1956 NEW ZEALAND GAZETTE No. 103

Crown may Set User Charges

In cases where the Crown or the Central 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 Central Regional Health Authority.

Enrolment Systems

The Central 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 Central 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 Central 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;

(vii) Processes for dealing with consumer complaints;

(viii) Processes for dealing with ethical issues including those relating to research and to the development of new technology; and

(ix) A statement on purchasing culturally appropriate health and disability services.

Special Needs

(g) That particular consideration is given to the needs of Maori.

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

The Central Regional Health Authority should seek to improve the health status of Maori, as far as reasonably possible in the transitional year, so that in the future they will have the same opportunity to enjoy the same level of health as non-Maori. To enable this to happen the Central Regional Health Authority should have regard to the Crown’s policy direction for Maori expressed in the document “Whaia te ora mo te iwi”, and in particular to:

(i) Recognise Maori aspirations and structures, and the desire of Maori to take greater responsibility for some of their own health care;

(ii) Purchase services and encourage initiatives that promote better health for Maori;

(iii) Allocate resources to take account of Maori health needs;

(iv) Encourage greater participation of Maori in the development of health solutions and be aware of successful Maori health service delivery models;

(v) Develop culturally appropriate practices and procedures for delivery of health and disability services to Maori; and

(vi) Encourage greater participation of Maori at all levels of the health and disability support sector.

(h) That particular consideration is given to groups with special needs.

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

People with Low Health Status

Strategies to improve access to health and disability services for Eligible People with lower health status, including Pacific Island communities, should be developed in the transitional year.

People with Disabilities—Support for Independence

As far as reasonably possible in the transitional year, Eligible People with disabilities and their families should:

(i) Have improved access to assessment and rehabilitative disability services;

(ii) Have access to disability services which are better co-ordinated and more flexible;

(iii) Have access to disability services which are culturally appropriate for their needs; and

(iv) Continue to have access to the disability services they are receiving as at 30 June 1993 until 30 June 1996 (except if the service is home help, in which case the option is until 30 June 1994 or the review date), unless that person is reassessed and agrees to a different service arrangement.

There should be greater emphasis on:

(v) Supporting Eligible People with disabilities to allow them to be as independent as possible, close to their homes, and integrated into their communities;

(vi) Appropriate management of deinstitutionalisation; and

(vii) The use of protocols for assessing the support needs of Eligible People with disabilities. (An assessment protocol for Eligible People with age-related disabilities will be introduced before 1 July 1993).

Part III: Meaning of Terms Used in This Notice

Terms defined in the Health and Disability Services Act 1993, and used in this Notice shall have the same meaning in this Notice unless the context requires otherwise.

Dated at Wellington this 25th day of June 1993.

W. F. BIRCH, Minister of Health.