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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