1958 NEW ZEALAND GAZETTE No. 103

throughout the region for which the Southern Regional Health Authority is responsible;

(iii) Some southern rural areas have higher than average work-related injuries and motor vehicle accidents;

(iv) Higher than average, but decreasing, rates of cot death;

(v) Pockets of increasing demand for child and family counselling;

(vi) Low rates of immunisation;

(vii) Higher than average admission rates for asthma, heart disease and strokes; and

(viii) Higher than the average rate of older people in long-term residential care.

Health and Disability Services to be Purchased

(b) That, in general, the Southern 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 Southern 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 Southern 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 Southern Regional Health Authority.

Enrolment Systems

The Southern 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 Southern 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 Southern 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 Southern 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 Southern 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