.
Patient Transport and Care.
772 0
Lease of Building 500 0
Executive Management Team Related Party Relationship Transaction by NDHB Expense
$000’s
Kim Tito • Whangarei District Council Member of Conservation Trust Water Rates, Waste Removal,
Building Consents
Owed to
$000’s
350 1
Margareth Broodkoorn • College of Nurses Aotearoa Board Member Membership Fees 6 0
Nick Chamberlain • Central Family Health Care Part Owner (premises) Immunisation, GMS, Clinical
Services
5,985 0
Robert Paine
• Northland Rugby Union Director Sponsorship, Advertising 19 0
• Sport Northland Director Healthy Eating and Healthy
Action
289 0
• The Kaipara Total Health
Care Joint Venture
Board Member (Chair) Lease of Building 500 0
61

62
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
Services provided from Related Parties 2009
Board and Advisory Committee Member Related Party Relationship Transaction by NDHB Expense
$000’s
Anthony Norman
Beryl Wilkinson
Colin Kitchen
• Oruaiti School board of
Trustees
Deputy Chairperson Healthy Eating Healthy Action
Nutrition Fund
Owed to
$000’s
1 0
• Age Concern,
President & Chairperson Health of Older People Care 102 0
Whangarei
Services
• Warm Housing,
Whangarei
Trustee EECA - Insulating Houses 0 0
• DHBNZ Quality & Safety Committee DHB Support services
Member
1 0
• Manaia Health PHO Community Committee
Member
Clinical Training 1,541 1141
• Accident Compensation Consumer Advisory Group ACC cover 788 0
Corporation
Member (General & HOP)
• Whangarei District Member - Disability Sector Water Rates, Rent, Waste
302 11
Council
Reference Group Removal
• Far North District Council Council Member (Northern Water Rates, Land Rates
Ward)
70 0
• NZ Fire Service Employee Fire Alarm Call Outs 17 4
• Top Energy Consumer Trustee Rent and Capital Expenditure
Projects
67 0
Craig Brown
• Northland Regional Councillor Water Discharge and Training 3 0
Council
Expenses
Daniel Bolton
• Accident Compensation Osteopath accepting ACC cover 788 0
Corporation
payments for service as
osteopathic practitioner
Erima Henare • Te Tai Tokerau PHO Chairperson Personal, Public, and Rural
Health Services
603 159
• NorthTEC Consultant Study Programme 90
John Wigglesworth
• Hokianga Health CEO Personal and Mental Health 5,779 702
Enterprise Trust
Services
Kevin Robinson • Te Runanga O Te Rarawa CEO Maori Personal and Mental
Health Services
978 50
Lynette Stewart • DHBNZ Member Travel Costs 1 0
• Te Tai Tokerau Maori
Rural Health Training
Consortium
Committee Member Te Tai Tokerau Oranga
Capacity Building Project
0 0
• University of Auckland Business School Alumni
Board Member
Study Programme 201 0
• Te Tai Tokerau MAPO CEO Local Diabetes Teams 0 0
Maureen Allan • Te Tai Tokerau PHO Employee Personal, Public, and Rural
Health Services
603 159
• Whakawhiti Ora Pai Board Director - Community Maori Health Services
Health Services
623 41
MC (Bill) Sanderson
• Kensington Private
Hospital
Shareholder Patient Care Services 16 0
Peter Jensen • Arataki Ministries Ltd Chairperson Mental Health Services 330 0
• Northland Regional
Council
Councillor Water Discharge and Training
Expenses
3 0
Sally Macauley • Far North District Council Deputy Mayor Water Rates, Land Rates 70 0
• Northland Regional Spouse a nominee Water Discharge and Training 3 0
Council
Northland Events Centre Expenses
• Order of St John Spouse a member, Venue and Equipment Hire. 741 0
Northern Regional Trust
Board and Chair of Area
Committee - Kaikohe
Patient Transport and Care.
Debbie Evans
• The Kaipara Total Health Board Member
Care Joint Venture
Lease of Building 500 0
Executive Management Team Related Party Relationship Transaction by NDHB Expense
$000’s
Denise Brewster-Webb
Kim Tito
Nick Chamberlain
Robert Paine
• Northland Community
Foundation
• Northland Regional
Council
• Central Family Health
Care
Trustee - Voluntary Community Health and Well
Being
Maori Member of the
Bream Bay Head Trust
Water Discharge and Training
Expenses
Owed to
$000’s
78 0
3 0
Part Owner (premises) Immunisation, GMS 0 0
• Sport Northland Director Healthy Eating and Healthy
Action
• The Kaipara Total Health
Care Joint Venture
10 1
Board Member (Chair) Lease of Building 500 0

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
18 Related Parties (Continued)
Subsidiaries
Northland District Health Board has a 54% shareholding in The Kaipara Total Health Care Joint Venture, a medical centre delivering health
services to the people of Kaipara district, Northland, New Zealand. The Kaipara Total Health Care Joint Venture has a balance sheet date
of 30 June.
The Kaipara Total Health Care Joint Venture has entered into the following lease and other contracts with Northland District Health Board:
Lease:
Northland District Health Board was granted a head lease of the Joint Venture property for a fi ve year term with two rights of renewal of fi ve
years each. Annual rent is $500,000 plus GST, (2009: $500,000 plus GST), payable monthly in advance.
Maintenance, Administration and Management Contracts:
Northland District Health Board is contracted to provide maintenance and administration for the Joint Venture. Annual Maintenance Contract
is $225,000 plus GST (2009: $225,000 plus GST), payable monthly in advance. Annual Administration and Management Contract is
$30,000 plus GST (2009: $30,000 plus GST)
The Kaipara Total Health Care Joint Venture made a distribution to Northland District Health Board of $122,038 (2009: $122,038).
No related party debts have been written off or forgiven during the year. The amount outstanding at year end was $nil (2009:$nil)
Transactions with other entities controlled by the Crown
There have been transactions with other entities controlled by the Crown that have not been separately disclosed because the transactions have
been carried out on the same terms as if the transactions had been carried out at arms length.
19 Termination Payments
For the year ended 30 June 2010 Northland District Health Board made six termination payments to employees totalling $194,989.
(2009: 5 payments, totalling $164,376)
20 Subsequent Event
There are no signifi cant events subsequent to balance date.
21 Accounting Estimates and Judgments
In preparing these fi nancial statements Northland District Health Board has made estimates and assumptions concerning the future. These
estimates and assumptions may differ from the subsequent actual results. Estimates and assumptions are continually evaluated and are
based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the
circumstances. The estimates and assumptions that have a signifi cant risk of causing a material adjustment to the carrying amounts of assets
and liabilities within the next fi nancial year are discussed below:
Property Plant and Equipment Useful Lives and Residual Value
At each balance date Northland District Health Board reviews the useful lives and residual values of its property, plant and equipment.
Assessing the appropriateness of useful life and residual value estimates of property, plant and equipment requires Northland District Health
Board to consider a number of factors such as the physical condition of the asset, expected period of use of the asset by Northland District
Health board, and expected disposal proceeds from the future sale of the asset.
An incorrect estimate of the useful life or residual value will impact the depreciation expense recognised in the statement of fi nancial
performance, and carrying amount of the asset in the statement of fi nancial position.
Northland District Health Board minimises the risk of this estimation uncertainty by:
- physical inspection of assets
- use of expert valuers
- asset replacement programs
Northland District Health Board has not made signifi cant changes to past assumptions concerning useful lives and residual values.
Additional disclosure for land and buildings and the carrying amounts for property, plant and equipment are set out in note 6.
Long service leave and retirement gratuities
Note 14 provides an analysis of the exposure in relation to estimates and uncertainties surrounding retirement and long service leave
liabilities.
63

64
Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
22 Capital Management
Northland District Health Board’s capital is its equity, which comprises crown equity, reserves, trust/special funds and retained earnings.
Equity is represented by net assets. The Northland District Health Board manages its revenues, expenses, assets, liabilities and general
fi nancial dealings prudently in compliance with the budgetary processes. The Northland District Health Board’s policy and objectives of
managing the equity is to ensure the Northland District Health Board effectively achieves its goals and objectives, whilst maintaining a
strong capital base. The Northland District Health Board policies in respect of capital management are reviewed regularly by the governing
Board. There have been no material changes in the Northland District Health Board’s management of capital during the period.
23a 2009 - 2012 Statement of Intent
Statement of Comprehensive Income by Output Class
For the year ended 30 June 2010 $000 $000 $000 $000 $000
Hospital Primary Public
Support Total
Services Services Services
Services
Revenue 299,801 103,376 16,196 49,626 468,999
Offsets 6,253 0 0 0 6,253
Total Revenue 306,054 103,376 16,196 49,626 475,252
Personnel Costs 114,108 14,345 8,426 5,993 142,872
Non Personnel Costs 84,006 9,543 4,595 5,572 103,716
Provider Payments 57,203 107,222 5,489 51,628 221,542
Offsets 6,253 0 0 0 6,253
Total Operating Expenditure 261,570 131,110 18,510 63,193 474,383
Surplus (Defi cit) 44,484 (27,734) (2,314) (13,567) 869
23b District Strategic Plan
According to the terms of the Public Health and Disability Act 2000 Section 38 (1) (c), Northland District Health Board’s District Strategic
Plan (DSP) must be reviewed at least once every three years. Northland District Health Board’s 2005 – 2010 DSP expired in May 2009
so the DHB is in breach of the Act.
The Ministry has advised Northland District Health Board that they will review the DSP after fi ve years and that Northland District Health
Board must prepare a new strategic plan for sign-off by May 2011.
The breaches occurred because Northland District Health Board and group decided to adopt more relevant output classes, but they were
not able to allocate the underlying budget information to the new output classes. The allocation process requires a substantial amount of
work and there was insuffi cient time for it to be carried out between the time new output classes were adopted and the time the Statement
of Intent was adopted.
While it is noted that Northland District Health Board has breached this section of the Act, this has been completed at the direction of the
Ministry of Health.
24 Directions issued by Ministers
Northland District Health Board have not received any directions issued by Ministers during the year ended 30 June 2010.

Northland District Health Board
Notes to the Financial Statements
For the Year Ended 30 June 2010
25 Variance Analysis
Key Financial Information Actual 2010 Budget 2010 Variance
$000s $000s $000s
Operational Revenue: 474,887 468,472 6,415
The increase in operational revenue against budget can be attributed to additional funding from the Ministry of Health, including Electives,
and sundry Ministry of Health Initiatives.
The revenue budget is based on the funding envelope advised by the Ministry of Health in December 2008 for the current fi nancial year.
Subsequent to this advice further funding was made available for the above additional services.
Operational Cost (including Capital Charge) 474,301 468,472 5,829
The major factor contributing to the increase in operational expenditure, including capital charge against budget is the provision of
additional services, as detailed in the above revenue comment. Such costs are incurred as employee costs, the costs of clinical supplies
and the payment to third party provider organisations.
Total Assets (excluding cash and investment balances) 105,717 106,079 (362)
Total Assets (excluding cash balances) are not signifi cantly different to budget. Fixed Assets are near to budget levels because of an
unbudgeted up lift in values following the revaluation at 30 June 2009, less an underspend on the site redevelopment due to commencement
delays.
Total Liabilities (excluding loans) 88,784 84,089 4,695
Liabilities are higher than budget due to increases in annual leave balances and a higher than expected gratuity provision.
Cash Resources (cash and investment balances less loans) 49,871 36,863 13,008
Cash is higher than budget due to increased liabilities and the timing of payments for the site redevelopment, these will reduce over future
periods.
65

66
Northland District Health Board
Statement of Accounting Policies
For the Year Ended 30 June 2010
Reporting entity
Northland District Health Board (NDHB) is a Health Board
established by the New Zealand Public Health and Disability Act
2000. NDHB is a Crown entity in terms of the Crown Entities Act
2004, owned by the Crown and domiciled in New Zealand.
NDHB is a reporting entity for the purposes of the NZ Public Health
and Disability Act 2000, the Financial Reporting Act 1993, the
Crown Entities Act 2004 and the Public Finance Act 1989.
NDHB is a public benefi t entity (PBE), as defi ned under NZIAS 1.
The consolidated fi nancial statements of NDHB and group for the
year ended 30 June 2010 comprise NDHB and its joint venture
subsidiary the Kaipara Total Health Care Joint Venture (54%
owned).
NDHB’s activities involve funding and delivering health and
disability services in a variety of ways to the community.
The fi nancial statements were authorised for issue by the Board in
October 2010.
Statement of compliance
The consolidated fi nancial statements have been prepared in
accordance with generally accepted accounting practice in New
Zealand (NZGAAP). They comply with New Zealand equivalents
to International Financial Reporting Standards (NZIFRS) as
appropriate for public benefi t entities, and other applicable
Financial Reporting Standards as appropriate for public benefi t
entities.
In addition, funds administered on behalf of patients have been
reported as a note to the fi nancial statements.
Basis of preparation
The fi nancial statements will be presented in New Zealand Dollars
(NZD), rounded to the nearest thousand. The fi nancial statements
are prepared on historical cost basis except for land and buildings
that are stated at their revalued amounts.
The accounting policies as set out below have been applied
consistently to all periods presented in these consolidated fi nancial
statements.
The preparation of fi nancial statements in conformity with
NZIFRS requires management to make judgments, estimates and
assumptions that affect the application of policies and reported
amounts of assets and liabilities, income and expenses. The
estimates and associated assumptions will be based on historical
experience and various other factors that are believed to be
reasonable under the circumstances, the results of which form the
basis of making the judgments about carrying values of assets and
liabilities that are not readily apparent from other sources. Actual
results may differ from these estimates.
The estimates and underlying assumptions are reviewed on an
ongoing basis. Revisions to accounting estimates will be recognised
in the period in which the estimate is revised if the revision affects
only that period or in the period of the revision and future periods
if the revision affects both current and future periods.
There have been no changes in accounting policies during the
fi nancial year.
The Board and group have adopted the following revisions to
accounting standards during the fi nancial year, which have only
had a presentational or disclosure effect:
• NZ IAS 1 Presentation of Financial Statements (Revised 2007)
replaces NZ IAS 1 Presentation of Financial Statements
(Issued 2004). The revised standard requires information in
fi nancial statements to be aggregated on the basis of shared
characteristics and introduces a statement of comprehensive
income. The statement of comprehensive income will enable
readers to analyse changes in equity resulting from non-owner
changes separately from transactions with owners. The Board
and group have decided to prepare a single statement of
comprehensive income for the year ended 30 June 2010
under the revised standard. Financial statement information for
the year ended 30 June 2009 has been restated accordingly.
Those items of other comprehensive income presented in the
statement of comprehensive income were previously recognised
directly in the statement of changes in equity.
• Amendments to NZ IFRS 7 Financial Instruments: Disclosures.
The amendments introduce a three-level fair value disclosure
hierarchy that distinguishes fair value measurements by the
signifi cance of valuation inputs used. A maturity analysis of
fi nancial assets is also required to be prepared if this information
is necessary to enable users of the fi nancial statements to
evaluate the nature and extent of liquidity risk. The transitional
provisions of the amendment do not require disclosure of
comparative information in the fi rst year of application.
Standards, amendments, and interpretations issued that are not yet
effective and have not been early adopted
Standards, amendments, and interpretations issued that are not
yet effective and have not been early adopted, and are relevant
to NDHB include:
• NZ IFRS 9 Financial Instruments will eventually replace NZ IAS
39 Financial Instruments: Recognition and Measurement. NZ
IAS 39 is being replaced through the following 3 main phases:
Phase 1 Classifi cation and Measurement, Phase 2 Impairment
Methodology, and Phase 3 Hedge Accounting. Phase 1 on
the classifi cation and measurement of fi nancial assets has
been completed and has been published in the new fi nancial
instrument standard NZ IFRS 9. NZ IFRS 9 uses a single
approach to determine whether a fi nancial asset is measured at
amortised cost or fair value, replacing the many different rules
in NZ IAS 39. The approach in NZ IFRS 9 is based on how
an entity manages its fi nancial instruments (its business model)
and the contractual cash fl ow characteristics of the fi nancial
assets. The new standard also requires a single impairment
method to be used, replacing the many different impairment
methods in NZ IAS 39. The new standard is required to be
adopted for the year ended 30 June 2014. NDHB has not yet
assessed the effect of the new standard and expects it will not
be early adopted.
Basis for consolidation
Subsidiaries
Subsidiaries are entities controlled by NDHB. Control exists
when NDHB has the power, directly or indirectly, to govern
the fi nancial and operating policies of an entity so as to obtain
benefi ts from its activities. In assessing control, potential voting
rights that presently are exercisable or convertible are taken into

Northland District Health Board
Statement of Accounting Policies
For the Year Ended 30 June 2010
account. The fi nancial statements of subsidiaries are included in
the consolidated fi nancial statements from the date that control
commences until the date that control ceases.
The consolidated fi nancial statements include the parent (Northland
District Health Board) and its subsidiary. The subsidiary is
accounted for using the purchase method, which involves adding
together corresponding assets, liabilities, revenues and expenses
on a line by line basis. All signifi cant inter-entity transactions are
eliminated on consolidation.
Transactions eliminated on consolidation
Intragroup balances and any unrealised gains and losses or
income and expenses arising from intragroup transactions, are
eliminated in preparing the consolidated fi nancial statements.
Investment in subsidiaries are carried at cost in NDHB’s own
“parent entity” fi nancials statements.
Budget Figures
The budget fi gures are those approved by the health board in
its District Annual Plan and included in the Statement of Intent
tabled in parliament. The budget fi gures have been prepared
in accordance with NZGAAP. They comply with NZIFRS and
other applicable Financial Reporting Standards as appropriate
for public benefi t entities. Those standards are consistent with
the accounting policies adopted by NDHB for the preparation of
these fi nancial statements
Foreign currency transactions
Transactions in foreign currency are translated at the foreign
exchange rate ruling at the date of the transaction. Monetary
assets and liabilities denominated in foreign currencies at the
balance sheet date are translated to NZD at the foreign exchange
rate ruling at that date. Foreign exchange differences arising on
translation are recognised in the surplus or defi cit.
Non-monetary assets and liabilities that are measured in terms
of historical cost in a foreign currency are translated using the
exchange rate at the date of the transaction. Non-monetary assets
and liabilities denominated in foreign currencies that are at fair
value are translated to NZD at foreign exchange rates ruling at
the dates the fair value was determined.
Property, plant and equipment
Classes of property, plant and equipment
The major classes of property, plant and equipment are as
follows:
• freehold land
• freehold buildings
• plant and equipment
• vehicles
• work in progress.
Owned assets
Except for land and buildings and the assets vested from the
hospital and health service (see below), items of property, plant
and equipment are stated at cost, less accumulated depreciation
and accumulated impairment losses. The cost of self-constructed
assets includes the cost of materials, direct labour, the initial
estimate, where relevant, of the costs of dismantling and removing
the items and restoring the site on which they are located, and an
appropriate proportion of direct overheads.
Land and buildings are revalued to fair value as determined
by an independent registered valuer every three years. The net
revaluation results are credited or debited to other comprehensive
income and is accumulated to an asset revaluation reserve in
equity for that class of asset. Where this would result in a debit
balance in the asset revaluation reserve, this balance is not
recognised in other comprehensive income but is recognised in
the surplus or defi cit.
Any subsequent increase on revaluation that off-sets a previous
decrease in value recognised in the surplus or defi cit will be
recognised fi rst in the surplus or defi cit up to the amount previously
expensed, and then recognised in other comprehensive income.
Accumulated depreciation at revaluation date is eliminated
against the gross carrying amount so that the carrying amount
after revaluation equals the revalued amount.
Property that is being constructed or developed for future use as
investment property is classifi ed as property, plant and equipment
and stated at cost until construction or development is complete,
at which time it is reclassifi ed as investment property.
Where material parts of an item of property, plant and equipment
have different useful lives, they are accounted for as separate
components of property, plant and equipment.
Property, Plant and Equipment
Vested from the Hospital and Health Service
Under section 95(3) of the New Zealand Public Health and
Disability Act 2000, the assets of Northland Health Limited (a
hospital and health service company) vested in Northland District
Health Board on 1 January 2001. Accordingly, assets were
transferred to NDHB at their net book values as recorded in the
books of the hospital and health service.
In effecting this transfer, the health board has recognised the cost
and accumulated depreciation amounts from the records of the
hospital and health service. The vested assets will continue to be
depreciated over their remaining useful lives.
Disposal of property, plant and equipment
Where an item of plant and equipment is disposed of, the gain
or loss recognised in the surplus or defi cit is calculated as the
difference between the net sales price and the carrying amount
of the asset.
The gain or loss is recognised in the reported net surplus or defi cit
in the period in which the transaction occurs. Any balance
attributable to the disposed asset in the asset revaluation reserve
is transferred to retained earnings.
Additions to property, plant and equipment
The cost of an item of property, plant and equipment is recognised
as an asset if, and only if, it is probable that future economic
benefi ts or service potential associated with the item will fl ow to
NDHB and the cost of the item can be measured reliably.
In most instances, an item of property, plant and equipment is
recognised at its cost. Where an asset is acquired at no cost, or
for a nominal cost, it is recognised at fair value as at the date of
acquisition.
67

68
Northland District Health Board
Statement of Accounting Policies
For the Year Ended 30 June 2010
Leased assets
Leases where NDHB assumes substantially all the risks and rewards
of ownership are classifi ed as fi nance leases. The assets acquired
by way of fi nance lease are stated at an amount equal to the
lower of their fair value and the present value of the minimum lease
payments at inception of the lease, less accumulated depreciation
and impairment losses.
The property held under fi nance leases and leased out under
operating lease is classifi ed as investment property and stated
at fair value. Property held under operating leases that would
otherwise meet the defi nition of investment property may be
classifi ed as investment property on a property-by-property basis.
Subsequent costs
Subsequent costs are added to the carrying amount of an item
of property, plant and equipment when that cost is incurred if it
is probable that the service potential or future economic benefi ts
embodied within the new item will fl ow to NDHB. All other costs
are recognised in the statement of comprehensive income as an
expense as incurred.
Depreciation
Depreciation is provided using the straight line method on all
property plant and equipment other than land, and recognised in
the surplus or defi cit.
Depreciation is set at rates that will write off the cost or fair value
of the assets, less their estimated residual values, over their useful
lives. The estimated useful lives of major classes of assets and
resulting rates are as follows:
Class of asset Estimated life Depreciation rate
• Buildings
- Structure 1 to 65 years (1.5% - 100%)
- Services 1 to 25 years (4% - 100%)
- Fit out 1 to 10 years (10% - 100%)
• Plant and Equipment 1 to 10 years (10% - 100%)
• Motor Vehicles 5 years (20%)
The residual value of assets is reassessed annually to determine if
there is any indication of impairment.
Work in progress is recognised at cost less impairment and
is not depreciated. The total cost of a project is transferred
to the appropriate class of asset on its completion and then
depreciated.
Borrowing costs
For each property, plant and equipment asset project, borrowing
costs are recognised as an expense in the period which they are
incurred.
Intangible assets
Intangible assets that are acquired by NDHB are stated at cost
less accumulated amortisation and impairment losses.
Costs that are directly associated with the development of software
for internal use, are recognised as an intangible asset. Direct
costs can include the software development employee costs and
an appropriate portion of relevant overheads.
Subsequent expenditure
Subsequent expenditure on intangible assets is capitalised only
when it increases the service potential or future economic benefi ts
embodied in the specifi c asset to which it relates. All other
expenditure is expensed as incurred.
Amortisation
Amortisation is provided in the surplus or defi cit on a straight-line
basis over the estimated useful lives of intangible assets unless
such lives are indefi nite. Intangible assets with an indefi nite useful
life are tested for impairment at each balance sheet date. Other
intangible assets are amortised from the date they are available
for use.
Class of asset Estimated life Amortisation rate
Software 2 to 3 years (33% - 55%)
Impairment of property, plant
and equipment and intangible assets
Intangible assets that have an indefi nite useful life, or not yet
available for use, are not subject to amortisation and are tested
annually for impairment. Assets that have a fi nite useful life are
reviewed for indicators of impairment at each balance date. When
there is an indicator of impairment the assets recoverable amount
is estimated. An impairment loss is recognised for the amount by
which the assets carrying amount exceeds its recoverable amount.
The recoverable amount is the higher of an assets fair value less
costs to sell and value in use.
Value in use is depreciated replacement cost for an asset where
the future economic benefi ts or service potential of the asset are
not primarily dependent on the assets ability to generate net cash
infl ows and where the entity would, if deprived of the asset, replace
its remaining future economic benefi ts or service potential.
The value in use for cash-generating assets and cash generating
units is the present value of expected future cash fl ows.
If an assets carrying amount exceeds its recoverable amount, the
asset is impaired and the carrying amount is written down to
the recoverable amount. For revalued assets the impairment loss
is recognised in other comprehensive income to the extent the
impairment loss does not exceed the amount in the revaluation
reserve in equity for that same class of asset. Where that results
in a debit balance in the revaluation reserve, the balance is
recognised in the surplus or defi cit.
For assets not carried at a revalued amount, the reversal of an
impairment loss is recognised in the surplus or defi cit.
Financial Instruments
Non-derivative fi nancial instruments
Non-derivative fi nancial instruments comprise investments in
equity securities, trade and other receivables, cash and cash
equivalents, interest bearing loans and borrowings, and trade
and other payables.
Financial instruments are initially recognised at fair value plus
transaction costs unless they are carried at fair value through surplus
or defi cit in which case the transaction costs are recognised in the
surplus or defi cit.
Financial instruments are derecognised when the rights to received
cash fl ows have expired or have been transferred and NDHB have

Northland District Health Board
Statement of Accounting Policies
For the Year Ended 30 June 2010
transferred substantially all the risks and rewards of ownership.
Financial assets are classifi ed into the following categories for the
purposes of measurement:
• Fair value through surplus or defi cit;
• Loans and receivables; and
• Fair value through other comprehensive income.
Classifi cation of the fi nancial asset depends on the purpose for
which the instruments were acquired.
Financial assets at fair value through
surplus or defi cit
Financial assets at fair value through surplus or defi cit include
fi nancial assets held for trading. A fi nancial asset is classifi ed in
this category if acquired principally for the purpose of selling in
the short-term or is part of a portfolio that are managed together
and for which there is evidence of short-term profi t-taking.
Financial assets acquired principally for the purpose of selling in
the short-term or part of a portfolio classifi ed as held for trading
are classifi ed as a current asset.
After initial recognition fi nancial assets in this category are
measured at their fair value with gains or losses on re-measurement
recognised in the surplus or defi cit.
Loans and receivables
Loans and receivables are non-derivative fi nancial assets with fi xed
or determinable payments that are not quoted in an active market.
They are included in current assets, except for maturities greater
than 12 months after the balance date, which are included in noncurrent
assets. NDHB’s loans and receivables comprise cash and
cash equivalents, trade and other receivables, term deposits, Trust
/ Special Fund assets and related party loans.
After initial recognition they are measured at amortised cost using
the effective interest method less any provision for impairment.
Gains and losses when the asset is impaired or derecognised are
recognised in the surplus or defi cit.
The effective interest rate method is a method of calculating the
amortised cost of a fi nancial instrument and of allocating interest
over the relevant period. The effective interest rate is the rate
that exactly discounts future cash receipts or payments through the
expected life of the fi nancial instrument, or where appropriate,
a shorter period to the net carrying amount of the fi nancial
instrument.
Financial assets at fair value through other comprehensive
income
Financial assets at fair value through other comprehensive
income are those that are designated as fair value through other
comprehensive income or are not classifi ed in any of the other
categories above. They are included in non-current assets unless
management intends to dispose of the investment within 12 months
of the balance date.
NDHB’s bond investments that it intends to hold long-term but
which may be realised before maturity are held in this category.
After initial recognition these investments are measured at their fair
value, with gains and losses recognised in other comprehensive
income except for impairment losses, which are recognised in the
surplus or defi cit.
On derecognition the cumulative gain or loss previously recognised
in other comprehensive income is re classifi ed from equity to the
surplus or defi cit.
Cash and cash equivalents
Cash and cash equivalents comprise cash balances and call
deposits with maturity of no more than three months from the date
of acquisition.
Accounting for fi nance income and expense is explained in a
separate note.
Interest-bearing loans and borrowings
Subsequent to initial recognition, other non-derivative fi nancial
instruments such as interest bearing loans and borrowings, are
measured at amortised cost using the effective interest method,
less any impairment losses.
Trade and other receivables
Trade and other receivables are initially recognised at fair value
and subsequently stated at their amortised cost less impairment
losses. Bad debts are written off during the period in which they
are identifi ed.
Trade and other payables
Trade and other payables are initially measured at fair value and
subsequently stated at amortised cost using the effective interest
rate method.
Impairment
At each balance sheet date NDHB assesses whether there is any
objective evidence that a fi nancial asset or group of fi nancial
assets is impaired. Any impairment losses are recognised in the
surplus or defi cit.
Loans and other receivables
Impairment of a loan or a receivable is established when there
is objective evidence that NDHB will not be able to collect
amounts due according to the original terms. Signifi cant fi nancial
diffi culties of the debtor/issuer, probability that the debtor/issuer
will enter into bankruptcy, and default in payments are considered
indicators that the asset is impaired. The amount of the impairment
is the difference between the assets carrying amount and the
present value of estimated future cash fl ows, discounted using the
original effective interest rate. For debtors and other receivables,
the carrying amount of the asset is reduced through the use of an
allowance account, and the amount of the loss is recognised in the
surplus or defi cit. When the receivable is uncollectible, it is written
off against the allowance account. Overdue receivables that
have been renegotiated are reclassifi ed as current (i.e. not past
due). For other fi nancial assets, impairment losses are recognised
directly against the instruments carrying amount.
Financial assets at fair value through other comprehensive
income
For equity investments, a signifi cant or prolonged decline in the
fair value of the investment below its cost is considered objective
evidence of impairment.
For debt investments, signifi cant fi nancial diffi culties of the debtor,
probability that the debtor will enter into bankruptcy, and default
in payments are considered objective indicators that the asset
69

70
Northland District Health Board
Statement of Accounting Policies
For the Year Ended 30 June 2010
is impaired. If impairment evidence exists for investments at fair
value through other comprehensive income, the cumulative loss
(measured as the difference between the acquisition cost and the
current fair value, less any impairment loss on that fi nancial asset
previously recognised in the surplus or defi cit) recognised in other
comprehensive income is reclassifi ed from equity to the surplus or
defi cit.
Equity instrument impairment losses recognised in the surplus or
defi cit are not reversed through the surplus or defi cit.
If in a subsequent period the fair value of a debt instrument increases
and the increase can be objectively related to an event occurring
after the impairment loss was recognised, the impairment loss is
reversed in the surplus or defi cit.
Inventories
Inventories are stated at the lower of cost and net realisable value.
Net realisable value is the estimated selling price in the ordinary
course of business, less the estimated costs of completion and
selling expenses.
Cost is determined on a fi rst in fi rst out basis.
The amount of any write-down for the loss of service potential or
from cost to net realisable value is recognised in the surplus or
defi cit in the period of the write-down.
Interest bearing borrowings
Interest bearing borrowings are recognised initially at fair value
less attributable transaction costs. Subsequent to initial recognition,
interest bearing borrowings are stated at amortised cost with any
difference between cost and redemption value being recognised
in the surplus or defi cit over the period of the borrowings on an
effective interest basis.
Employee benefi ts
Defi ned contribution plan
Obligations for contributions to defi ned contribution plans are
recognised as an expense in the surplus or defi cit as incurred.
Long service leave,
sabbatical leave and retirement gratuities
NDHB’s net obligation in respect of long service leave, sabbatical
leave and retirement gratuities is the amount of future benefi t that
employees have earned in return for their service in the current
and prior periods. The obligation is calculated on an actuarial
basis and involves the projection, on a year by year basis, of
the entitlements, based on accrued service. These benefi ts are
estimated in respect of their incidence according to assumed rates
of death, disablement, resignation and retirement and in respect
of those events according to assumed rates of salary progression.
A value is placed on the resulting liabilities by discounting the
projected entitlements back to the valuation date using a suitable
discount rate.
Annual leave,
conference leave and medical education leave
Annual leave, conference leave and medical education leave are
short-term obligations and are calculated on an actual basis at
the amount NDHB expects to pay. These are recognised in the
surplus or defi cit when they accrue to employees. NDHB accrues
the obligation for paid absences when the obligation both relates
to employees’ past services and it accumulates.
Sick leave
NDHB recognises a liability for sick leave to the extent that
compensated absences in the coming year are expected to be
greater than the sick leave entitlements earned in the coming
year. The amount is calculated based on the unused sick leave
entitlement that can be carried forward at balance date to the
extent NDHB anticipates it will be used by staff to cover those
future absences.
Provisions
A provision is recognised at fair value when NDHB has a present
legal or constructive obligation as a result of a past event, it is
probable that an outfl ow of economic benefi ts will be required
to settle the obligation and that a reliable estimate can be made.
If the effect is material, provisions are determined by discounting
the expected future cash fl ows at a pre-tax rate that refl ects current
market rates and where appropriate, the risks specifi c to the
liability. The movement in provisions are recognised in the surplus
or defi cit.
Revenue relating to service contracts
NDHB is required to expend all monies appropriated within certain
contracts during the year in which it is appropriated. Should this
not be done, the contract may require repayment of the money
or NDHB, with the agreement of the Ministry of Health, may be
required to expend it on specifi c services in subsequent years. The
amount unexpended is recognised as a liability.
Income tax
NDHB is a crown entity under the New Zealand Public Health
and Disability Act 2000 and is exempt from income tax under
section CB3 of the Income Tax Act 1994.
Goods and services tax
All items in the fi nancial statements are presented exclusive of
GST, except for receivables and payables, which are presented
on a GST inclusive basis. Where GST is not recoverable as input
tax then it is recognised as part of the related asset or expense.
The net amount of GST recoverable from, or payable to, the
Inland Revenue Department (IRD) is included as part of receivables
or payables in the statement of fi nancial position.
The net GST paid to, or received from the IRD, including the GST
relating to investing and fi nancing activities is classifi ed as an
operating cash fl ow in the statement of cashfl ows.
Commitments and contingencies are disclosed exclusive of GST.
Revenue
Crown funding
The majority of revenue is provided through an appropriation
in association with a Crown Funding Agreement. Revenue is
recognised monthly in accordance with the Crown Funding
Agreement payment schedule, which allocates the appropriation

Northland District Health Board
Statement of Accounting Policies
For the Year Ended 30 June 2010
equally throughout the year. It is measured at fair value of
consideration received or receivable.
Goods sold and services rendered
Revenue from goods sold is recognised when NDHB has transferred
to the buyer the signifi cant risks and rewards of ownership of the
goods and NDHB does not retain either continuing managerial
involvement to the degree usually associated with ownership nor
effective control over the goods sold.
Revenue from services is recognised, to the proportion that a
transaction is complete, when it is probable that the payment
associated with the transaction will fl ow to NDHB and that
payment can be measured or estimated reliably, and to the extent
that any obligations and all conditions have been satisfi ed by
NDHB.
Rental income
Rental income is recognised in the surplus or defi cit on a straightline
basis over the term of the lease. Lease incentives granted are
recognised as an integral part of the total rental income over the
lease term.
Interest
Interest Income is recognised using the effective interest method.
Expenses
Operating lease payments
An operating lease is a lease whose term is short compared to
the useful life of the asset or piece of equipment. Payments made
under operating leases are recognised in the surplus or defi cit on
a straight-line basis over the term of the lease. Lease incentives
received are recognised in the surplus or defi cit over the lease
term as an integral part of the total lease expense.
Financing costs
Net fi nancing costs comprise interest paid and payable on
borrowings calculated using the effective interest rate method.
Equity
Equity is the community’s interest in NDHB and is measured as
the difference between total assets and total liabilities. Equity is
disaggregated and classifi ed into a number of components.
The components of equity are Retained Earnings, Revaluation
Reserve (consisting of Land and Buildings), Trust/Special Funds and
fair value through other comprehensive income reserves. Special
funds are funds donated or bequeathed for a specifi c purpose.
The use of these assets must comply with the specifi c terms of
the sources from which the funds were derived. The revenue and
expenditure in respect of these funds is included in the surplus or
defi cit. An amount equal to the expenditure is transferred from the
Trust fund component of equity to retained earnings. An amount
equal to the revenue is transferred from revenue earnings to trust
funds.
Insurance Contracts
The future cost of ACC claim liabilities is revalued annually based
on the latest actuarial information. Movements of the liability are
refl ected in the surplus or defi cit. Financial assets backing the
liability are designated at fair value through surplus and defi cit.
Contingent liabilities
Contingent liabilities are recorded in the statement of contingent
liabilities at the point at which the contingency is evident.
Contingent liabilities are disclosed if the possibility that they will
crystallise is not remote.
Standards, amendments, and interpretations issued
that are not yet effective and have not been early adopted
The cost of service statements, as reported in the statement of
service performance, report the net cost of services for the outputs
of NDHB and are represented by the cost of providing the output
less all the revenue that can be allocated to these activities.
Cost of Service (Statement of Service Performance)
The cost of service statements, as reported in the statement of
service performance, report the net cost of services for the outputs
of NDHB and are represented by the cost of providing the output
less all the revenue that can be allocated to these activities.
Cost allocation
NDHB has arrived at the net cost of service for each signifi cant
activity using the cost allocation system outlined below.
Cost allocation policy
Direct costs are charged directly to output classes. Indirect costs
are charged to output classes based on cost drivers and related
activity and usage information.
Criteria for direct and indirect costs
Direct costs are those costs directly attributable to an output
class.
Indirect costs are those costs that cannot be identifi ed in an
economically feasible manner with a specifi c output class.
Cost drivers for allocation of indirect costs
The cost of internal services not directly charged to outputs is
allocated as overheads using appropriate cost drivers such as
actual usage, staff numbers and fl oor area.
71

72
Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
A report on Northland DHB’s performance against the Health Targets set by the Minister of Health and other internally-determined targets.
Output Classes
This section is organised around “output classes”, described in the table below. These are broadly similar types of services grouped together for the
purposes of the SOI to make it more understandable to audiences outside the health sector.
Output class Defi nition Description Funding sources
Public health services Publicly funded services that protect
and enhance health in the whole
population or identifi able subpopulations
(as distinct from curative
services which deal with health and
disability problems and conditions).
Sometimes called ‘population health
services’.
Primary and
community services
Health Targets
Personal health services in the
community that people can access
directly.
Hospital services Specialist services that are generally
accessible only if people are referred
by a health professional, commonly
a GP. Sometimes called ‘secondary
services’.
Support services Services delivered following a
process of “needs assessment and
service coordination”, generally for
older people and those with terminal
conditions.
Health promotion services which encourage people to
improve health and prevent ill health.
Health protection services to protect the public
from environmental risk (water quality, sewerage
supply, food preparation) and communicable
diseases (immunisation programmes, and screening
programmes such as breast and cervical screening,
B4 School Checks).
Services provided by general practitioners, Maori
health providers, pharmacists, nurse practitioners,
public health nurses, Plunket, midwives, and a host of
others.
Two levels of service:
(a) secondary (general hospital) services, as provided
at Whangarei Hospital
(b) tertiary (super-specialty) services, mostly provided
by Auckland DHB, which NDHB pays for.
Needs Assessment and Service Coordination
(NASC), an organisation contracted to: (a) determine
a person’s eligibility and need for publicly-funded
disability support services (needs assessment); (b)
allocate services to be delivered by providers (service
coordination).
Services provided include age-related residential
care, home-based support services, palliative care
(hospice) services.
Publicly funded.
A mix of private, publicly
funded and not-for-profi t
providers.
Mostly publicly funded,
with some private
providers.
NASC is publicly funded.
Services are delivered
by a mix of public and
private providers.
DHBs are expected to meet six Health Targets, national indicators designed to improve the performance of health services. The table below describes
the Health Targets and where the 2009/10 results may be found within the Statement of Service Performance.
Health Target and indicator Location within SSP
Increased immunisation: percentage of 2-year-olds fully immunised. Public Health Services Output Class
Better diabetes and cardiovascular services:
Primary and Community Services Output Class
percentage of diabetics who are receiving annual free checks
percentage of diabetics receiving AFCs whose blood sugar is under
the recommended level
percentage of people in eligible populations who have had in the last
fi ve years laboratory blood tests for assessing cardiovascular disease
risk.
Better help for smokers to quit: hospitalised smokers will be provided with Public Health Services Output Class
advice and help to quit.
Shorter waits for cancer treatment: percentage of patients waiting less Hospital Services Output Class
than 6 weeks between fi rst specialist assessment and the start of radiation
oncology treatment.
Shorter stays in emergency departments: percentage of ED patients who Hospital Services Output Class
were admitted, transferred or discharged from ED within 6 hours.
Improved access to elective surgery: meet the agreed number of Hospital Services Output Class
discharges under the Planned MoH Elective Initiative.

Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Public Health Services Output Class
Output Rationale Measure Baseline 2009/10 2009/10 Explanatory notes
Description Categories
data target actual
Smoking One of the six national Health Number of
Cessation Targets.
quit attempts
Programme Tobacco smoking is one of the supported by
referrals most signifi cant lifestyle factors primary health
behind long term conditions care providers
(see also diabetes, CVD, through ABC.
cancer below).
Most smokers want to quit,
and there are simple, effective
interventions that can be
routinely provided in both
primary and secondary care.
1
Total population 2,000 4,000 203 Target not met.
referred, Formal reports from primary
29 care are not required until
completed 2010/11; 2009/10 has
been a preliminary phase
devoted largely to planning
the future approach.
Hospitalised Total population
smokers will be
provided with
advice and
help to quit.
n/a2 80% 31.8%
annual
result
59.5%
June 2010
result3 Target not met.
Although the target was
introduced in July 2009,
NDHB’s service was not
properly established and
staffed until early 2010.
Progress from quarter to
quarter has been signifi cant
(from Q1 to Q4: 13%,
22%, 36%, 55%) and up to
59.5% in June. We expect
performance to continue to
rise during 2010/11.
Breast screens4 Breast cancer is the most % of women Total population 33% 34% 40.8% All targets exceeded.
common cancer in women aged 45-69 Maori
33% 34% 38.0%
and the risk of developing it receiving Non-Maori
33% 34% 41.7%
increases with age. For older breast screens.
women, breast screening
using mammography (breast
xrays) followed by appropriate
treatment is the best way to
reduce the chance of dying
from breast cancer.
Article I.
1 Ask, Brief intervention, Cessation support, a simplifi ed version of a process health workers can use when dealing with smokers.
2 Systems in NDHB hospitals to capture this data reliably were not established until 2009/10. Reports for the same measure from primary care
are not formally required until 2010/11.
3 The June 2010 result was used by MoH as a measure of DHB performance.
4 The coverage may meet the target over two years but be variable from one year to the next. Breast screening is a two-year programme, and the
number of weeks spent in an area of Northland by the mobile service can differ (it was 5 weeks in 2008 but 8 weeks in 2009). The
programme is run in partnership with Waitemata DHB who, as lead providers, set the targets. Variables affecting planning are the annual 3%
increase in the target population and the requirement to screen additional numbers of women per annum to compensate for those who are
screened twice within the 24 month period but only counted once. This is required to meet the BreastScreen Aotearoa National Policy & Quality
Standards and is predicted to affect 3,000-5,000 women across the BreastScreen Waitemata Northland programme.
73

74
Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Public Health Services Output Class
Output Rationale Measure Baseline
Description Categories
data
Cervical Cervical cancer is one of % of women
screens the most preventable of all aged 20-69
cancers. Having regular receiving
cervical smears can reduce cervical
a woman’s risk of developing
it by 90 percent. (See also
HPV vaccination below.)
screens. 5
Total population 71%
Maori
71%
Non-Maori
71%
B4 School The B4SC is a health and % of new
Checks (B4SC) development assessment at a entrants
key stage in a child’s life. It receiving
aims to identify any health,
developmental or behavioural
problems that may affect a
child’s wellbeing and ability to
learn and take part in school.
B4SC.
2-year-old
immunisations
One of the six national Health
Targets.
Immunisation is one of the
most cost-effective health
interventions. It provides not
only individual protection
for certain diseases but also
population-wide protection
by reducing the incidence
of diseases and preventing
them spreading to vulnerable
people (so-called “herd”
immunity).
NZ’s current immunisation
rates are low by international
standards and Northland’s
are one of the lowest in the
country.
% of 2-yearolds
fully
immunised
2009/10
target
75%
75%
75%
2009/10
actual
Explanatory notes
74.9%
6 Some targets met.
67.1% Performance for overall
78.4% population is close to target
but Maori rates are lower.
Maori are a target group for
NDHB’s Cervical Screening
Service and will continue
to be for primary care
providers.
Total population n/a 7 1,493 8 1,792 Target exceeded.
Total population
Maori
Non-Maori
9 69%
65%
73%
10 85%
85%
85%
76%
73%
80%
Performance for all
population groups is below
target. Reasons:
• connectivity and data
transfer problems with the
reporting software, which
are gradually being sorted
out
• 4% of children drop
off between Northland
PHOs and the national
registry because they
aren’t associated with a
provider or on the national
immunisation register (also
being worked on)
• PHO P erformance
Programme target was by
the third birthday, and it
is taking time to shift all
providers to the secondbirthday
target
• a signifi cant proportion
(>5%) of parents do not
consent to having their
children immunised.
Article I.
5 Actuals data is combined from two sources: (a) national PHO performance programme reports, which cover cervical screens in GP surgeries
(where more than 97% are performed); (b) the NDHB cervical screening service, which targets harder-to-reach, higher need women.
6 Maori and non-Maori data is not available for NDHB screens, so Maori totals have been estimated at 80% of the total. There may be a small
error in this fi gure, but as the NDHB screens comprise only 2.6% of the total, it will make no material difference to the percentages.
7 No baseline data exists because the programme was begun only in Sep 2008. Targets don’t exist for out-years because NDHB’s contract with
MoH is only until June 2009, and with the provider until August 2010; if and when the contract is renewed, out-year targets will be established.
Targets agreed with the provider don’t include ethnicity.
8 SOI target was originally 1,050, which was what NDHB had negotiated with Manaia PHO, the lead provider. MoH changed this during the
year to 1,493.
9 From 2009/10 Q4 report, which covers the whole year.
10 No targets were included in the 2009/10 SOI. These are copied from the District Annual Plan 2009/10.

Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Public Health Services Output Class
Output Rationale Measure Baseline
Description Categories
data
Immunisations The vaccine prevents two of % of Year Total population
11 n/a
against HPV the most common types of 8 girls Maori
n/a
HPV that cause about 70% completing Non-Maori
n/a
of cervical cancer. The a course of
vaccination campaign works immunisation
alongside cervical cancer against human
screening to minimise the papillomavirus
occurrence of cervical cancer (HPV)
among NZ’s women.
Healthy Eating,
Healthy Action
Higher rates of breastfeeding
in infancy correlate with a
lower chance later in life of
developing ill health, including
long term conditions.
% of mothers
exclusively
and fully
breastfeeding12 74% at 6 wks
57% at 3 mths
27% at 6 mths
73%
55%
21%
2009/10
target
80%
80%
80%
73%
55%
24%
2009/10
actual
Explanatory notes
51% Targets not met.
60% Targets were incorrect – all
53% should have been 70%.
Reasons for gap:
• out of school 17-19
year olds are particularly
diffi cult to connect
with and convince that
vaccination is both
relevant and necessary
• the vaccine is new and
there were concerns
regarding its effi cacy and
safety
• the vaccine targets
12 year old girls for
protection against an STI
which caused concerns
among some parents
• three se parate
vaccinations require
commitment from the
girl, family and friends to
ensure completion.
73% Targets met.
58%
28%
Article I.
11 No baseline data exists because the programme was not begun until 2008/09.
12 The target was set on the basis of data that covered only Plunket services because that was all that was available at the time. The actual data
includes three of the four Tamariki Ora (Maori provider) well-child services in Northland. NDHB is working on retrieving data from the remaining
provider.
75

76
Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Primary and Community Services Output Class
Output Rationale Measure Baseline
Description Categories
data
Diabetes Diabetes, CVD and cancer (all % of diabetics Total population 60%
Annual Free part of the six Health Targets) who are Maori
60%
Checks (AFCs) together account for about receiving AFCs Pacifi c
60%
three-quarters of deaths and
are major causes of illness
and restricted functioning.
Diabetes is a signifi cant
cause of problems with the
cardiovascular/ circulatory
system and kidney disease.
Diabetes is a “long term
condition” because once it
is acquired it is with people
for life. Screening detects
signs that are ‘precursors’ to
the condition developing fully,
so that preventive strategies
Other
60%
can be put in place and the
% of diabetics Total population
condition averted. It also
receiving Maori
detects as early as possible
AFCs whose Pacifi c
people who already have
blood sugar Other
diabetes so that more effective
is under the
management plans can be
recommended
established.
level
76%
70%
50%
80%
Cardiac
monitoring
A reorganised,
a seamless,
communitybased
oral
health service.
Diabetes, cardiovascular
disease and cancer (all part
of the six Health Targets)
together account for about
three-quarters of deaths and
are major causes of illness
and restricted functioning.
Northland has consistently
had among the worst oral
health statistics. Adolescents
are a vulnerable group
because traditionally they
have had to transfer from the
school dental service’s public
system to private providers
and the drop-off rate has been
high (a situation which will be
remedied with the revamped
and expanded oral health
service being put in place
at present). Maintaining
adequate levels of enrolment
is important for adolescents.
% of people
in eligible
populations
who have in
the last fi ve
years had
laboratory
blood tests
(lipids and
HbA1c) for
assessing
cardiovascular
disease risk.
% adolescents
enrolled with
oral health
services.
Total population
Maori
Other
16 72.7%
64.9%
76.0%
2009/10
target
13 60%
60%
60%
60%
76%
70%
50%
80%
74.7%
66.9%
77.8%
2009/10
actual
Explanatory notes
49.9% Targets not met.
57.4% Northland’s PHOs have
n/a been making steady
47.2% increases in the numbers
of people receiving AFCs.
However each year the
denominator, the MoH’s
estimate of how many
diabetics there are in
Northland, increases, and
the percentage coverage
fi gure hasn’t yet caught
up . PHOs have been
made aware of these
issues and are prioritising
diabetes within their annual
workplans.
81.1% Targets met.
81.5%
15 n/a
80.8%
78.0% All targets met.
71.0%
81.0%
Total population 17 29% 48% 49.5% Target met.
Article I.
13 Targets apply to calendar years (eg 2008/09 is for 2008). Targets do not exist for out-years because, under the national service specifi cation
for Local Diabetes Teams, they are required to be set annually by the Local Diabetes Team.
14 Targets are set on the basis of MoH’s estimates of a DHB’s total number of diabetics. The Northland estimate jumped from 6,907 in 2008 to
8,191 in 2009, so though the percentage target has not increased for 2009/10, it represents 770 extra people checked.
15 NNDHB is no longer required to report on Pacifi c people for either diabetes indicator.
16 Q3 2008/09 (end-of-year data is not available).
17 Baseline data is for 2007/08, the latest available because there are long delays in the processing of claims by dentists.

Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Hospital Services Output Class
Output Rationale Measure Baseline 2009/10 2009/10 Explanatory notes
Description Categories
data target actual
Conditions POPN is a scheme to enable Referrals into Cellulitis
n/a n/a 203 No target was set because
treated general practitioners to the Primary Pneumonia and
POPN is an as yet untried
appropriately provide treatment for people Options asthma
service with no baseline
in the primary with selected acute conditions Programme Dehydration (incl.
data. Referrals to POPN
health care who would normally have Northland gastroenteritis)
will be monitored during
setting. been treated by secondary (POPN) for Deep vein
2009/10 to assess the
services. It aims to provide common thrombosis (DVT)
impact of the programme.
treatment for these conditions potentially
Radiation
more cost effectively, and free avoidable
up hospital resources for more hospitalisations
urgent and severe conditions.
One of the six national Health % of patients Total population 100% 100% 90% All Northland patients are
oncology Targets.
waiting less
treated by the Auckland
treatments Diabetes, CVD and cancer (all than 6 weeks
Cancer Service, and NDHB
part of the six Health Targets) between fi rst
works with Auckland DHB in
together account for about specialist
working towards this target.
three-quarters of deaths and assessment
During 2009/10 ADHB
are major causes of illness and the start
had capacity problems
and restricted functioning. of radiation
for some months (key staff
For cancer, some of the oncology
away, equipment being
biggest gains are to be made treatment .
repaired and replaced,
in ensuring early access to
investigation and process
treatment (both radiation
delays). Since then
therapy and chemotherapy)
performance has improved.
to improve the chances of
Operational systems and
recovery.
processes are currently being
streamlined.
Relapse plans Severe disorders permanently % of clients Maori, ≥ age 20 95% 90% 96% All targets met.
for long-term affect 3% of the population. with long-
clients. People with serious mental term (known Maori, ≥ age 91% 90% 91%
illness can maintain to services 20, addictions
stable lives if appropriate for ≥2 years) only
supports are in place and mental health
recommended treatment is conditions who Maori, child & 92% 90% 90%
followed. A relapse places a have up-to-date youth
strain on the service user, their relapse plans.
family and other supporters,
as well as health services
Maori, total
94% 90% 95%
who must intensify the level
of service provided. Using a
Total, ≥ age 20 92% 90% 94%
plan, service users and their
Total, ≥ age 20, 93% 90% 90%
families are able to recognise
warning signs and act
addictions only
quickly to prevent illness from
Total, child &
97% 90% 92%
recurring.
youth
Total population
Article I.
18 Baseline data is for 2007/08, the latest available because there are long delays in the processing of claims by dentists.
19 POPN identifi ed the four conditions as potentially treatable in primary care, thus avoiding more expensive hospital admissions.
20 Data is for ten months only, from September (when POPN began) to June.
Includes patients in category A (urgent, within 24 hours), B (curative, within 2 weeks) and C (palliative) but excluding D (combined radiotherapy
and chemotherapy).
21 Baseline data is exceptionally high because of a one-off effort made to catch up on outstanding plans, but it will not be possible to apply this
amount of resources routinely.
93%
90%
93%
77

78
Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Hospital Services Output Class
Output Rationale Measure Baseline
Description Categories
data
Improvements One of the six national Elective
to processes Health Targets and an Service Patient
and systems. important contributor to the Flow Indicators
Government’s “better, sooner, (ESPIs)
more convenient” policy.
Elective surgery is an
effective way of increasing
people’s functioning because
it remedies or improves
disabling conditions.
Hospital services traditionally
give the greatest priority to
those with the most acute and
urgent needs, so NDHB has
been making a concerted
effort to consciously direct
resources towards elective
surgery.
22
1. DHB services that
>90%
appropriately
acknowledge and
process all patient
referrals within ten
working days.
2. Patients waiting longer

Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Hospital Services Output Class
Output Rationale Measure Baseline 2009/10
Description Categories
data target
Reduced One of the six national Percentage of Total population n/a n/a
length of stay Health Targets and an ED patients
24 [95%]
in emergency important contributor to the who were
departments Government’s “better, sooner, admitted,
(EDs). more convenient” policy. transferred or
The purpose of EDs is to discharged
provide urgent care, so from ED within
by defi nition timeliness is
important.
Medical and nursing literature
has linked long stays and
overcrowding in EDs to poorer
clinical outcomes.
6 hours.
2009/10
actual
Article I.
24 The SOI originally didn’t have a target for 2009/10, but 95% was set during 2009/10 after the SOI was signed off.
Explanatory notes
86% Target not met.
Numerous improvements
were made to processes
in ED during 2009/10.
However so far the
system for collecting data
on patients in ED and
monitoring their progress
has been manual. Further
signifi cant improvements
will only come with the
introduction of an ED
information system (to occur
during 2010/11). This
includes an electronic
whiteboard which will
provide live, up-to-date
information about patient
status.
79

80
Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Support Services Output Class
Output Rationale Measure Baseline 2009/10 2009/10 Explanatory notes
Description Categories
data target actual
Community The increasing number of Average
Wellness for older people, along with self-defi ned
Older Adults their higher level of need, is perception
programme. placing increasing pressure of health
on home based support and status using
residential care budgets. EuroQol.
Home based support services
are coming under growing
pressure because there is
an increasing number of
older people receiving them
(currently approximately
12% of Northland’s over 65
population). This growth will
be sustainable only if we
allocate resources to those
most in need and encourage
older people to remain as fi t
and healthy as possible.
25
Total population 63% 80% 57.5% Target not met.
Target was set too high
because it was based on
imperfect data from the
learning phase of a smallscale
pilot project. Once
the pilot project proper
began, baseline data was
revealed to be 42.8%, so
the 57.5% actual represents
an improvement of 14.7%.
Restorative
home based
support.
Average scores
on the EADL
scale. 26
Level of client
need: 27
Critical
(Kaitaia only)
Signifi cant
Low
48.0
39.0
50.6
50.0
50.0
53.0
28.6
36.0
42.4
Target not met.
The second phase of the
pilot project shows minimal
change for clients. Possible
reasons include small sample
size, assessor ability and
level of ‘engagement’ in
the pilot study. Further
investigation will occur
during the pilot project.
Self-defi ned
perception of
health status
using EuroQol 28
70% 80% n/a Target not met.
The average score for all
clients (comparable to the
original single-category
target of 70%) was 65%.
Critical
n/a n/a 52.0% This apparent decrease in
(Kaitaia only)
self-defi ned quality of health
Signifi cant
n/a n/a 65.3% raises questions about either
Low
n/a n/a 61.3% the effectiveness of the
intervention or the method
of measurement. Further
investigation will occur
during the pilot project.
Article I.
25 EuroQol is a tool for gauging self-defi ned health status, and measures mobility, self care, daily activities, pain & discomfort, and anxiety or
depression. These scores use EuroQol’s Visual Analogue Scale (VAS) in which a higher score indicates a perceived higher health related quality
of life.
26 The EADL is an assessment of functional ability. It is scored out of 66, with a higher score equating to a greater level of independence. EADL is
one of the tools used to measure the effectiveness of the Restorative Home Support Pilot project, conducted in Kaitaia (47 clients) and Kerikeri (49
clients).
27 The 2009/10 SOI used only two categories, complex and non-complex, but an interim evaluation of the pilot showed a need for further
functional difference. The former category of non-complex now equates to low needs, while complex has been divided into new categories of
signifi cant and critical.
28 EuroQOL is defi ned in footnote 25. At the pre-intervention stage, all clients were assessed as one group, so a single fi gure of 70% was used as
the baseline. However an interim evaluation during the pilot showed a need for further functional difference, hence the three categories of used
for reporting.

Northland District Health Board
Statement of Service Performance
For the Year Ended 30 June 2010
Support Services Output Class
Output Rationale Measure Baseline 2009/10
Description Categories
data target
Palliative Care Each year approximately No. of patient Total population 0 520
Liaison Team 300 people die in Northland referrals to the
for Secondary hospitals. Most deaths of new service.
Services. Northlanders are caused by
long term conditions, and
many of these people had not
been referred to a specialist
palliative care service. Early
access to specialist palliative
care benefi ts patients with
a life-limiting illness that
is not curable and whose
progressive disease and
symptoms are best managed
from a palliative perspective.
North Haven Hospice has
been contracted to deliver
this new specialist palliative
care service at Whangarei
Hospital to provide a
continuum of care delivered
from both community- and
hospital-based specialist
palliative care services. The
specialist palliative care
service works closely with
generalist palliative care
providers such as GPs,
aged residential care, and
community based nursing
services to ensure patients
receive coordinated and
comprehensive services that
meet their needs.
2009/10
actual
Explanatory notes
344 Target not met.
This is a new service that
was being established
during 2009/10. The
target was an estimate
based on a prediction of 10
clients per week. The actual
fi gure refl ects that this target
was about one-third too high
for the fi rst year.
81

DIRECTORY
BOARD MEMBERS
Anthony Norman (Chair from 1 January 2010)
MC (Bill) Sanderson, Deputy Chair
Pauline Allan-Downs
Daniel Bolton
Craig Brown
Debbie Evans
Erima Henare
Peter Jensen
Colin Kitchen
Sally Macauley
EXECUTIVE OFFICERS
Karen Roach, Chief Executive
Neil Beney, General Manager, Chronic and Complex Care
Margareth Broodkoorn, Director of Nursing & Midwifery
Dr Nick Chamberlain, General Manager, Clinical Services
Dr Gloria Johnson, Chief Medical Advisor
Robert Paine, General Manager, Finance, Human Resources and Commercial Services
Kim Tito, General Manager, Service Development & Funding and Maori Health
Jeanette Wedding, General Manager, Child, Youth, Maternal, Public Health & Oral Services
Sue Wyeth, General Manager, Mental Health and Regional Hospitals
REGISTERED OFFICE
DHB Offi ce, Private Bag 9742, Whangarei 0148
POSTAL ADDRESS
DHB Offi ce, Private Bag 9742, Whangarei 0148
TELEPHONE
(09) 470 0000
FAX
(09) 470 0001
WEBSITE
www.northlanddhb.org.nz
AUDITOR
Audit New Zealand on behalf of the Offi ce of
the Controller & Auditor General
BANKERS
Bank of New Zealand Limited, Whangarei
SOLICITORS
Webb Ross Lawyers, Whangarei

NORTHLAND DISTRICT HEALTH
BOARD
Maunu Road, Private Bag 9742,
Whangarei 0148
Phone: (09) 470 0000
Fax: (09) 470 0001
WHANGAREI HOSPITAL
Maunu Road, Private Bag 9742,
Whangarei 0148
Phone: (09) 430 4100
Fax: (09) 430 4115 during working hours
Fax: (09) 430 4132 after hours
DARGAVILLE HOSPITAL
Awakino Road, PO Box 112, Dargaville 0340
Phone: (09) 439 3330
Fax: (09) 439 3531
BAY OF ISLANDS HOSPITAL
Hospital Road, PO Box 290, Kawakawa 0243
Phone: (09) 404 0280
Fax: (09) 404 2851
KAITAIA HOSPITAL
29 Redan Road, PO Box 256, Kaitaia 0441
Phone: (09) 408 9180
Fax: (09) 408 9251