28 March 2019
Marie Daly
NZ Rural Hospital Network Executive Committee
[FYI request #9711 email]
Dear Marie
Official Information Act request
Thank you for your request for information dated 28 February 2019 for:
“The New Zealand Rural Hospital Network wants to clearly understand each DHB's
process for allocating, monitoring and reporting the annual DHB Rural Adjuster Fund.
1. For each of the past three years ending June 2016, June 2017 and June 2018
what was the DHBs Rural Adjuster funding component of the PBFF funding
pool?
2. Does the DHB fund and provide rural hospital services?
If yes, continue to answer questions 2.1, 2.2 and 2.3. If no, go to question 3
2.1. Provide the following information about the rural hospitals in your DHB.
If there are none, please report this.
• Name or location of hospital
• List of services the hospital provides
• The business structure of the hospital eg DHB owned and operated / NGO or
Iwi owned and operated
• Annual Budget
2.2. How is the annual budget for each of the rural hospitals listed in the table in
2.1 set?
2.3. How does the DHB apply the annual rural adjuster funding to the benefit of
each of the rural hospitals listed in the table in question 2.1?
3. Does the DHB fund and provide rural community services?
If yes, continue to answer questions 3.1, 3.2 and 3.3. If no, go to question 3
3.1. Provide the following information about the rural community services in your
DHB.
If there are none, please report this.
• Location of services
• List of Community services in each location
• The business structure of the service provider eg DHB owned and operated /
NGO or Iwi owned and operated
• Annual Budget.
3.2. How is the annual budget for the community services listed in the table in 3.1
set?
3.3. How does the DHB apply the annual rural adjuster funding to the benefit of
each of the rural community listed in the table in question 3.1?
4. For each of the past three years, under each of the components of the Rural
Adjuster, quantify the al ocation of Rural Adjuster funding through the DHBs
contracts with its contracted providers or Service Level Al iance Teams.
• Small hospital facilities
• Community services
• Offshore Islands
• Travel and Accommodation
• Inter hospital transfers
• Governance
• Rural GP/PHO payments
5. i. Does the DHB include reporting requirements specific to the use of rural
adjuster funding in its contracts with service providers whose contract includes
rural adjuster funding.
i . If yes, provide a list of the reporting requirements included in the DHB
contracts with these providers.”
The responses to your questions are below.
1.
For each of the past three years ending June 2016, June 2017 and June
2018 can you please confirm what the DHBs Rural Adjuster funding
component of the PBFF funding pool is?
As previously advised this question has been transferred to the Ministry of
Health to answer.
2.
Does the DHB fund and provide rural hospital services?
Yes
2.1. Provide the following information about the rural hospitals in your DHB
Hospital
Location
Services
Pohlen Hospital
Matamata
Maternity services
Observation beds
Thames Hospital
Thames
Secondary care
Emergency care
Medical wards
Maternity services
Laboratory services
Radiology services
Taumarunui Hospital
Taumarunui
Secondary care
Emergency care
Medical wards
Maternity services
Laboratory services
Radiology services
Te Kuiti Hospital
Te Kuiti
Secondary care
Emergency care
Medical wards
Maternity services
Laboratory services
Radiology services
Tokoroa Hospital
Tokoroa
Secondary care
Emergency care
Medical wards
Maternity services
Laboratory services
Radiology services
The business structure of the hospital e.g. DHB owned and operated/
NGO or Iwi owned and operated?
Pohlen Hospital is privately owned and operated. The other four are Waikato
DHB owned and operated facilities.
Annual Budgets
Pohlen Hospital is funded by a fee for service basis. The annual budget is
$223,979.22.
The other four Waikato DHB operated hospitals are funded $6.6 milion per
year to provide the rural services.
2.2. How is the annual budget for each of the rural hospitals listed in the table
in 2.1 set?
The annual budgets are based on volume activity and complexity of patients
presenting to the Level
1 and 2 hospitals.
2.3. How does the DHB apply the annual rural adjuster funding to the benefit
of each of the rural hospitals listed in the table in question 2.1?
The rural adjuster is included in $6.6mil ion dollars allocated to the provider arm
for the rural hospitals; the provider arm then as part of their budgeting process
allocates associated funds to each of the rural hospitals. This funding allocation
is reflected in the Price Volume Schedule agreed between the funder and
provider arm.
3.
Does the DHB fund and provide Rural Community Services?
Yes. The funding is in recognition of rural location in addition to other funding
such as capitation, pharmacy and usual rest home provision. The total annual
budget is $3,754m per annum.
3.1. Provide the following information about the rural community services in
your DHB.
The services outlined below address question 3.1.
PHO Service
Location
Midlands Health Network
• Te Kuiti
• Tokoroa
Rural Bonus, Reasonable
• Whitianga
• Waihi
Roster, Retention and
• Whangamata
• Colville
Recruitment with General
• Coromandel
• Huntly
Practices
• Colville
• Morrinsville
• Putaruru
Telephone Nurse Triage
Services
Rural Sub hubs in
Coromandel, Whitianga
and Whangamata
General Practices
GPs in Thames ED for 6
hours on Saturdays
Hauraki PHO
• Matamata
Rural Bonus, Reasonable
• Thames
Roster, Retention and • Huntly
Recruitment with General
• Colville
Practices
• Whitianga
• Waihi
• Tokoroa
Telephone Nurse Triage Services
Rural Sub Hub in Matamata
National Hauora Coalition Telephone Nurse Triage
(PHO)
Waikato DHB
Southern rural hospitals and Thames Hospital
Contribution to deliver
primary medical care from
8.00 pm to 8.00 am is every
day including all weekends
and public holidays.
Financial support for rural
pharmacies.
• Tairua
Four rural pharmacies
• Te Kauwhata
receive additional funding
• Ngatea
(this is where they are the
• Coromandel
only one in town and are 30
minutes from other nearest
pharmacy).
Rural GP Inpatient Beds
• Pohlen Hospital
• Te Aroha & District Hospital Trust
• Waihi Hospital
• Moana House Trust
• Oceania Co Ltd
• Phoenix Resthome and Hospital
3.2. How is the annual budget for the community services listed in the table in
3.1 set?
The annual budgets are set based on the previous years’ delivery and a
discussion with the individual provider organisations.
3.3. How does the DHB apply the annual rural adjuster funding to the benefit
of each of the rural community listed in the table in question 3.1?
The services listed in 3.1 are not funded from the Rural Adjuster.
4.
For each of the past three years, under each of the components of the
Rural Adjuster, quantify the allocation of Rural Adjuster funding through
the DHBs contracts with its contracted providers or Service Level
Alliance Teams.
•
Small hospital facilities
The information is unable to be provided as it is not collected or reported to the
District Health Board and therefore this part of your request is refused under
section 18(e) of the Official Information Act because the information does not
exist.
However we have continued to invest in rural health care provision over this
period requested. The funding applied to rural hospitals greatly exceeds the
Rural Adjuster.
•
Community services
The information is unable to be provided as it is not collected or reported to the
District Health Board and therefore this part of your request is refused under
section 18(e) of the Official Information Act because the information does not
exist. However, we have continued to invest in rural health care provision over
the period requested.
•
Offshore Islands
Waikato DHB does not fund services to any Offshore Islands.
•
Travel and Accommodation
Travel and Accommodation is funded in accordance with National Travel
Assistance criteria
•
Inter hospital transfers
The information is unable to be provided as it is not collected or reported to the
District Health Board and therefore this part of your request is refused under
section 18(e) of the Official Information Act because the information does not
exist. However we have continued to invest in rural health care provision over
this period requested.
•
Governance
We do not hold any information in relation to Governance.
•
Rural GP/PHO
Waikato DHB operates two Rural Service Level Al iance Teams for rural
general practice, (RSLATs) being Hauraki (RSLAT) Midlands Health Network
(RSLAT) which provide guidance on Rural GP/PHO payments. The services
established by each of the RSLAT’s are outlined in response to question 3.2
5.
Does the DHB include reporting requirements specific to the use of rural
adjuster funding in its contracts with service providers whose contract
includes rural adjuster funding.
No. Other than rural adjuster being reflected in the annual funding allocation
via the Price Volume Schedule there are no specific reporting requirements for
the rural adjuster funding.
You have the right to request the Ombudsman investigate and review the decision to
withhold the information. The Ombudsman’s postal address is:
The Ombudsman
Office of the Ombudsmen
P O Box 10-152
WELLINGTON
Yours sincerely
Tanya Maloney
Executive Director, Strategy, Funding and Public Health
Document Outline
