21 October 2025
Julie Armstrong
[FYI request #31371 email]
Tēnā koe Julie
Your request for official information, reference: HNZ00091592
Thank you for your email on 24 June 2025, asking Health New Zealand | Te Whatu Ora (Health
NZ) for the following under the Of icial Information Act 1982 (the OIA):
1. An explanation for why Health New Zealand’s funding of blood testing differs
between regions. This appears to result in a "postcode lottery" effect for patients
depending on their location.
2. The reason for charges being applied to standard Vitamin D (25-OH) tests in the
Waikato region, when ordered by a general practitioner. Is this standard practice,
and how does it compares to other regions?
3. A copy of any discussions, summaries, meeting minutes, policy documents, or
reports from the past 5 years that relate to decisions by any Technical Advisory
Group, Management Group, or other relevant body within Health New Zealand
regarding:
4. The funding for Vitamin D-25 OH blood tests; and
5. The criteria or requirements for GPs to request specific tests under public funding.
Please break down by region.
6. A description of the funding framework used by Health New Zealand for determining
eligibility and coverage for these blood tests ordered through general practice,
including any formal guidelines in place. Please supply the supporting evidence
provided to such groups.
7. The total public funding allocated for Vitamin D 25-OH blood tests in the most recent
full financial year, broken down by region.
Response
For clarity I wil answer each request in turn.
1. An explanation for why Health New Zealand’s funding of blood testing differs
between regions. This appears to result in a "postcode lottery" effect for patients
depending on their location.
Health NZ inherited from the previous 20 District Health Boards a set of contracts that have
significant variability in terms of the range of tests and who is eligible to order them. Additionally,
there are different funding approaches across the laboratory services.
Health NZ is working towards standardising these arrangements. The timeframe to standardise
the arrangements has not been set.
2. The reason for charges being applied to standard Vitamin D (25-OH) tests in the
Waikato region, when ordered by a general practitioner. Is this standard practice,
and how does it compare to other regions?
The agreement with the Waikato laboratory provider does not include Vitamin D testing. Requests
for Vitamin D tests are forwarded to the Waikato hospital laboratory if the referrer includes suitable
clinical information to confirm the testing is warranted. If there is insufficient clinical detail, the
patient has the option to pay for the test or go back to their General Practitioner (GP) and have the
clinical/diagnostic information added.
Vitamin D is an expensive test and should only be used in specific clinical situations such as high-
risk group for rickets/osteomalacia, cystic fibrosis, proven malabsorption, bariatric surgery,
refugees, deeply pigment skin, full veil wearers.
3. A copy of any discussions, summaries, meeting minutes, policy documents, or
reports from the past 5 years that relate to decisions by any Technical Advisory
Group, Management Group, or other relevant body within Health New Zealand
regarding:
a. The funding for Vitamin D-25 OH blood tests; and
b. The criteria or requirements for GPs to request specific tests under public
funding. Please break down by region.
Health NZ does not hold the information on decision by the previous District Health Boards and
there have been no Health NZ meetings on this topic. Your request for this information is refused
under section 18(e) of the OIA as this information does not exist.
4. A description of the funding framework used by Health New Zealand for determining
eligibility and coverage for these blood tests ordered through general practice,
including any formal guidelines in place. Please supply the supporting evidence
provided to such groups.
Health New Zealand uses a funding system that al ows certain people (called “Approved
Referrers,” like GPs) to request blood tests for patients who meet specific criteria (“Eligible
persons”). The contracts with laboratories also include clauses to help manage how often tests are
ordered, to avoid unnecessary testing. For example:
“(A) You wil put in place strategies to manage demand and limit unnecessary or inappropriate
laboratory testing. Your strategies wil include the following as appropriate in the circumstances:
•
working collaboratively with Approved Referrers and clinical governance groups and
facilitators to encourage evidence-based test requesting;”
The laboratory does this with local clinicians and does not necessarily directly involve Health NZ.
We note the potential for a patient to take too much Vitamin D is low if the recommended daily
doses are taken. Therefore, unless clinically indicated a Vitamin D test is not necessary.
5. The total public funding allocated for Vitamin D 25-OH blood tests in the most recent
full financial year, broken down by region.
The contracts do not fund on a fee per test basis. The contracts provide a set funding level per
annum for all testing. Therefore, it is not possible to provide the level of funding allocated to
Vitamin D 25-OH blood tests. This part of your request has been refused under section 18(g) of the
OIA as there is no requirement under the OIA for agencies to create new information or compile
information they do not hold.
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. Al requester data, including your name and
contact details, wil be removed prior to release.
Nāku iti noa, nā
Danielle Coe
Manager, Government Services
Health New Zealand I Te Whatu Ora
