The following letter was sent from the Director-General of Health to district health board chief executives on 12 November 2018.
Tēnā koutou katoa
Well Child Tamariki Ora Review
Making New Zealand the best place in the world to be a child is a top Government priority. To achieve this vision, New Zealand’s first Child Wellbeing Strategy is being developed, with oversight from the Prime Minister in her role as Minister for Child Poverty Reduction. The Ministry of Health and district health boards are contributing to the development and delivery of this strategy.
Our health system will help realise this vision by making sure children have the best chance to develop during their early years. Collectively, we play an important role in empowering children to thrive socially, emotionally and developmentally. The Well Child Tamariki Ora programme is an essential platform for ensuring child wellbeing by delivering essential universal health care to New Zealand children and providing vital health checks to all children under five years of age. This helps to ensure they’re healthy while identifying and addressing issues at an early stage.
To make sure the Well Child Tamariki Ora programme can continue to support this important work effectively, including responding appropriately to whānau with high health and social needs, we intend to review the programme. The Review will look at the extent to which the programme is currently meeting the needs of children and their families, identifying what’s working well and what it is that we need to improve.
The Ministry intends to co-lead the Well Child Tamariki Ora Review with DHB partners and with Māori to strengthen Tamariki Ora services. The Review will include input from Well Child Tamariki Ora providers and other agencies, including the Ministry of Education and Oranga Tamariki.
Rationale for reviewing Well Child Tamariki Ora
The Review is intended to be a key health system deliverable supporting the Government’s child wellbeing priority, resulting in a Well Child Programme that is more flexible, gives whānau more choice and is better integrated with other health and social services. It will assess and redesign Well Child Tamariki Ora’s funding, contracting and service delivery models to ensure the programme is financially sustainable and delivering the best possible health and wellbeing outcomes for babies, children and families. By identifying gaps in the programme, the Review will also help our sector improve health equity.
The Well Child Tamariki Ora Review has four aims:
- Improving sustainability and performance of the Well Child Tamariki Ora programme
- Driving equitable health and development outcomes for children
- Enabling the Well Child Tamariki Ora programme to more effectively contribute to wider child wellbeing
- Ensuring value for money.
The Review will be informed by evidence about what works when it comes to improving the wellbeing of children while considering the adequacy and sustainability of current funding for Well Child Tamariki Ora providers. The Review will also look at how the Well Child Tamariki Ora service can better meet the needs of children’s whānau, caregivers and wider communities which we know will better enable children to thrive.
Scope of the Review
The following aspects of the Well Child Tamariki Ora programme will be assessed and redesigned:
- Well Child Tamariki Ora Schedule – opportunities for improving the timing and content of Well Child Tamariki Ora contacts. This includes the Ministries of Health and Education working to align and integrate services to enhance school readiness.
- Equity – addressing current access and outcome inequities and looking at opportunities to introduce a more proportionate response to address light to intensive needs while offering more choice when it comes to mode of delivery.
- Funding and contracting – development of a funding formula to ensure fair allocation of funding across the service, and an outcome-based contracting framework that can adapt to support funding of providers based on consumer demand.
- Data and insights – the Well Child Tamariki Ora programme has the potential to provide rich information about child wellbeing in the early years. The Review will look at the development of a national database and collection to include in the Integrated Data Infrastructure.
The Well Child Tamariki Ora Review has a 12 month timeframe to deliver a new equitable funding and service delivery model for the Well Child Tamariki Ora programme. In parallel, the Ministry of Health and DHB leaders are working on the sector’s contribution to the Department of the Prime Minister and Cabinet (DPMC)-led Child and Youth Wellbeing Strategy.
The Review and the Maternity Services Improvement Programme will be the health system’s key contributions to this work.
The Review will provide a great foundation for the Child Wellbeing Strategy to respond to the science and evidence, family and whanau voices and emerging Government priorities for investment in child wellbeing. It’s anticipated the new equitable funding and service delivery model for the Well Child Tamariki Ora programme will be in place from 1 July 2020.
Implications for DHBs
As the Ministry anticipates the Review will take 12 months with implementation of any changes to follow, existing Well Child Tamariki Ora contractual arrangements will need to be maintained during the Review period. An interim commissioning plan will be designed to support the programme to provide continuity and sustainability of the service and ensure a smooth transition to the revised service.
The Ministry Review team will work closely with your DHB in addition to Well Child Tamariki Ora providers, Māori, Pasifika peoples, consumers, and other stakeholders to ensure the review enables equitable participation at all levels.
Keeping you engaged
I appreciate you and your team may have questions about what the Review means for your DHB. The Ministry will keep you and your team updated regularly about the status of the Review and any changes which follow this process. The schedule to engage with stakeholders and the public is yet to be arranged.
You can contact the Review team if you need more information in the meantime by email (firstname.lastname@example.org).
Publicly promoting the changes
A suggested letter outlining the key information to share with your WCTO providers is attached. I would be grateful if you could please send this to your Well Child Tamariki Ora providers as soon as possible.
Information and resources about the Well Child Tamariki Ora Review will be published on the Ministry of Health website to ensure stakeholders are kept up-to-date. The Ministry sees the Review as a positive opportunity to enhance the service we’re providing to New Zealand families, and intends to promote the Review proactively.
Thank you for your support as we undertake the Review with a focus on delivering better outcomes for our tamariki and their whānau.
Ngā mihi nui
Dr Ashley Bloomfield
Director-General of Health