Review Released On Access To Primary Health Services And Dental Care For Tamariki And Rangatahi In Care

A report from Aroturuki Tamariki, the Independent Children’s Monitor, on access to primary health services and dental care for tamariki (children) and rangatahi (young people) in care has found Oranga Tamariki has not yet implemented basic health requirements.

Research has shown that tamariki and rangatahi in care are more likely than others to have poor long-term health outcomes. The National Care Standards (NCS) Regulations came into effect in 2019 and set out the minimum standards required when a child comes into care, including that health and dental needs are identified through annual checks. These regulations apply to Oranga Tamariki, and any other agency with custody and care responsibilities.

Aroturuki Tamariki Chief Executive Arran Jones says while Oranga Tamariki does not provide the health or dental services itself, it does have an obligation to know if it is meeting the regulations and to take reasonable steps to ensure tamariki get what they need. “That means knowing if tamariki and rangatahi in its care are enrolled with a doctor and getting annual health and dental checks.”

“We found that more needs to be done to implement these regulations. We heard from tamariki, caregivers and Oranga Tamariki social workers that clearer guidance, and better recording and sharing of this information is needed. Since we started this review, Oranga Tamariki has a better understanding of whether tamariki are enrolled, however it remains unable to say whether tamariki are receiving annual health and dental checks, nor have Oranga Tamariki worked with the health sector to agree on what a health check includes. We also heard a willingness on the part of primary health and dental professionals, who are generally eager to prioritise tamariki and rangatahi in care, but they are not always made aware that the child is in care,” says Mr Jones.

For the Experiences of Care in Aotearoa 2021/2022 report, Oranga Tamariki reported that 56 percent of tamariki in its care were enrolled with a Primary Health Organisation (PHO). Since this review was started, Oranga Tamariki conducted a data match with Te Whatu Ora and estimates that 93 percent of tamariki and rangatahi in its care were enrolled with a PHO.

The one-off data match between Oranga Tamariki and Te Whatu Ora estimates that around 70 percent of tamariki had been seen by their doctor, however Oranga Tamariki don’t know if they received an annual health check or just had their current health issue (such as a sore foot) addressed.

“These annual health checks can identify health needs and ensure plans and services are put in place to improve long-term outcomes for tamariki in care,” says Mr Jones.

Oranga Tamariki also doesn’t know if tamariki in its care have had an annual dental check. Open Home Foundation could tell us that 75 percent of tamariki in its care had received one.

“We hope that Oranga Tamariki will work quickly to provide clear guidance on what an annual health check requires, and also put systems in place to ensure enrolment and annual health and dental checks are recorded in all case files so social workers and caregivers know who a child’s doctor is and where any gaps are,” says Mr Jones.

Aroturuki Tamariki will continue to monitor whether Oranga Tamariki is improving its compliance with the NCS regulations regarding access to primary health and dental care through its annual Experiences of Care in Aotearoa report.

The report is available on the Aroturuki Tamariki website https://aroturuki.govt.nz/reports/access-to-primary-health-services-and-dental-care

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