11 September 2024
A J A MacRae
[FYI request #27056 email] Tēnā koe
Your request for official information, reference: HNZ00050360
Thank you for your email on 29 May 2024, asking Health New Zealand | Te Whatu Ora for the
following under the Official Information Act 1982 (the Act):
Currently gender affirming healthcare pathways listed publicly online, and on health district
intranets accessible by practitioners, are not always consistent with the actual service
provided (or not provided) by public hospitals. Information provided by practitioners and
administrators within specialist departments often contradicts MoH guidelines for provision
of gender affirming care. Patients and general practitioners encounter a lack of
transparency in priority assessment and patient exclusion criteria when attempting to
access certain procedures, which is immensely frustrating, and wastes both the patients'
and practitioners' time. For example, a deferral letter for an orchidectomy from the Urology
department at Wellington Regional Hospital provided a link to electiveservices.govt.nz,
where the department claimed I could find the prioritisation guidelines for orchidectomy
referrals. The link has been defunct for over a decade and the website appears to have
never contained the gender affirming guidelines the department claimed it did.
In light of this lack of transparency or clear pathways, I would like to request the following
information from Te Whatu Ora,
1-What are the pathways for accessing gender affirming:
-Orchidectomy
-Hysterectomy
-Oophorectomy
-Mastectomy?
2-What are the priority assessment/triaging processes for:
-Orchidectomy
-Hysterectomy
-Oophorectomy
-Mastectomy?
3-Are these pathways/guidelines/practices different for different hospitals or different health
districts?
5-If funding or resources are not available at a certain hospital or in a health district, is there
a process for referring patients to other hospitals?
6-How many of the above procedures have been performed by each hospital/health district
within the last 5 years for gender affirming reasons?
7-How many referrals for these procedures have been deferred/declined by each
hospital/health district?
Response
I apologise for the delay in providing our response. The time taken is not what we aspire to. This is
something we are working to get on top of as we deal with a high volume of requests and the
understandably high public interest in our work.
1-What are the pathways for accessing gender affirming:
-Orchidectomy
-Hysterectomy
-Oophorectomy
-Mastectomy?
2-What are the priority assessment/triaging processes for:
-Orchidectomy
-Hysterectomy
-Oophorectomy
-Mastectomy?
3-Are these pathways/guidelines/practices different for different hospitals or different health
districts?
5-If funding or resources are not available at a certain hospital or in a health district, is there
a process for referring patients to other hospitals?
In order to provide the information you have requested Health NZ would need to divert personnel
from their core duties and allocate extra time to complete this task. The diversion of these
resources would impair Te Whatu Ora’s ability to carry out our other core functions. As such, your
request is refused under section 18(f) of the Act, as it requires substantial collation.
I have considered whether fixing a charge for the supply of the information or extending the
timeframe for response would enable Health NZ to respond. I do not consider that either option
would remove the impact that supplying the information would have on our other operations.
6-How many of the above procedures have been performed by each hospital/health district
within the last 5 years for gender affirming reasons?
Health NZ is able to provide the numbers for these procedures, we cannot identify whether they
were performed for gender affirming reasons.
The number of publicly funded procedures from our most recent five financial years of published
data for these procedures was:
2016/17 2017/18
2018/19
2019/20
2020/21
Orchidectomy (block code 1184)
371
383
386
373
460
Abdominal hysterectomy (block code 1268)
2402
2379
2255
2624
2841
Vaginal hysterectomy (block code 1269)
765
827
732
519
527
Oophorectomy (block code 1243)
275
269
286
400
441
Subcutaneous mastectomy (block code 1747)
229
230
227
237
266
Simple mastectomy (block code 1748)
1380
1366
1404
1346
1440
Please note that this data is provisional and used for operational purposes. It has not been through
the full quality assurance process that we use before publishing data and therefore is subject to
change.
7-How many referrals for these procedures have been deferred/declined by each
hospital/health district?
I am refusing your request under section 18(g) of the Act as the information you have requested is
not held by Health NZ | Te Whatu Ora and we have no grounds to believe that the information is
held by another entity subject to the Act.
Again, my apologies for the delay in providing this response.
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
Danielle Coe
Manager (OIA) Government Services
Health New Zealand | Te Whatu Ora
TeWhatuOra.govt.nz
Health NZ, PO Box 793,
Wellington 6140, New Zealand
