Taxpayers will fork out millions to elect hundreds of health board bosses just four months before a major review of the health system is due.
One board member is calling for next year's elections to be scrapped to await the outcome of the Government-ordered review, due on January 31, 2020.
But Minister of Health David Clark said he had no intention of postponing or cancelling the elections.
Waikato District Health Board member Mary Anne Gill believes the public health system needs urgent overhauling and electing 140 new board members across the country next year was bad timing and bad management of precious health dollars.
"I'm calling for the Government to cancel the DHB local elections in September 2019. It's quite a radical suggestion."
Of the DHBs surveyed over how much the 2016 election cost, 13 responded, totalling $3.59m.
The highest was Canterbury DHB at $741,930, then Waikato on $551,600 and Counties Manukau $426,781. Auckland spent $409,258. Waitemata did not respond in time.
In January a Weekend Herald investigation found taxpayers forked out almost $66 million last year to pay 444 people to run the country's 20 district health boards.
The bulk of that money, up to $60m, paid for 231 chief executives and their senior executives while 209 board members - 140 of whom were elected and the rest appointed - and four commissioners were paid almost $6m for just 30 days of work each year.
Gill said it did not make sense to hear the first draft of the health review by Heather Simpson in July next year, elect new board members two months later, induct them, then hold the first board meetings of the new term the same month Simpson would release her final review.
"Why would you put a whole lot of new board members in and they start in January 2020 and then a few months later a whole restructure of the health system takes place?"
In announcing the review in May, Clark said it would be wide-ranging and designed to future-proof the health and disability services.
"It will look at the way we structure, resource and deliver health services - not just for the next few years but for decades to come."
Asked about the timing of the review and the board elections, Clark said DHB elections provided local accountability and were an important feature of the health system.
"It is important that our DHBs continue to serve their local communities and deliver quality health care as usual while the review of the Health and Disability Sector is conducted. Postponing elections would create unnecessary uncertainty."
Clark said the draft terms of reference for the review were deliberately wide.
"I am not about to pre-judge the outcome of the review. In any case, any changes that the Government ultimately decides on will take time to implement.
"Strong DHB leadership and governance will be vital during any transition period."
Simpson was selected to conduct the review because of her background in health economics and is best known as the chief of staff to former Prime Minister Helen Clark from 1999 to 2008.
The review would take in New Zealand's ageing and expanding population, chronic diseases such as cancer and diabetes that create service pressure, the health outcomes of Maori and Pacific people, primary and community-based care, the health workforce and long-term sustainability of the public health system.
The $66m it cost taxpayers for health bosses to manage and govern DHBs last year did not include expenses, which amounted to $5.2m over three years for DHB chief executives, executive directors and board chairs and members.
Gill's concerns come as DHBs grapple with deficits for this year and next. Waikato DHB earlier this year was in line for a $21.8m deficit but the latest figure is not yet available.
DHB deficits will be presented to the Ministry of Health in time for the next financial year.
Gill, who confirmed she would not stand for the DHB again, said now was the time to act.
"From a statutory point of view, if you weren't to hold the local body elections for DHB members in September next year, you'd have to start putting that in place now."