7 OCTOBER NEW ZEALAND GAZETTE 3387

understanding of what they can expect from the publicly-funded health and disability services system.

b) give full and proper effect to the Hospital Services Plan. Under the Hospital Services Plan, the Government has committed itself to maintaining broadly the current configuration of services for 3 years. Any service modifications should be appropriately worked through with the communities concerned and should go through appropriate officials’ processes.

c) in both urban and rural New Zealand, ensure as reasonable a spread of services as practicable, with an emphasis on improving health outcomes. That is, locate service delivery points in a way that will facilitate access to those services, according to reasonable and practicable criteria. While the nature of highly specialised tertiary services may result in delivery at a limited number of points, for secondary (and especially lower-level secondary services) and community services, the spread will lead to improved access and better outcomes.

d) develop workable funding policies that ensure the ongoing provision of primary and secondary services in rural New Zealand (including incentives, community nursing, nurse-led practices and other types of schemes to support rural service delivery).

e) fund cost-effective modern technology to support improved quality in health service delivery where appropriate, including appropriate support for the development of such initiatives as Healthline and telemedicine.

f) develop long-term certainty around continuity of service delivery throughout New Zealand, especially primary medical and nurse-led initiatives, by funding services that fit a long-term service-delivery plan.

g) having ensured that a consistent HFA policy on the rural and tertiary adjuster framework (consistent with the Medium-Term Strategy) was established and communicated to HHSs in time for operation in the 2000/01 year, work to refine this policy as necessary.

h) resolve the remaining issues on the cost of capital in the pricing of services.

i) where appropriate, and with the agreement of patients, make use of surplus capacity in publicly-owned services by transferring services from facilities that are unable to provide the service in the meantime to facilities with surplus capacity.

j) where appropriate, and with the agreement of patients, use the funding policies developed under (i) to assist in maintaining viability (critical mass of those facilities) of rural health services.

k) participate fully with other government agencies, the health sector and the general public in work on the policy reviews announced by the Government, especially the primary care strategy, the primary services compliance cost reduction test panel and the dental/oral health strategy.

l) continue working with the Ministry of Health to develop, and to the extent practicable determine, a consistent approach to palliative care services.

m) support effective workforce development policies and mechanisms, developed under the leadership of the Ministry of Health, and designed to ensure continuity of service delivery and, where appropriate, service enhancements throughout New Zealand.

n) it is expected that the Health and Disability (Safety) Bill will be fully enacted early next year. Once fully enacted, the HFA should fund those services that are covered by the new legislation, only from providers that are certified under the processes established by the new law.

o) generally ensure that all contracted services are focused on achieving the Government’s Medium-Term Strategy goals and that all contracts are performed effectively and efficiently.

Goal 2: Timely, equitable and nationally consistent access to elective services

Improve access to a nationally consistent level of publicly funded elective surgery services. This includes more timely access to first assessments and services, and ensuring that elective services are prioritised on a fair, transparent and consistent basis nationwide.

In particular:

a) ensure that the booking system, which is to be fully implemented by 30 June 2000, operates smoothly and that any ongoing modifications necessary to improve the system are implemented.

b) couple implementation of the booking system with continuous evaluation of its operation to ensure clinical ‘buy-in’ and achievement of the overall objective of ensuring that elective services are prioritised on a fair, transparent and consistent basis nationwide.

Goal 3: Acknowledging the special relationship between Māori and the Crown

Acknowledge the special relationship between Māori and the Crown in the health sector to ensure that publicly funded health and disability support services are responsive to Māori and continue to enable greater Māori participation at all levels of the health and disability sector.

In particular:

a) recognise the desire of Māori to take increased responsibility for their own health care by supporting existing and new Māori health and social service providers.

b) ensure that mainstream services are responsive to the needs of all Māori, whether Iwi or non-Iwi based.

c) participate fully with other government agencies in implementing the Government’s objective of strengthening co-ordination of Māori social services and improving health outcomes for Māori.

d) continue to implement the general policy directions for Māori health in Whaia te ora mo te iwi (1992).

Goal 4: Decreased long-standing disparities in health status

Make marked progress in decreasing the long-standing disparities in health and disability status, in particular for the needs of Māori and the needs of Pacific peoples, so that these groups can enjoy the same level of health status as other New Zealanders.

In particular:

a) implement service delivery plans designed to reduce disparities in health and disability status for those groups experiencing historically poorer outcomes than the population in general, including Māori, Pacific people and families of all ethnic groups experiencing multiple social and economic disadvantage.

b) explicitly consider and address the impact of health disparities in all documents which plan future developments in health services funding.

c) funding policies should ensure the ongoing strength of current Māori and Pacific providers of services, as well as providers of services to families of all ethnic groups.