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In New Zealand the existing Crown entities and area health boards were amalgamated to create 21 DHB's. Each required a number of board members, elected by the areas electorate, with a Ministry of Health appointed Chair. In addition each DHB has a Chief Executive Officer, Medical Advisor and Nursing advisor.

Whilst the system has been successful in targetting health funding to local issues (instead of national needs) and increasing the focus upon Primary Health Care , critics have argued that the system is too beauraucratic; in addition the number of boards has been questioned and it is likely that some may eventually be forced to merge.