Contracts - Te Whatu Ora - Health New Zealand - Improving access to primary healthcare services to transgender people

Simon Tegg made this Official Information request to Health New Zealand

The request was partially successful.

From: Simon Tegg

Dear Health New Zealand,

The budget bid Improving access to primary healthcare services to transgender people is now an operational programme of work managed by Health NZ.
In previous requests to the Ministry of Health (H2023019669) I discovered that the budget bid contained errors and received an admission of regret from Deputy Director General Maree Roberts. https://fullyinformed.nz/assets/files/H2...

The errors were:
- The budget bid overstated the number of transgender people (i.e the target population of the programme) in New Zealand by a factor of ~10.
- The budget bid claimed that the primary care delivery of hormone therapy has the potential to reduce the need for future genital surgeries (and thus save money). However the citations for this claim did not support this.

The second claim was repeated multiple times throughout the budget bid and Treasury subsequently gave the budget bid a rating of 4/5 for "value for money", 5/5 for "alignment" , and 4/5 for "delivery". [Treasury document https://fullyinformed.nz/assets/files/Do...

The government has changed so it is unclear if the programme would be so aligned with the current government's focus on economic efficiency and evidence. It is also unclear if Treasury would have given this bid a favorable "value for money" rating had Treasury known of its errors, and whether the programme would have been subsequently funded.

I assume that the programme is overseen by a governance and/or advisory group and/or manager (hereafter "governance group") within Health NZ.

From Health NZ:
- I request the names of the members of the governance group, its working name, establishment date, and purpose.
- I request confirmation that the governance group has been advised of errors in the budget bid.
If confirmation can be provided, I request the content of that advice whether written or recalled by officials.

From Health NZ and the Ministry of Health:
- I request confirmation that Treasury has been advised of errors in the budget bid.
- I request confirmation that the current Minister, Dr Shane Reti, has been advised of errors in the budget bid.
If confirmation can be provided, I request the content of that advice whether written or recalled by officials.

From Health NZ:
- I request the contract details, reporting schedules, evaluation frameworks and any reports between Health NZ and the contractors regarding this programme.
- I request all other correspondence between Health NZ and contractors regarding this programme.

If parts of a requested document are deemed to be out of scope, I request the full unredacted document

Yours faithfully,

Simon Tegg

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From: hnzOIA
Health New Zealand

Tēnā koe, 

 

Thank you for contacting Te Whatu Ora, Health NZ. This is an automatic
reply to confirm that we have received your email.  Depending on the
nature of your request you may not receive a response for up to 20 working
days.  We will try to respond to your query as quickly as possible.

 

 

Ngā mihi

 

Te Whatu Ora, Health NZ.

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From: hnzOIA
Health New Zealand


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Kia ora 
 
Thank you for your request of 2 February 2024 for the following
information:
 
From Health NZ and the Ministry of Health:
- I request confirmation that Treasury has been advised of errors in the
budget bid.
- I request confirmation that the current Minister, Dr Shane Reti, has
been advised of errors in the budget bid.
 
This part of your request asks for information which is more closely
aligned with the functions of Manatū Hauora Ministry of Health.  For this
reason, Te Whatu Ora has decided to transfer your request in part
to Manatū Hauora Ministry of Health under section 14(b)(ii) of the Act. 
You can expect a response from the Manatū Hauora Ministry of Health in due
course.
 
Under section 28(3) of the Act you have the right to ask the Ombudsman
to review any decisions made under this request. The Ombudsman may be
contacted by email at: [1][email address] or by calling 0800
802 602. If you have any queries related to this request, please do not
hesitate to get in touch.  
 
Ngā mihi  
 
Te Whatu Ora Ministerial Team
 
Te Whatu Ora – Health New Zealand
TeWhatuOra.govt.nz
 

****************************************************************************
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legal privilege.
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If you have received this message in error, please notify the sender
immediately and delete this message.
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From: OIA Requests
Health New Zealand


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Kia ora Simon
  
Thank you for your request for official information. The reference number
for your request is: H2024035836
 
From Health NZ and the Ministry of Health:
- I request confirmation that Treasury has been advised of errors in the
budget bid.
- I request confirmation that the current Minister, Dr Shane Reti, has
been advised of errors in the budget bid.
  
As required under the Official Information Act 1982, Manatū Hauora will
endeavour to respond to your request no later than 20 working days after
the day your request was received. If you'd like to calculate the
timeframe, you can use the Ombudsman's online calculator
here: [1]http://www.ombudsman.parliament.nz/  
  
If you have any queries, please feel free to contact the OIA Services Team
on [2][email address]. If any additional factors come to light which
are relevant to your request, please do not hesitate to contact us so that
these can be taken into account. 

Under section 28(3) of the Act you have the right to ask the Ombudsman to
review any decisions made under this request. The Ombudsman may be
contacted by email at: [3][email address] or by calling 0800
802 602.

Ngā mihi 
 
OIA Services Team 
[4]Ministry of Health information releases 

****************************************************************************
Statement of confidentiality: This e-mail message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
****************************************************************************

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From: hnzOIA
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Tēnā koe Simon

Thank you for your email of 2 February 2024, asking for the following
information under the Official Information Act 1982 (the Act):

The budget bid Improving access to primary healthcare services to
transgender people is now an operational programme of work managed by
Health NZ. 
In previous requests to the Ministry of Health (H2023019669) I discovered
that the budget bid contained errors and received an admission of regret
from Deputy Director General Maree Roberts.
https://aus01.safelinks.protection.outlo...
e82fd4cfb907908dc22fd98ce%7C23cec7246d204bd19fe9dc4447edd1fa%7C0%7C0%7C638423719805370299%7CUnknown%7CTWFpbGZsb3d8eyJ
WIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=n4Yu741I%2BraKbqI8%2BdzSWIoKfmVvPuxLPi%2BTY7WYOuw%3D&reserved=0
The errors were:
- The budget bid overstated the number of transgender people (i.e  the
target population of the programme) in New Zealand by a factor of ~10.
- The budget bid claimed that the primary care delivery of hormone therapy
has the potential to reduce the need for future genital surgeries (and
thus save money). However the citations for this claim did not support
this.  
The second claim was repeated multiple times throughout the budget bid and
Treasury subsequently gave the budget bid a rating of 4/5 for "value for
money", 5/5 for "alignment" , and 4/5 for "delivery". [Treasury document
https://aus01.safelinks.protection.outlo...
/?url=https%3A%2F%2Ffullyinformed.nz%2Fassets%2Ffiles%2FDocuments%2520for%2520Release-2.pdf&data=05%7C02%7Chnzoia%40health.govt.nz%7C82487ace82fd4cfb907908dc22fd98ce%7C23cec7246d204bd19fe9dc4447edd1fa%7C0%7C0%7C638423719805378595%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV
2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%
7C%7C&sdata=DLhfA4TZ5OQ7EKFAMZiwUVoRbsFpbLJBiDlMV4HvFaU%3D&reserved=0]
The government has changed so it is unclear if the programme would be so
aligned with the current government's focus on economic efficiency and
evidence.  It is also unclear if Treasury would have given this bid a
favorable "value for money" rating had Treasury known of its errors, and
whether the programme would have been subsequently funded. 
I assume that the programme is overseen by a governance and/or advisory
group and/or manager (hereafter "governance group") within Health NZ. 
From Health NZ:
- I request the names of the members of the governance group, its working
name, establishment date, and purpose.  
- I request confirmation that the governance group has been advised of
errors in the budget bid.
If confirmation can be provided, I request the content of that advice
whether written or recalled by officials.    
From Health NZ and the Ministry of Health:
- I request confirmation that Treasury has been advised of errors in the
budget bid.
- I request confirmation that the current Minister, Dr Shane Reti, has
been advised of errors in the budget bid.
If confirmation can be provided, I request the content of that advice
whether written or recalled by officials.    
From Health NZ:  
- I request the contract details, reporting schedules, evaluation
frameworks and any reports between Health NZ and the contractors regarding
this programme.   
- I request all other correspondence between Health NZ and contractors
regarding this programme. 
 

This email is to let you know that Te Whatu Ora needs more time to make a
decision on your request.

The Act requires that we advise you of our decision on your request no
later than 20 working days after the day we received your request.
Unfortunately, it will not be possible to meet that time limit and we are
therefore writing to notify you of an extension of the time to make our
decision, to 22 March 2024

This extension is required because the volume of information is such that
necessary to make a decision on your request are such that a proper
response cannot reasonably be made within the original time limit.

If you have any questions, please contact us at [1][Health New Zealand request email]

If you are not happy with this extension, 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.

Nāku iti noa, nā

Vicky 

Ministerial Services
 
Te Whatu Ora – Health New Zealand
TeWhatuOra.govt.nz
 

****************************************************************************
Statement of confidentiality: This e-mail message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
****************************************************************************

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From: hnzOIA
Health New Zealand


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Kia ora Simon 

Thank you for your email of 2 February 2024, asking for the following
information under the Official Information Act 1982 (the Act):
The budget bid Improving access to primary healthcare services to
transgender people is now an operational programme of work managed by
Health NZ. 
In previous requests to the Ministry of Health (H2023019669) I discovered
that the budget bid contained errors and received an admission of regret
from Deputy Director General Maree Roberts.
[1]https://aus01.safelinks.protection.outlo...
e82fd4cfb907908dc22fd98ce%7C23cec7246d204bd19fe9dc4447edd1fa%7C0%7C0%7C638423719805370299%7CUnknown%7CTWFpbGZsb3d8eyJ
WIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=n4Yu741I%2BraKbqI8%2BdzSWIoKfmVvPuxLPi%2BTY7WYOuw%3D&reserved=0
The errors were:
- The budget bid overstated the number of transgender people (i.e  the
target population of the programme) in New Zealand by a factor of ~10.
- The budget bid claimed that the primary care delivery of hormone therapy
has the potential to reduce the need for future genital surgeries (and
thus save money). However the citations for this claim did not support
this.  
The second claim was repeated multiple times throughout the budget bid and
Treasury subsequently gave the budget bid a rating of 4/5 for "value for
money", 5/5 for "alignment" , and 4/5 for "delivery". [Treasury document
[2]https://aus01.safelinks.protection.outlo...
/?url=https%3A%2F%2Ffullyinformed.nz%2Fassets%2Ffiles%2FDocuments%2520for%2520Release-2.pdf&data=05%7C02%7Chnzoia%40health.govt.nz%7C82487ace82fd4cfb907908dc22fd98ce%7C23cec7246d204bd19fe9dc4447edd1fa%7C0%7C0%7C638423719805378595%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV
2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%
7C%7C&sdata=DLhfA4TZ5OQ7EKFAMZiwUVoRbsFpbLJBiDlMV4HvFaU%3D&reserved=0]
The government has changed so it is unclear if the programme would be so
aligned with the current government's focus on economic efficiency and
evidence.  It is also unclear if Treasury would have given this bid a
favorable "value for money" rating had Treasury known of its errors, and
whether the programme would have been subsequently funded. 
I assume that the programme is overseen by a governance and/or advisory
group and/or manager (hereafter "governance group") within Health NZ. 
From Health NZ:
- I request the names of the members of the governance group, its working
name, establishment date, and purpose.  
- I request confirmation that the governance group has been advised of
errors in the budget bid.
If confirmation can be provided, I request the content of that advice
whether written or recalled by officials.    
From Health NZ and the Ministry of Health:
- I request confirmation that Treasury has been advised of errors in the
budget bid.
- I request confirmation that the current Minister, Dr Shane Reti, has
been advised of errors in the budget bid.
If confirmation can be provided, I request the content of that advice
whether written or recalled by officials.    
From Health NZ:  
- I request the contract details, reporting schedules, evaluation
frameworks and any reports between Health NZ and the contractors regarding
this programme.   
- I request all other correspondence between Health NZ and contractors
regarding this programme. 
 
Health New Zealand advised on Monday the 12 of February that we would need
more time to work on you request and we would make a decision about your
request by 22 March 2024.

However in order to provide you with the information requested, could you
please clarify what exactly you are after in order for us to collate the
information in a manner that is feasible retrievable.
 
What are you seeking in regards to the correspondence between Health NZ
and contractors regarding this programme? There is a significant amount of
information and substantial manual collation would be required to locate
and prepare all documents within scope of your request. As such, if you do
not narrow down your request we may refuse your request under section
18(f) of the Act.
 
Can you please provide this clarification by COB 21 of February 2024 or we
may refuse this request.

We look forward to receiving your response. 

Ngā mihi

Vicky
 
Ministerial Services
 
Health New Zealand - Te Whatu Ora 

****************************************************************************
Statement of confidentiality: This e-mail message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
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From: Simon Tegg

Dear hnzOIA,

I narrow the request by dropping the request for "all other correspondence between Health NZ and contractors regarding this programme" but keep the "contract details, reporting schedules, evaluation frameworks and any reports between Health NZ and the contractors regarding this programme." as well as the rest the points in my original request.

Yours sincerely,

Simon Tegg

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From: OIA Requests
Health New Zealand


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Attachment H2024035836 response letter.pdf
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Kia ora Simon,
Please find attached our response to your official information request.

Ngā mihi 

  

OIA Services Team

Manatū Hauora | Ministry of Health

M[1]inistry of Health information releases 
U[2]nite against COVID-19 

****************************************************************************
Statement of confidentiality: This e-mail message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
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From: Simon Tegg

Dear Emma Prestige (Ministry of Health)

Thankyou for your response,
Please provide the advice on the errors to Treasury and Dr Ayesha Verrall as described in your last email.

Yours sincerely,

Simon Tegg

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From: OIA Requests
Health New Zealand


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Kia ora Simon,
  
Thank you for your request for official information. The reference number
for your request is: H2024037331
  
As required under the Official Information Act 1982, Manatū Hauora will
endeavour to respond to your request no later than 20 working days after
the day your request was received. If you'd like to calculate the
timeframe, you can use the Ombudsman's online calculator
here: [1]http://www.ombudsman.parliament.nz/  
  
If you have any queries, please feel free to contact the OIA Services Team
on [2][email address]. If any additional factors come to light which
are relevant to your request, please do not hesitate to contact us so that
these can be taken into account. 

Under section 28(3) of the Act you have the right to ask the Ombudsman to
review any decisions made under this request. The Ombudsman may be
contacted by email at: [3][email address] or by calling 0800
802 602.

Ngā mihi 
 
OIA Services Team 
[4]Ministry of Health information releases 
 
 

------------------- Original Message -------------------
From: Simon Tegg <[FOI #25594 email]>;
Received: Thu Mar 07 2024 21:11:54 GMT+1300 (New Zealand Daylight Time)
To: OIA Requests <[email address]>; OIA <[email address]>;
Subject: Re: Response to your official information request ref:
H2024035836

Dear Emma Prestige (Ministry of Health)

Thankyou for your response,
Please provide the advice on the errors to Treasury and Dr Ayesha Verrall
as described in your last email.

Yours sincerely,

Simon Tegg
 

****************************************************************************
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attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
****************************************************************************

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2. mailto:[email address]
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4. https://www.health.govt.nz/about-ministr...

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From: hnzOIA
Health New Zealand


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Kia ora Simon, 
 
Thank you for your request for information. Please find attached our
response to your request.
 
If you have any questions, please get in touch at
[1][Health New Zealand request email].
 
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 [2]www.ombudsman.parliament.nz or by phoning 0800 802 602.
 
Ngā mihi,
 
Health NZ Ministerial Team
 
Government Services
Office of the Chief Executive

Health New Zealand | Te Whatu Ora

****************************************************************************
Statement of confidentiality: This e-mail message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
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2. file:///tmp/foiextract20240320-36-1xc3rpu#

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From: Simon Tegg

Tēnā koe Deborah Woodley,

Noting that the names of the individual members of GAPCAG cannot be released due to the potential for harassment, I request a summary of the composition of GAPCAG. That is:
- the number of members
- their professional background
- their reimbursement

Obviously the name of the project manager, Max Whitehurst, is public knowledge as it is in the linked material above. Whitehust has a background in transgender rights advocacy.

Noting that the public health system has commitments to evidence-based medicine and impartiality, I request this information in order to assess the competencies and impartiality of GAPCAG.

It is a pivotal time for the practice of paediatric sex trait modification. The NHS has just ended the routine use of puberty blockers citing the lack of evidence of benefit and safety concerns of blocking the brain, bone, cogntive, and sexual and reproductive development that occurs at a normally timed puberty. For example, an impatial GAPCAG would be up to date with Abbruzzese et al (2023)'s critique of the poor evidence base https://www.tandfonline.com/doi/full/10.... and Professor of Neuropsychology Sallie Baxendale's recent review of impact of suppressing puberty on neuropsychological function https://onlinelibrary.wiley.com/doi/full... which states that:

"There is no evidence that cognitive effects are fully reversible following discontinuation of treatment.... There is some evidence of a detrimental impact of pubertal suppression on IQ in children."

An impartial GAPCAG would be including these international assessments in its advice to Te Whatu Ora.
A potentially irreversible impact on cognitive function is obviously something a health consumer and their families would expect to know, even if uncertain. If puberty suprression consent forms ommitted these impacts then obviously that would make "informed consent" process unlawful.

These are the some of the issues that I would expect an impartial GAPCAG to be on top of, and highlight the public interest in understanding the GAPCAG's composition and expertise. Thankyou for responding to my requests so far and contributing to the public's understanding of the GAPC programme.

Ngā mihi,

Simon Tegg

Link to this

From: hnzOIA

Tēnā koe, 

 

Thank you for contacting Health NZ, Te Whatu Ora. This is an automatic
reply to confirm that we have received your email.  Depending on the
nature of your request you may not receive a response for up to 20 working
days.  We will try to respond to your query as quickly as possible.

 

 

Ngā mihi

 

Health NZ, Te Whatu Ora.

Statement of confidentiality: This email message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege. If you are not the intended recipient, do not read, use,
disseminate, distribute or copy this message or attachments. If you have
received this message in error, please notify the sender immediately and
delete this message

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From: OIA Requests
Health New Zealand


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Kia ora Simon,

 

Please find attached our response to your official information request.

 

Ngā mihi 

  

 

OIA Services Team

Manatū Hauora | Ministry of Health

M[1]inistry of Health information releases 
U[2]nite against COVID-19 

 

****************************************************************************
Statement of confidentiality: This e-mail message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
legal privilege.
If you are not the intended recipient, do not read, use, disseminate,
distribute or copy this message or attachments.
If you have received this message in error, please notify the sender
immediately and delete this message.
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From: hnzOIA


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Kia ora Simon, 
 
Thank you for your request for information. Please find attached our
response to your request.
 
If you have any questions, please get in touch at
[1][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 [2]www.ombudsman.parliament.nz or by phoning 0800 802 602.
 
Ngā mihi, 
 
Health New Zealand | Te Whatu Ora Ministerial Team 
 
Government Services
Office of the Chief Executive

Health New Zealand | Te Whatu Ora
Statement of confidentiality: This email message and any accompanying
attachments may contain information that is IN-CONFIDENCE and subject to
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disseminate, distribute or copy this message or attachments. If you have
received this message in error, please notify the sender immediately and
delete this message

References

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