1950

NEW ZEALAND GAZETTE

No. 103

Health Status

(a) That, as far as possible having regard to the transitional year, the particular socio-economic and demographic characteristics of the region for which the Northern Regional Health Authority is responsible, and related health status concerns, are taken into account in the purchase of health and disability services for Eligible People.

The following items are to be noted in relation to this objective.

The socio-economic and demographic characteristics of the region for which the Northern Regional Health Authority is responsible are:

(i) A growing population;

(ii) A population which is ageing overall, but in which there is a significant proportion of younger people, especially in Pacific Island communities and among the Maori population;

(iii) A Maori population comprising 13% of the population (compared with 12.8% of New Zealand’s total population). There is a significant concentration of Maori in rural communities in the Northland area;

(iv) A variation in the distribution of ethnic groups, ranging from a high concentration of Maori in the rural communities of Whangarei and the far North, to a high concentration of Pacific Island Polynesian in the southern zone of the Auckland urban area; and

(v) A variation in the dispersion of communities, ranging from urban Auckland Central with a population density of 19.7 persons per hectare, to the dispersed communities of Whangarei with a population density of 3.3 persons per hectare.

Some of the major concerns about health status and health and disability services for the Northern Regional Health Authority are:

(i) An expected higher utilisation in the medium and long term of secondary health services and disability services because of the growing older adult population;

(ii) An expected increased demand on pregnancy and childbirth, newborn and child health services associated with high fertility rates;

(iii) A need to address access and responsive concerns because of the socio-economic and ethnic diversity of the region for which the Northern Regional Health Authority is responsible; and

(iv) A need to address the particular health status, and needs for services, of Maori and Pacific Island Polynesians.

Health and Disability Services to be Purchased

(b) That, in general, the Northern Regional Health Authority purchase those health and disability services to which Eligible People had access funded from Crown Vote: Health or (in certain specified instances) Crown Vote: Social Welfare in 1992/1993, including services in respect of accidents.

(c) Wherever possible, given the transitional year, that the Northern Regional Health Authority recognise the following priorities for changes in service provision:

(i) Improved provision of comprehensive co-ordinated therapeutic mental health (including substance abuse) services ranging from primary to inpatient services;

(ii) Improved “well child care” services including parenting skills development, “well child” screening, immunisation, prevention of hearing loss, and prevention of injury to under five year olds;

(iii) Greater emphasis on community support and on providing appropriate support services in the community to enable independence;

(iv) Provision for a more comprehensive and co-ordinated range of services to address the special needs of Maori;

(v) Improved access to assessment and rehabilitation and disability services; and

(vi) Appropriately managed deinstitutionalisation.

Terms of Access to Services

(d) In general, to maintain existing terms of access to services for Eligible People.

The following items are to be noted in relation to this objective:

Crown may Set User Charges

In cases where the Crown or the Northern Regional Health Authority stipulates the total fee payable to a provider for a service, the Crown will in general place limits on the amount of that fee payable by the service user (the user charge). There will continue to be some exemptions from user charges. In other cases, the Crown may specify the minimum amount to be paid by the Northern Regional Health Authority.

Enrolment Systems

The Northern Regional Health Authority and some providers of health and disability services may wish to enter purchase arrangements which require a particular provider to establish a practice register. It is not anticipated that a full practice enrolment system could be agreed between the Northern Regional Health Authority and primary care providers in the transitional year. Such a system would raise issues on which the Crown and the Accident Rehabilitation and Compensation Insurance Corporation need to be consulted before it is developed.

Forensic Psychiatric Services

In order to secure the best forensic psychiatric services, the national network of six multi-disciplinary regional forensic teams, seven regional medium secure units, a national maximum security facility and appropriate rehabilitation facilities must be used.

Cervical Screening

The national cervical screening programme and register services will continue with national co-ordination provided by the Ministry of Health.

Blood Transfusion Services

It is important to provide a high quality blood transfusion service, which continues to recognise that the donation of blood is critical to the service, and is an important contribution individuals can make towards the welfare of fellow New Zealanders. The “gift” status of donated blood is to be preserved.

(e) To develop in the transitional year assessment and review procedures to determine access to services.

Quality Standards for Service

(f) To improve the quality and cultural appropriateness of health and disability services.

To assist in meeting this objective, the Northern Regional Health Authority should develop mechanisms to monitor whether appropriate standards are achieved, and should also develop:

(i) A statement of commitment to quality;

(ii) Definitions of the parameters of quality;

(iii) Principles and processes for developing protocols for the delivery of services;

(iv) Requirements on providers of health or disability services to develop quality improvement plans and programmes;

(v) Monitoring, evaluation and reporting procedures;

(vi) Processes for consulting with communities, service users and providers of services about the quality of health and disability services;