On behalf of Debbie Brown, Acting General Counsel
Gloria,
Please find below response to your further Official Information Act request dated 10 July 2018:
From your response it seems that the Bay of Plenty DHB only provides services once care is approved via the high cost treatment pool - is this correct? I ask as the Ministry of Health website notes that patients must have been on hormone therapy for 12 months and must provide 3 reports from mental health professionals in order to qualify for funding through the high cost treatment pool. Does this mean that patients in the Bay of Plenty district must self-fund hormone therapy and mental health assessments?
Relative to other priorities, if the Endocrine Service has capacity to meet the referred demand (the patients are prioritised for access to the endocrine service) then the endocrine service would initiate treatment, or advise a primary care practitioner of the treatment protocol that is appropriate. In many DHBs the day to day management of the endocrine needs of the actively transitioning, or the stable transitioned person, are managed by trans-friendly General Practitioners.
Mental health assessments would be treated in the same way by the DHB (ie, if the service has capacity to meet the demand and within normal prioritisation decisions).
Regards,
Cherie Martin
Legal Executive
Governance & Quality / CEO Office
Bay of Plenty District Health Board
Private Bag 12024, Tauranga 3143
Ph: (07) 579 8545
From: Cherie
Martin
Sent: Tuesday, 10 July 2018 9:41 a.m.
To: '[FYI request #7890 email]'
Subject: DHB gender-affirming healthcare services
Hi Gloria,
Receipt of your email is acknowledged and a response will be made as soon as possible.
Kind regards,
Cherie Martin
Legal Executive
Governance & Quality / CEO Office
Bay of Plenty District Health Board
Private Bag 12024, Tauranga 3143
Ph: (07) 579 8545
From: Gloria Fraser [mailto:[FYI request #7890 email]]
Sent: Tuesday, 10 July 2018 4:21 a.m.
To: Cherie Martin
Subject: Re: DHB gender-affirming healthcare services
Kia ora Cherie,
Could you please clarify a few points for me:
From your response it seems that the Bay of Plenty DHB only provides services once care is approved via the high cost treatment pool - is this correct? I ask as the Ministry of Health website notes that patients must have been on hormone therapy for 12 months and must provide 3 reports from mental health professionals in order to qualify for funding through the high cost treatment pool. Does this mean that patients in the Bay of Plenty district must self-fund hormone therapy and mental health assessments?
Or, does the response mean that services may be provided on a case by case basis without high cost treatment pool approval? If so, could you please advise which services might be funded?
In regards to the question about real life experience being unclear, please see the Ministry of Health definition of real life experience: https://www.health.govt.nz/our-work/preventative-health-wellness/delivering-health-services-transgender-people/gender-reassignment-surgery
Ngā mihi,
Gloria Fraser
From: Cherie
Martin
Sent: Friday, 22 June 2018 1:09 p.m.
To: '[FYI request #7890 email]'
Subject: DHB gender-affirming healthcare services
On behalf of Debbie Brown, Acting General Counsel
Gloria,
Please find below response to your Official Information Act request dated 22 May 2018:
<![if !supportLists]>1. <![endif]>Could you please advise whether the following gender-affirming healthcare services are funded by the Bay of Plenty District Health Board for transgender patients, and whether the services are currently available:
- Hormone therapy
- Mastectomy
- Hysterectomy
- Orchidectomy
- Facial hair removal
- Breast augmentation
- Voice training
There is not set funding in place for these services however the DHB understands that in the event that a case for gender-affirming healthcare services is approved as per the high cost treatment pool that the DHB will have responsibilities to provide adjunct services in support of the approved services.
<![if !supportLists]>2. <![endif]>Could you please provide information about the process of accessing those services that are available?
Access would be via referral to specialist services
Specifically, is an assessment by a mental health professional required in order to access gender-affirming healthcare services? If so, which services?
Yes, an assessment is required by a mental health professional in order to access all gender affirming healthcare services
In the case of hormone therapy, can primary health providers prescribe hormones, or does this have to be initially approved by an endocrinologist?
Hormone therapy is initially approved by an endocrinologist.
Is any period of real life experience required to access surgery?
This question is unclear.
<![if !supportLists]>3. <![endif]>Finally, could you please advise what the process is if transgender patients require one of the above services, but the Bay of Plenty District Health Board does not offer this service? Does the Bay of Plenty District Health Board currently fund patients to travel to other areas to access this healthcare?
Patients eligible for services located out of district would be funded to travel according to National Transport and Accommodation (NTA) criteria.
Regards,
Cherie Martin
Legal Executive
Governance & Quality / CEO Office
Bay of Plenty District Health Board
Private Bag 12024, Tauranga 3143
Ph: (07) 579 8545
-----Original Message-----
From: Gloria Fraser [mailto:[FYI request #7890 email]]
Sent: Tuesday, 22 May 2018 8:11 p.m.
To: Communications
Subject: Official Information request - DHB gender-affirming healthcare services
Tēnā koutou,
I am writing to request information about the gender-affirming healthcare services provided by the Bay of Plenty District Health Board.
Could you please advise whether the following gender-affirming healthcare services are funded by the Bay of Plenty District Health Board for transgender patients, and whether the services are currently available:
- Hormone therapy
- Mastectomy
- Hysterectomy
- Orchidectomy
- Facial hair removal
- Breast augmentation
- Voice training
Could you please provide information about the process of accessing those services that are available?
- Specifically, is an assessment by a mental health professional required in order to access gender-affirming healthcare services? If so, which services?
- In the case of hormone therapy, can primary health providers prescribe hormones, or does this have to be initially approved by an endocrinologist?
- Is any period of real life experience required to access surgery?
Finally, could you please advise what the process is if transgender patients require one of the above services, but the Bay of Plenty District Health Board does not offer this service? Does the Bay of Plenty District Health Board currently fund patients to travel to other areas to access this healthcare?
If any part of my request is unclear, please don't hesitate to contact me.
If any of the information that I have requested is unavailable or would be difficult to retrieve, but similar information might be readily available, I would be happy to discuss altering or refining my request.
Ngā mihi,
Gloria Fraser
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