Health Performance Report Released

The third annual report on regional health authority performance was released today by Health Minister Bill English.

"These performance monitoring reports are significant because they give us detailed information about what we're getting from the health system," said Mr English.

Releasing Purchasing for Your Health 1995/96, Mr English said he was pleased to see that RHAs maintained, and in some areas increased, access to health and disability services.

"Progress was also made in a number of other areas. More than half of all GPs were involved in budget-holding arrangements by the end of 1995/96, helping to bring expenditure growth in primary care under control. Since then significant further progress has been made in this area.

"However, it is taking the RHAs some time to develop the tools to control expenditure in all areas. Waiting lists continued to grow, although progress was made in implementing booking systems and clinical guidelines for treatment.

"RHAs were set up in an environment where we had very little information about the performance of our health organisations. There is no doubt that there is still significant room for improvement, but having this kind of detailed information is the first step in doing that.

"Now that we have moved to one funding agency I hope we are able to continue the level of region-by-region monitoring that has been possible with the four RHAs.

"This is certainly one of the issues the Transitional Health Authority will have to consider," he said.

Ends

For further information contact:
Liz Rowe, Press Secretary, 04-471 9154 (wk) or 04-383 5491 (hm)
Eileen O'Leary, Press Secretary, 04-471 9731 (wk) or 04-475 4143(hm)

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KEY PERFORMANCE ISSUES FOR 1995/96
Regional health authorities' (RHAs) performance in the 1995/96 is summarised below in terms of key issues:

RHAs overall maintained, and in some areas increased, access to services. Exceptions, however, were in the area of dental health and some key surgical procedures in some regions.

RHAs successfully managed the transfer of functions from the Public Health Commission and programmes from the Department of Social Welfare.

RHAs, with the exception of Midland RHA, were unable to agree contracts in a timely fashion with some CHEs. Some improvements in relationships were evident.

RHAs improved contract specifications and developed their purchasing frameworks during the year. There were also examples of increased flexibility and innovation in contracting.

Waiting lists for surgical services continued to grow. Progress was made in implementing booking systems and clinical guidelines, especially by Midland RHA.

RHAs continued to develop planned changes for maternity services purchasing; however, they met with significant provider resistance when implemented on 1 July 1996.

There is still little progress observable through health status measures in the health gain priority areas of Maori health, child health, mental health and physical environmental health. RHA activity in 1995/96 included:

some shifting of resources into mental health services;

continuing progress in implementing Maori initiatives and provider development; and

implementation of the new Well Child schedule.

Limited progress was made by RHAs in improving mental health services. Central and Midland RHAs did not achieve their targets for purchasing of mental health services. Midland RHA, in particular, performed poorly with regard to mental health.

RHAs' strategies for controlling expenditure growth in areas of primary care have had some success.

RHAs did not meet their targets for teenage dental coverage. Expenditure per capita on adolescent dental services reduced, markedly in the Northern region and slightly in Central, raising questions regarding levels of utilisation and access following some dentists' withdrawal from provision of these services in the previous year. Central RHA took action to maintain access by purchasing alternative delivery mechanisms.

RHAs. Especially Midland and Central, need to make further progress than in 1995/96 if they are to implement the DSS Framework within the required timeframe.

RHAs had difficulty implementing joint projects (such as changes to statim dispensing).

Expected purchasing priorities were not always reflected in service delivery. For example, Northern RHA's hip and knee replacement numbers reduced in volume in spite of the RHA consistently having volumes of these priority procedures below target levels in past years.

The implementation of strategies for national purchasing of some public health services was successfully led by Northern RHA.

Midland RHA was innovative in implementing the first budget-holding contract with general practitioners in New Zealand with the risk being held by the provider group.

Northern RHA required an additional $14.2 million contribution from the Crown above base funding to maintain services delivered by its major secondary/tertiary care hospital provider.

Southern RHA required an additional $14.7 million contribution from the Crown above base funding to enable it to purchase an acceptable range of services. It was unable to settle contracts with its two major CHEs without this additional funding. Southern RHA completed a strategic business plan to recover to a viable financial position over time.