District health board heads are about to find out if the new Health Minister is going to ask for resignation letters from each of them.
David Clark says resignations may be accepted if DHB chairs aren't "on the same wave-length" as the new government.
Dr Clark said he was "very seriously considering" asking for resignation letters and would make a decision shortly.
"I want to be sure that the district health board chairs ... are in agreement with the current government's agenda and direction. I need them to be on board with where we're heading."
Health ministers can appoint the chair, deputy chair and up to four members of each DHB board. They are key positions that help enable the government to achieve its policies in otherwise arms-length DHBs.
Current chairs include Dr Lester Levy, who heads all three Auckland DHBs, Hawke's Bay businessman Andrew Blair who heads the two Wellington-based DHBs and the Southern Partnership Group involved in the rebuild of Dunedin Hospital, former diplomat John Wood whose relatively recent appointment tipped Mark Solomon into deputy, and Bob Simcock in Waikato, who's a member of the National Party.
Dr Clark said he wanted to achieve the goal of "making sure that the sector is very focused on delivering the things that we campaigned on and the things that we think are the priority and [which] most New Zealanders in fact have voted for." He would take advice and make sure he got all his processes right.
If he went ahead he would request the letters and decide which to accept and which not. He would retain the option as minister of sacking a board appointment that he did not want.
However the current political appointments "by and large have shown themselves to be very competent", he said.
If he did go ahead with the resignation-letter option he anticipated the vast majority of DHB chairs would be on board. "Let's be realistic, these are professional people who have been managing in a very difficult climate with constrained resources and our sector overall does deliver really good patient outcomes".
Dr Clark is today visiting the Canterbury DHB, which has the highest deficit of all 20 health boards at $51 million and has a well-publicised poor relationship with the Health Ministry over its finances.
He said he was keen to visit DHBs and meet their chairs to "get a sense of what's happening from the ministry's perspective and from the perspective of the DHBs". Relations had been strained and need rebuilding, and he was taking the lead in showing a willingness to listen, he said, and he had also made his expectations clear to the Ministry of Health.