A Dunedin academic says elected district health boards do not necessarily produce the best outcomes for the health system.
A leaked proposal from the Director-General of Health's office suggests reducing the number of elected board representatives and replacing them with more members chosen by the Health Minister.
Professor Robin Gauld specialises in health care policy at the Dunedin School of Medicine.
He said issues with the current system included low voter turnout and that people tended to vote for people they knew, regardless of their experience in the health sector.
He said one option would be to make expressions of interest from people with a wide pool of professional expertise a priority, which the elected model does not currently call for.
Associaton of Medical Specialists executive director Ian Powell said the proposal appeared to be about increasing central government's control.
He said the current district health board model stood up well to international comparisons.
Health Minister Jonathan Coleman said it was very unlikely there would be any changes to district health board governance while he was in charge.
Concerns about relationship with ministry
Meanwhile, one Canterbury District Health Board (DHB) member has said the Ministry of Health does not appear interested in working collaboratively with local communities.
Andrew Dickerson, who was elected to the board in 2007, said the leaked proposal reflected the ministry's desire to be more centralised, controlling and bureaucratic.
Mr Dickerson said the relationship between the board and the ministry had deteriorated in the past 12 months.
"We have a 92 percent increase in children being admitted for reasons of mental illnesses.
"We have a 60 percent increase in children requiring the input of specialist mental health services," he said.
"Those sort of increases are unprecedented, they are only happening in Canterbury but the approach of the Ministry of Health has been complete indifference."
