8 JULY

NEW ZEALAND GAZETTE

1955

(c) Encourage efficiency, flexibility, and innovation in the delivery of health and disability services;

(d) Break down barriers between public and private providers of health and disability services, including voluntary and charitable organisations;

(e) Break down barriers between primary and secondary health services;

(f) Seek to improve the health status of Maori, so that in future Maori will have the opportunity to enjoy the same level of health as non-Maori;

(g) Direct Government assistance to those who are least able to make provision for themselves,

(h) Recognise the importance of public health initiatives in preventing illness and injury;

(i) Recognise the needs and importance of family and non-professional caregivers and voluntary agencies;

(j) Widen the choice of health and disability services, and providers of such services, available to consumers;

(k) Increase the sensitivity of the health and disability support systems to the changing needs of people in New Zealand;

(l) Provide incentives to promote rehabilitation;

(m) Ensure changes are implemented in a way that minimises disruption to the lives of people with health problems or disabilities, and their care-givers; and

(n) Achieve the above objectives within available funding and without exposing taxpayers to greater burdens in the future.

(l) To assist meeting these medium term objectives, the Crown intends to:

(a) Ensure fair funding of regional health authorities ("RHAs") relative to their populations by moving to equitable funding for personal health services between 1994/1995 and 1996/1997;

(b) Integrate funding for primary and secondary health services;

(c) Encourage the development of better specifications of the health and disability services purchased and provided;

(d) Recognise the importance of public health initiatives; and

(e) Encourage co-operation between the Public Health Commission and the RHAs in the purchase of services promoting the public health, particularly in relation to immunisation and the prevention of:

• cot death;
• melanoma;
• child hearing loss;
• tobacco smoking in pregnancy; and
• cervical cancer.

Part II: Objectives for the Financial Year to 30 June 1994

(l) The Crown's objectives for the financial year to 30 June 1994 (the "Funding Period") have been developed across areas that deal with the health status of people who are eligible for health and disability services purchased or to be purchased by the Central Regional Health Authority ("Eligible People"), the health and disability services purchased or to be purchased, the terms of access by Eligible People to those services, the standards of those services, and the special needs of Maori and other communities or people in the region for which the Central Regional Health Authority is responsible.

(ll) The Crown's objectives for the Funding Period are:

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 Central 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 Central Regional Health Authority is responsible are:

(i) A population in which there is a significant proportion of children and younger people (under 15) and adults aged between 23 and 44, but a smaller proportion of elderly population (65 plus);

(ii) A variation in the dispersion of communities, ranging from the Wellington Central zone with a population density of 12.6 persons per hectare, to Hastings with a density of 2.5 persons per hectare;

(iii) A variation in the proportion of the population who are Maori, ranging from 20% in Hawkes Bay to 5% in Nelson-Marlborough (compared to 12.8% of New Zealand's total population being Maori); and

(iv) A variation in the proportion of the population that is Pacific Island Polynesian, ranging from 16.8% in Wellington to 0.1% in Nelson.

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

(i) The demand for child and adolescent services;

(ii) The control of lifestyle and communicable diseases;

(iii) The prevalence of hearing impairment, arthritis, blindness and intellectual handicap;

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

(v) A disproportionate number of people in institutional care.

Health and Disability Services to be Purchased

(b) That, in general, the Central 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 Central 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: