4 June 2024
Gywn Walker
[FYI request #26498 email]
Tēnā koe Gywn
Your request for official information, reference: HNZ00044877
Thank you for your email on 22 April 2024, asking Health New Zealand | Te Whatu Ora (Health
NZ) for the following under the Official Information Act 1982 (the Act):
1) The Gender-Affirming Primary Care Advisory Group's presentation to the CARN
Conference in June 2023.
2) The Phase 1 review draft document circulated within the GAPCAG, and all advisory
group responses (referenced in item 8. of the 7/11/2023 meeting).
3) The current number of GAPCAG members and their designated group roles and/or titles.
Response
For the sake of clarity, I will answer each question in turn.
1) The Gender-Affirming Primary Care Advisory Group's presentation to the CARN
Conference in June 2023.
The Gender Affirming Primary Care Advisory Group did not present at the Cross Agency Rainbow
Network (CARN) Conference in June 2023. Therefore, we refuse your request for this information
under section 18(e) of the Act as the information requested does not exist.
2) The Phase 1 review draft document circulated within the GAPCAG, and all advisory
group responses (referenced in item 8. of the 7/11/2023 meeting).
The Phase 1 review draft document circulated within the Gender Affirming Primary Care Advisory
Group (GAPCAG) and all advisory group responses referenced in item 8 of the 7/11/2023 meeting
is attached as Appendix 1 – Review of phase 1.
Some information has been redacted under section 9(2)(a) to protect the privacy of the individuals
concerned, section 9(2)(ba)(i) where information is subject to an obligation of confidence and
release would be likely to prejudice the supply of information, section 9(2)(g)(i) to maintain free and
frank expression of opinions, section 9(2)(g)(ii) to ensure protection from improper pressure or
harassment, and section 9(2)(j) to carry on negotiations without prejudice or disadvantage.
The need to withhold that information is not outweighed by the public interest to make that
information available.
3) The current number of GAPCAG members and their designated group roles and/or titles.
The GAPCAG consists of 12 members excluding the ex officio members. The membership
consists of members who bring the perspectives of the following designated groups:
•
Takatāpui communities
•
Mahu, Vakasalewalewa, Palopa, Fa'afafine, Akava'ine, Fakafifine and Fakaleiti/leiti
(MVPFAFF) and other Pacific communities
•
Whaikaha or disabled communities
•
Primary care including General Practitioners (GPs) working in primary or community care
•
Community advocacy and support groups.
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
Deborah Woodley
Director – Starting Well
National Commissioning
Appendix 1: Review of Phase 1 – Gender-Affirming Primary Care (GAPC) Project
TeWhatuOra.govt.nz
Health NZ, PO Box 793,
Wellington 6140, New Zealand
Te Whatu Ora
APPENDIX 1
Health New Zealand
Improving Access to Gender-Affirming Primary Care - Review of Phase 1
Purpose
1 The purpose of this document is to provide an overview of the first phase of the Gender-Affirming Primary Care (GAPC) Project and share
key learnings from the review.
2 Budget 2022 allocated $2.182 million over four years to improving access to primary care for transgender (trans) and non-binary people.
The funding is allocated over three workstreams:
a.
Workstream A: funding up to eight primary and community health providers to deliver gender-affirming services over four years.
b.
Workstream B: updating national guidelines for gender-affirming health care and lead referral pathways for gender-affirming health
services and support.
c.
Workstream C: workforce development to improve workforce responsiveness to transgender patients.
3 For further contextual information on the background of the budget initiative, please see Background to GAPC project memo.
4 Phase 1 of the GAPC Project covers the establishment period, from the development of the budget bid to the contracting of services for
delivery. It also includes the establishment of the Gender-Affirming Primary Care Advisory Group (GAPCAG) to support the delivery of the
work programme and provide direction on key issues.
5 As a part of the continuous quality improvement process, a review has been undertaken to evaluate the work programme.
1982
6 The GAPCAG was consulted on the review of Phase 1 , and their feedback is integrated below. A separate review on the GAPCAG itself is
attached as Appendix 1 .
Act
Work programme
Work undertaken in Phase 1
Milestone
Status
Establish project documentation; project plan,
Complete
procurement plans to cover each workstream, RAID
register, gap register
Establish advisory group
Complete Information
Contract with a provider to update Guidelines for Gender
Complete
Affirming Care
Contract with 2 providers to deliver community driven
Complete
models of gender-affirming primary care (CDMC)
Contract with a provider to deliver workforce development
Complete
Contract with a provider to deliver evaluation of CDMC
Complete
Official
Project design
the
7 The design of the budget initiative was already fully formed by the time it reached the Primary Care team in July 2022. The Primary Care
team had no input into the design of the budget bid, which meant that phasing of implementation did not take into account timeframes for
recruitment, procurement and building relationships with key stakeholders. Recruitment for the project manager role was delayed due to
the reform as teams moved from what was then known as the Ministry of Health to Te Whatu Ora, which contributed to a slippage of
timelines originally posed in the budget. under
8 The restructure and change of staff further contributed to the slippage of timelines, as there was initially some ambiguity as to who would
be acting as Senior Responsible Officer (SRO) of the project and where documents should go for sign out. However, once an SRO was
appointed, the support and guidance of the two people who have had this role has proved invaluable.
9 There was consistent commentary from both internal and external stakeholders that the budget allocation for community driven models of
care was insufficient to address the unmet need for gender-affirming healthcare.
10 Pacific health colleagues noted that $25,000 available per year per provider is not sufficient and that further funding for meaningful
Realeased
engagement is required to move away from a tokenistic approach and enable services to be designed with community.
no ed thaffhe funding available is such a low value i was no possible to pufin
place a proJec hat met the aspirations of the first Request For Proposal (RFP) (including consultation and co-design) and add to service
delivery in a meaningful way. They also noted that 'it is distressing to see the low value that has been assigned to an area of health care
that is acknowledged to require significantly more support than is currently in place'.
Resourcing
12 Within Te Whatu Ora, the lack of institutional knowledge on issues faced by trans and non-binary populations, coupled with significant
levels of unmet need, meant there was a considerable body of work required beyond the delivery of the �ect. 9"(2T@T(ii
13 These requests, coupled with media and machinery of government requests, required more resourcing to support than was anticipated. As
there is a great deal of interest in this work from various communities and individuals, as well as circulation of misinformation and
link to page 4 link to page 4 link to page 4
1982
Act
Information
Official
the
under
Realeased
Monitoring of contract for updating guidelines for gender-
Ongoing
affirming care
Monitoring of first 2 contracts for CDMC
Ongoing
Monitoring of contract for workforce development
Ongoing
Monitoring of contract for CDMC evaluation
Ongoing
Ongoing – due to go live
from October/November, four
Phase 2 procurement for CDMC
contracts anticipated to be in
place April 2024
Maintenance of GAPCAG
Ongoing
29 Following this review, the following steps will be taken moving forward:
a.
exploration of options to enable an equity focussed approach to procurement, including prioritisation of Māori and/or Pacific providers.
Where different approaches have been implemented, information will be gathered on what has worked well.
b.
integration of equity for disabled people and options for working collaboratively with Whaikaha will be explored
c.
ensuring that Pacific and whaikaha perspectives drive decision making about services that will meet their needs
d.
consideration of how conflicts of interest can be managed to ensure the integrity of the procurement process, while having the right people
involved to address community needs
e.
exploring other options for platforms to schedule GAPCAG meetings that may be more accessible for members
f.
sharing information on the organisational structure and functions within Te Whatu Ora, Te Aka Whai Ora and Manatū Hauora when this
becomes available.
1982
Act
Information
Official
the
under
Realeased
3
1982
Act
Information
Official
the
under
Realeased
Document Outline
