31 May 2024
B Evans
[FYI request #26717 email]
Tēnā koe
Your request for official information, reference: HNZ00047611
Thank you for your email on 13 May 2024, asking Health New Zealand | Te Whatu Ora (Health NZ)
for information under the Official Information Act 1982 (the Act). Please see outlined below a
response to each part of your request.
1) What was the process in commissioning PATHA for the above? Please provide criteria,
emails, briefs, meeting minutes etc.
Health NZ follows the Government’s procurement rules that are publicly available here:
www.procurement.govt.nz/procurement/principles-charter-and-rules/government-procurement-
rules/.
Organisations were required to submit tenders that demonstrated their ability to meet the
requirements outlined in the Request for Proposals attached as
Appendix One.
Tenders were then assessed based on the evaluation criteria by an evaluation panel that consisted
of four members and represented a range of perspectives and expertise. The evaluation criteria
and scoring scale can also be found in Appendix One.
The part of your request which asks for emails, briefs, meeting minutes, etc, is refused under
sections 9(2)(g)(i) and section 9(2)(b)(ii) of the Act. This is to maintain the effective conduct of
public affairs through the free and frank expression of opinions by or between employees of any
public service organisation in the course of their duty as the release of this information would be
likely to unreasonably prejudice the commercial position of the organisation who supplied it. It is in
the public interest that such information continues to be supplied.
2) How has PATHA shown Health New Zealand that they are reputable, evidence-based,
and independent of the culture/ideology wars currently raging in the transgender
healthcare space?
3) The Cass Review Final Report gave PATHA's last guidelines the 2nd to lowest score of
all guidelines globally (149/600).
What is the quality assurance process for reviewing what PATHA produces now to
ensure it is accurate, comprehensive, balanced and evidence-based?
I am refusing to answer these questions under section 18(e) of the Act. This information does not
exist, and the Act does not require us to form an opinion where one does not already exist.
4) What are the requirements of the work to be completed by PATHA for the above? e.g.:
Systematic review of evidence to date?;
Full and transparent methodology and data used in systematic evidence review, to be
freely publicly available?;
The medical, ethical or other standards that the review, guidelines and pathways must
adhere to and state comprehensively?
The service specification for this contract includes a literature review. Additionally, the draft
guidelines will be reviewed by clinical stakeholders and undergo a sign out process to ensure that
contents are clinically and culturally safe.
5) What are the deliverables of the work to be completed by PATHA for the above? e.g:
Report to the Minister of Health on the state of ‘gender-affirming care’ in NZ - using data
from around the NZ, split by Region and type and age of care?; trends over-time,
concerns?
GP-ready publishable guidelines for evidence-based care for gender-questioning
persons including non-medicalised pathways?;
Website-ready explanations of best -practice for gender questioning patients?;
What else?
The minimum service requirements of the Guidelines state that the Guidelines must:
• include guidance on clinical and cultural best-practice when delivering care to transgender
patients
• include guidance for commencing hormone therapy in primary care
• be delivered in a format that is suitable for online publication and distribution via printed copy
• reflect consultation with the below groups, provide guidance on addressing the needs of:
a. takatāpui, Māori transgender and non-binary people and their whānau
b. MVPFAFF+ people, Pacific transgender, and non-binary people and their whānau
c. transgender and non-binary tāngata whaikaha (disabled peoples) and their whānau
d. rangatahi or youth and their whānau.
6) What is the cost of this contract with PATHA? Please specify different elements and
deliverables and their dates, a copy of the contract and any correspondence about the
contract.
The budget allowed for up to $200,000 to be spent on the development of the Guidelines, however
the contracted amount is $124,000. The breakdown of the elements and deliverables can be found
in
Appendix Two – Payment and invoicing schedule, however I am refusing to release the cost of
each element under section 9(2)(b)(ii) of the Act. I am also refusing to release a copy of the
contract and correspondence about the contract under section 9(2)(b)(ii) of the Act. The release of
these pieces of information would be likely to unreasonably prejudice the commercial position of
the organisation contracted.
7) What are the current “referral pathways”?
A person’s gender-affirmation is highly individual and may include different aspects of gender-
affirming care depending on their individual goals. Referral pathways are currently variable and
managed by individual districts depending on the availability of, and capacity of, services and
clinicians in the area.
How to get in touch
If you have any questions, you can contact us at
[email address].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may proactively
release a copy of this response on our website. All requester data, including your name and
contact details, will be removed prior to release.
Nāku iti noa, nā
Deborah Woodley
Director – Starting Well
National Commissioning
