Health Sector - Information Supporting the Estimates of Appropriations for the Government of New Zealand for the Year Ending 30 June 2010

Information Supporting the Estimates is organised on the basis of sectors, with each Vote and its administering department allocated to one sector (with a small number of exceptions). The Information Supporting the Estimates comprises of sector overview information, together with statements of responsibility; performance information for appropriations in Votes covered by the sector; and statements of forecast service performance and forecast financial statements of departments included in the sector. Statements of Intent of departments included in the sector form part of the supporting information.

Formats and related files

Chapters of the Economic Development and Infrastructure Sector volume of the Information Supporting the Estimates 2009/10 are available in Adobe PDF and HTML formats.

Using PDF Files

Cover, Contents#

Introduction#

Purpose of Information Supporting the Estimates
Votes and Departments in Each Sector
Purpose and Nature of Appropriations
Guide to Reading Information Supporting the Estimates
Terms and Definitions
Useful Links

Sector Overview#

Ministerial Statements of Responsibility
Chief Executive Statements of Responsibility

Performance Information for Appropriations in Each Vote#

Vote Health

Statement of Forecast Service Performance of Departments#

Forecast Financial Statements of Departments#

Statement of Common Accounting Policies
Ministry of Health

Statements of Intent of Departments (separately produced but forming part of this volume)#

Ministry of Health

Health and Disability Support Services - Lakes DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Lakes DHB.

Expenses#

Expenses - Health and Disability Support Services Lakes DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	234,294	234,294	245,689

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($7.271 million), demographics ($1.554 million) and funding to advance Government priorities ($2.382 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Lakes DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	8,825	8,825	8,825	8,825
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	2,382	2,382	2,382	2,382

Note - The past policy initiatives for all 21 appropriations for District Health Boards were reported in total in Auckland DHB's appropriation. However, as indicated in last year's Estimates, the current policy initiatives for each DHB would be separately reported in each DHB's appropriation.

Health and Disability Support Services - MidCentral DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from MidCentral DHB.

Expenses#

Expenses - Health and Disability Support Services MidCentral DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	373,103	373,103	399,608

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($11.573 million), demographics ($10.919 million) and funding to advance Government priorities ($3.800 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services MidCentral DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	22,492	22,492	22,492	22,492
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	3,800	3,800	3,800	3,800

Health and Disability Support Services - Nelson-Marlborough DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Nelson-Marlborough DHB.

Expenses#

Expenses - Health and Disability Support Services NelsonMarlborough DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	309,705	309,705	322,716

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($9.681 million), demographics ($31,000) and funding to advance Government priorities ($3.175 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services NelsonMarlborough DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	9,712	9,712	9,712	9,712
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	3,175	3,175	3,175	3,175

Health and Disability Support Services - Northland DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Northland DHB.

Expenses#

Expenses - Health and Disability Support Services Northland DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	389,731	389,731	417,725

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($12.191 million), demographics ($11.010 million) and funding to advance Government priorities ($3.990 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Northland DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	23,201	23,201	23,201	23,201
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	3,990	3,990	3,990	3,990

Health and Disability Support Services - Otago DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Otago DHB.

Expenses#

Expenses - Health and Disability Support Services Otago DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	418,864	418,864	436,500

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($13.002 million), demographics ($109,000) and funding to advance Government priorities ($4.248 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Otago DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	13,111	13,111	13,111	13,111
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	4,248	4,248	4,248	4,248

Health and Disability Support Services - South Canterbury DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from South Canterbury DHB.

Expenses#

Expenses - Health and Disability Support Services South Canterbury DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	137,842	137,842	143,662

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($4.283 million), demographics ($2,000) and funding to advance Government priorities ($1.406 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services South Canterbury DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	4,285	4,285	4,285	4,285
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	1,406	1,406	1,406	1,406

Health and Disability Support Services - Southland DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Southland DHB.

Expenses#

Expenses - Health and Disability Support Services Southland DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	234,756	234,756	244,770

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($7.358 million), demographics ($9,000) and funding to advance Government priorities ($2.415 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Southland DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	7,367	7,367	7,367	7,367
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	2,415	2,415	2,415	2,415

Health and Disability Support Services - Tairawhiti DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Tairawhiti DHB.

Expenses#

Expenses - Health and Disability Support Services Tairawhiti DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	115,426	115,426	123,786

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($3.614 million), demographics ($3.403 million) and funding to advance Government priorities ($1.186 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Tairawhiti DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	7,017	7,017	7,017	7,017
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	1,186	1,186	1,186	1,186

Health and Disability Support Services - Taranaki DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Taranaki DHB.

Expenses#

Expenses - Health and Disability Support Services Taranaki DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	257,887	257,887	268,645

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($7.952 million), demographics ($21,000) and funding to advance Government priorities ($2.598 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Taranaki DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	7,973	7,973	7,973	7,973
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	2,598	2,598	2,598	2,598

Health and Disability Support Services - Waikato DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Waikato DHB.

Expenses#

Expenses - Health and Disability Support Services Waikato DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	781,745	779,745	841,504

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($24.487 million), demographics ($22.944 million) and funding to advance Government priorities ($7.994 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Waikato DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	47,431	47,431	47,431	47,431
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	7,994	7,994	7,994	7,994

Health and Disability Support Services - Wairarapa DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Wairarapa DHB.

Expenses#

Expenses - Health and Disability Support Services Wairarapa DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	99,926	99,926	104,172

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($3.138 million), demographics ($4,000) and funding to advance Government priorities ($1.026 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Wairarapa DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	3,142	3,142	3,142	3,142
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	1,026	1,026	1,026	1,026

Health and Disability Support Services - Waitemata DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Waitemata DHB.

Expenses#

Expenses - Health and Disability Support Services Waitemata DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	1,013,278	1,013,278	1,065,771

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($31.856 million), demographics ($9.708 million) and funding to advance Government priorities ($10.362 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Waitemata DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	41,564	41,564	41,564	41,564
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	10,362	10,362	10,362	10,362

Health and Disability Support Services - West Coast DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from West Coast DHB.

Expenses#

Expenses - Health and Disability Support Services West Coast DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	101,740	101,740	106,112

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($3.188 million), demographics ($7,000) and funding to advance Government priorities ($1.045 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services West Coast DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	3,195	3,195	3,195	3,195
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	1,045	1,045	1,045	1,045

Health and Disability Support Services - Whanganui DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Whanganui DHB.

Expenses#

Expenses - Health and Disability Support Services Whanganui DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	172,777	172,777	181,245

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($5.361 million), demographics ($1.231 million) and funding to advance Government priorities ($1.745 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Whanganui DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	6,592	6,592	6,592	6,592
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	1,745	1,745	1,745	1,745

Health Services Funding (M36)#

Scope of Appropriation#

Funding to respond to emerging health sector risks, provision for DHB structural deficit support, and contingency funding for Government priority health policy initiatives.

Expenses#

Expenses - Health Services Funding (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	174,869	147,869	239,738

Reasons for Change in Appropriation#

The nearly $65 million increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below), the transfer of Primary Health Care Policy Strategy funding to a new appropriation (refer Part 1.4 "Reconciliation of Changes in Appropriation Structure") and the transfer of costs and the transfer out of funding to other appropriations following the completion of policy development and implementation planning.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Health Services Funding (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Manage sector risks within Vote Health	Achieved	Achieved	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health Services Funding (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Ambulance Services	2009/10	-	(2,000)	(2,000)	(2,000)	(2,000)
Sector Risk Management	2008/09	(27,023)	(51,226)	(47,181)	(36,375)	(18,437)
Line-by-Line Review Savings	2008/09	(16,564)	(5,959)	(3,584)	(3,534)	(3,534)
Voluntary Bonding Scheme	2011/12	-	-	-	6,728	8,526
Training 800 Health Professionals to Support New Elective Surgery Theatres	2009/10	-	10,000	20,000	20,000	20,000
GP/Lead Maternity Carer Optional Visit	2009/10	-	1,408	2,816	2,816	2,816
Forecast Funding Track (FFT) and Demographics - Ministry of Health	2009/10	-	85,841	83,841	83,841	83,841
Encouraging more training in rural and provincial areas	2009/10	-	500	1,500	1,000	1,000
DHB Deficit Support	2009/10	-	53,332	38,332	23,332	8,332
Forecast Funding Track (FFT) and Demographics	2008/09	10,192	10,192	10,192	10,192	10,192
Sector risk management	2008/09	18,198	16,116	27,252	520	520
Improving patient safety using bedside verification of drugs in DHB hospitals	2008/09	2,300	3,200	3,200	3,200	3,200
Primary Health Care Strategy Implementation	2008/09	19,490	19,490	19,490	19,490	19,490
Reorientation of Child and Adolescent Oral Health Services	2008/09	14,000	15,000	20,000	30,000	30,000
Healthy Housing Programme	2008/09	15,000	15,000	-	-	-
Support for Health Sector to build capability and innovate	2008/09	7,000	7,000	7,000	7,000	7,000
Enhancing Surveillance and Control of Anti-microbial Resistance	2008/09	1,000	1,000	1,000	1,000	1,000
Forecast Funding Track (FFT)	2007/08	4,851	4,851	4,851	4,851	4,851
Demographics	2007/08	2,687	2,687	2,687	2,687	2,687
Improve Patient Safety Using Bedside Verification of Drugs in DHB Hospitals	2007/08	3,500	3,500	2,100	1,100	1,000
Transitional Funding For Primary Healthcare Initiatives	2007/08	2,900	2,900	-	-	-
EnergyWise Home Grants Scheme	2007/08	1,800	1,800	1,800	-	-
Sector Risk Management	2007/08	81,000	81,000	81,000	81,000	81,000
Other Initiatives and Risk Management	2005/06	202,936	203,047	209,929	209,929	209,929
Holidays Act	2004/05	7,900	7,900	7,900	7,900	7,900
Other Initiatives and Risk Management	2004/05	7,100	14,211	14,211	14,211	14,211
Disability Support Services and Health of Older People	2005/06	33,745	33,745	33,745	33,745	33,745
Cataracts	2005/06	8,711	6,756	6,756	6,756	6,756
Mental Health Blueprint	2008/09	-	22,222	22,222	22,222	22,222
Orthopaedics	2005/06	26,667	26,667	26,667	26,667	26,667
Primary Health Care Strategy	2005/06	63,111	71,111	71,111	71,111	71,111
Additional Forecast Funding Track	2005/06	736	736	736	736	736
Additional Funding for Demographic Changes	2005/06	92	92	92	92	92
Demographics	2004/05	4,000	4,000	4,000	4,000	4,000
Rollout of the Health Funding Package	2006/07	488,889	488,889	488,889	488,889	488,889
Health Funding Package	2005/06	475,556	475,556	475,556	475,556	475,556
Demographic change - to fund health services for changes in population numbers, age mix, ethnicity and deprivation	2003/04	4,057	4,057	4,057	4,057	4,057

These policy initiatives have been shown against their original appropriation, or the current equivalent. Subsequent changes may have been made to some of these initiatives by way of fiscally neutral transfers to other appropriations, devolution of funding to DHBs or rephasing of the expenditure through expense transfers.

Management of Residual Health Liabilities and District Health Board Term Debt (M36)#

Scope of Appropriation#

Funding for Crown Health Financing Agency (CHFA) to provide and manage the Crown term debt facilities for DHBs, provide independent advice to the Minister on the credit worthiness and financial sustainability of DHBs, and to manage residual area health board liabilities.

Expenses#

Expenses - Management of Residual Health Liabilities and District Health Board Term Debt (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	1,751	1,751	1,700

Reasons for Change in Appropriation#

The decrease in this appropriation arises from a fiscally neutral transfer to another appropriation.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Management of Residual Health Liabilities and District Health Board Term Debt (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
The quantity, quality and nature of the services provided as agreed between the Minister and the CHFA, and within the timeframes specified:	100%	100%	Revised standards shown below
providing and managing Crown term loan facilities for DHBs, including refinancing of maturing private bank debt and new loan facilities for major capital works	N/A		100%
managing residual area heath board liabilities, including contingent liabilities arising in relation to the acts or omissions of an Area Health Board prior to 1 July 1993, patient trust funds, and residual property leases	N/A		100%
to provide independent advice to the Minister on the credit worthiness and financial sustainability of DHBs	N/A		100%
Quarterly reports provided to the Minister of Health, summarising delivery of services against specifications in its agreement with the Minister, identifying any significant variations, any corrective actions required to be taken, and any potential risks to delivery according to the agreed quality, quantity and price	100%	100%	Four
The Statement of Intent and Annual Report of the CHFA tabled in Parliament in accordance with the Crown Entities Act 2004	Achieved	Achieved	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Management of Residual Health Liabilities and District Health Board Term Debt (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2008/09	77	77	77	77	77
Forecast Funding Track (FFT)	2007/08	52	52	52	52	52
Demographics	2007/08	29	29	29	29	29
Additional Forecast Funding Track	2005/06	16	16	16	16	16
Additional Funding for Demographic Changes	2005/06	2	2	2	2	2

Meningococcal Vaccine Programme (M36)#

Scope of Appropriation#

Funding for the purchase and delivery of a vaccine against the epidemic strain of group B meningococcal disease to target population groups.

Expenses#

Expenses - Meningococcal Vaccine Programme (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	2,132	2,132	1,800

Reasons for Change in Appropriation#

The decrease in this appropriation arises from fiscally neutral expense transfers between the years.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Meningococcal Vaccine Programme (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Number of doses used of MeNZB held in stock	N/A	Under Development	40,000
Analysis of MeNZB effectiveness and safety undertaken and reported on using statistical modelling and monitoring of patient safety	N/A	Under Development	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Meningococcal Vaccine Programme (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Meningococcal Vaccine Ongoing Delivery	2006/07	6,765	6,632	-	-	-

Monitoring and Protecting Health and Disability Consumer Interests (M36)#

Scope of Appropriation#

Provision of services to monitor and protect health consumer interests by the Health and Disability Commissioner, District Mental Health Inspectors and Review Tribunals, and the Mental Health Commission.

Expenses#

Expenses - Monitoring and Protecting Health and Disability Consumer Interests (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	14,659	14,659	14,484

Reasons for Change in Appropriation#

The decrease in this appropriation arises from fiscally neutral transfers to other appropriations.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Monitoring and Protecting Health and Disability Consumer Interests (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Health and Disability Commissioner
The performance measures are those contained in the Crown entity's 2009/10 Statement of Intent
Mental Health Commission
The performance measures are those contained in the Crown entity's 2009/10 Statement of Intent
Mental Health reviews and inquiries
34 District Inspectors provide monthly reports to the Director of Mental Health on their duties undertaken in accordance with the Mental Health (Compulsory Assessment and Treatment Act 1992)	100%	90%	100%
The Mental Health Review Tribunal will report annually to the Director of Mental Health on their duties in accordance with the reporting requirements of the Tribunal's contract with the Ministry	100%	100%	1 report
As and when required, inquiries into the mental health care and treatment of patients will be completed and reported within the agreed timeframes	Achieved	Achieved	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Monitoring and Protecting Health and Disability Consumer Interests (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2008/09	633	633	633	633	633
Health and Disability Commissioner advocacy services	2008/09	275	550	550	550	550
Forecast Funding Track (FFT)	2007/08	400	400	400	400	400
Demographics	2007/08	220	220	220	220	220
Health and Disability Commissioner - Expand Advocacy services	2007/08	550	550	550	550	550
Additional Forecast Funding Track	2005/06	117	117	117	117	117
Additional Funding for Demographic Changes	2005/06	14	14	14	14	14

National Advisory and Support Services (M36)#

Scope of Appropriation#

Provision of advisory and support services by independent service providers.

Expenses#

Expenses - National Advisory and Support Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	340	340	340

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Advisory and Support Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Monthly reports on the delivery of services provided to the Ministry of Health in accordance with the service specifications of their contract.	100%	100%	4 reports received on time

National Child Health Services (M36)#

Scope of Appropriation#

For the funding and purchase of child health services directly by the Crown.

Expenses#

Expenses - National Child Health Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	55,443	54,443	58,994

Reasons for Change in Appropriation#

The almost $3.500 million decrease in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below).

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Child Health Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Well Child/Tamariki Ora Framework
Well Child/Tamariki Ora Framework services are delivered including seven core Well Child contacts for every enrolled child, and specified additional contacts for first time and high needs parents: services are delivered according to criteria specified in Ministry/Provider agreements quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved
Information and advisory services to support the Well Child/Tamariki Ora Framework are delivered: services are delivered according to criteria specified in Ministry/Provider agreements quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved
B4 Schools Check
DHBs will provide four year olds with B4 School Checks, which is the 8th and final Well Child check and will provide the volumes of checks as specified in funding arrangements	N/A	Under Development	100%
Aim Hi
Continue to fund school-based health services to schools with high need youth in Counties Manukau. School health services are provided to nine Counties Manukau schools, providing access to approximately 9,300 students	Revised measure	100% for 2008/09 measure	100%
Youth Access to Health Services
Establish school-based health services in decile 2 secondary schools, providing access to 12,700 students	N/A	Under Development	24
The number of decile 2 composite and kura kaupapa schools, providing access to 900 senior students.	N/A	Under Development	14

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Child Health Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(500)	-	-	-	-
Plunket Well Child	2008/09	1,927	1,927	1,927	1,927	1,927
PlunketLine	2008/09	1,750	3,500	3,500	3,500	3,500
B4 School Checks	2008/09	9,900	9,410	9,410	9,410	9,410
Forecast Funding Track (FFT) and Demographics	2008/09	1,700	1,700	1,700	1,700	1,700
AIMHI Healthy Community Schools - Nurse Component	2008/09	560	1,130	1,130	1,130	1,130
Youth Access to Health Services	2008/09	1,836	3,812	5,583	5,583	5,583
Forecast Funding Track (FFT)	2007/08	1,111	1,111	1,111	1,111	1,111
Demographics	2007/08	609	609	609	609	609
Plunket Well Child Contacts (Telephone Delivery)	2007/08	1,500	1,500	1,500	1,500	1,500
AIMHI Health Community Schools - Nurse Component and Project Evaluation	2007/08	1,010	1,010	1,010	1,010	1,010

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

National Contracted Services - Other (M36)#

Scope of Appropriation#

For the funding and purchase of other health services including mobile surgical services, telephone advice services, sexual and reproductive health services, and services associated with the implementation of the Oral Health and Cancer Control Strategies.

Expenses#

Expenses - National Contracted Services Other (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	123,302	118,402	172,018

Reasons for Change in Appropriation#

The almost $49 million increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below), devolution of funding to DHBs, fiscally neutral transfers to other appropriations and rephasing of the expenditure through expense transfers.

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Contracted Services Other (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
PHARMAC
The quantity, quality and nature of the services provided as agreed between the Minister and PHARMAC, and within the timeframes specified	N/A	Under Development	100%
Quarterly reports provided to the Minister of Health, summarising delivery of services against specifications in its agreement with the Minister, identifying any significant variations, any corrective actions required to be taken, and any potential risks to delivery according to the agreed quality, quantity and price	N/A	Under Development	Four reports
The Statement of Intent and Annual Report of the PHARMAC tabled in Parliament in accordance with the Crown Entities Act 2004	N/A	Under Development	Achieved
Health Research Council
The quantity, quality and nature of the services provided as agreed between the Minister and the Health Research Council, and within the timeframes specified	N/A	Under Development	100%
Quarterly reports provided to the Minister of Health, summarising delivery of services against specifications in its agreement with the Minister, identifying any significant variations, any corrective actions required to be taken, and any potential risks to delivery according to the agreed quality, quantity and price	N/A	Under Development	Four reports
The Statement of Intent and Annual Report of the Health Research Council tabled in Parliament in accordance with the Crown Entities Act 2004	N/A	Under Development	Achieved
Nationally Purchased Personal Health
National services which currently include: telephone triage and health advice services, sexual and reproductive health services, mobile surgical services, services associated with the implementation of the Oral Health and Cancer Control Strategies, and hospital chaplaincy services; are delivered: Services are delivered according to criteria specified in Ministry/Provider agreements Quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved
Improving performance in oral health by increasing oral health service utilisation for children and adolescents	N/A	Under Development	10% enrolment increase over three years
Reducing cancer waiting times: percentage of patients waiting less than 6 weeks between specialist assessment and the start of radiation oncology treatment (excluding category D)	N/A	Under Development	100%
National Implementation of InterRAI assessment tool Implementation of the InterRAI Home Care and Contact Assessments tools by nine DHBs for assessing the needs of older people to access long term support services in the community or residential care	N/A	Under Development	100%
National Mortality Review Establishment of local DHB led multi-sector groups The review of preventable child and youth deaths by local multi-sector groups, resulting in multi-sector quality improvement action to prevent further deaths	Achieved	Achieved	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Contracted Services Other (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(12,650)	(5,746)	(5,746)	(5,746)	(5,746)
Boosting Hospice Care	2009/10	-	15,000	15,000	15,000	15,000
Boost Funding for Subsidised Medicines	2009/10	-	8,900	11,200	13,000	13,800
Innovations	2008/09	4,500	7,000	7,000	7,000	7,000
Hepatitis C	2008/09	4,000	4,000	4,000	4,000	4,000
Child/Adolescent Oral Health	2008/09	6,598	14,153	18,087	19,568	19,569
Bedside Verification of Drugs	2008/09	5,800	5,300	4,300	4,200	4,200
Child/Adolescent Health	2008/09	335	801	1,104	827	827
Forecast Funding Track (FFT) and Demographics	2008/09	5,958	5,958	5,958	5,958	5,958
Interim Funding Pool for People with Chronic Health Conditions	2008/09	6,550	6,550	10,000	10,000	10,000
Financial incentives for DHBs to realise efficiencies & progress Health Targets	2008/09	43,065	43,065	43,065	43,065	43,065
National Implementation of InterRAI assessment tool	2008/09	1,509	1,509	3,000	4,000	4,000
Service Planning and New Health Intervention Assessment Framework (SPNIA)	2008/09	1,340	1,340	1,460	1,580	1,580
Cancer Control Strategy	2008/09	3,630	3,630	3,630	3,630	3,630
Quality Improvement Control Projects	2007/08	3,009	2,019	2,019	2,019	2,019
Oral Health Business Case Development	2007/08	702	683	634	634	634
Safe Staffing Support Unit	2007/08	400	400	400	400	400
Extreme Complex Burns	2007/08	3,400	3,400	3,400	3,400	3,400
Forecast Funding Track (FFT)	2007/08	1,826	1,826	1,826	1,826	1,826
Demographics	2007/08	1,002	1,002	1,002	1,002	1,002
Aged Residential Care	2007/08	37,500	37,500	37,500	37,500	37,500
Pharmaceuticals Budget	2007/08	20,000	20,000	20,000	20,000	20,000
Improve Terms and Conditions For Low-Paid DHB Workforce	2007/08	10,000	10,000	10,000	10,000	10,000
Cancer Control Action Plan	2007/08	6,500	6,500	6,500	6,500	6,500
Extend "Get Checked" Programme to Include Cardiovascular Disease	2007/08	3,300	3,300	3,300	3,300	3,300
Breast Screening Age Extension	2006/07	7,300	7,300	7,300	7,300	7,300
Additional Demographic Funding	2006/07	4,336	4,336	4,336	4,336	4,336
Additional Forecast Funding Track Funding	2006/07	54,882	54,882	54,882	54,882	54,882
Additional Forecast Funding Track	2005/06	4,427	4,427	4,427	4,427	4,427
Additional Funding for Demographic Changes	2005/06	545	545	545	545	545
Removal of Asset Testing	2005/06	12,444	12,444	12,444	12,444	12,444
Family Income Assistance	2004/05	1,244	1,244	1,244	1,244	1,244
ACC Primary Referred Pharmaceuticals and Laboratory Costs	2003/04	9,156	9,156	9,156	9,156	9,156
Removal of Asset Testing	2005/06	106,133	106,133	106,133	106,133	106,133
Demographic change - to fund health services for changes in population numbers, age mix, ethnicity and deprivation	2004/05	2,082	2,082	2,082	2,082	2,082

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

National Disability Support Services (M36)#

Scope of Appropriation#

Delivery of disability support services provided through DHBs and third-party service providers.

Expenses#

Expenses - National Disability Support Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	889,671	889,671	895,386

Reasons for Change in Appropriation#

The increase of almost $6 million in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below), devolution of funding to DHBs and rephasing of the expenditure through expense transfers.

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Disability Support Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Accessible, understandable and reliable information about disability support services is available to people: disability information and advice services are delivered according to criteria specified in Ministry/Provider agreements fact sheets on funded disability support services are available through the Ministry of Health website	N/A	Under Development	Achieved
Needs assessment and service co-ordination services are delivered: services are delivered according to criteria specified in Ministry/Provider agreements quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved
Disability Support Services are available: services are delivered according to criteria specified in agreements quality of services are measured and improved through the programme of evaluation	N/A	Under Development	Achieved
Compulsory care and rehabilitation services are provided for people who are subject to the Intellectual Disability (Compulsory Care and Rehabilitation Act (IDCC&R Act)) Monitoring by District Inspectors of services delivered to care recipients is ongoing, and providers report, and are audited, on their compliance with relevant quality and safety standards, and the IDCC&R Act	N/A	Under Development	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Disability Support Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Intellectual Disability (Compulsory Care and Rehabilitation)	2009/10	-	7,800	9,800	9,800	9,800
Huntington's Disease	2008/09	225	1,200	1,200	1,200	1,200
Doubtless Bay	2008/09	583	583	583	583	583
Wage Rates	2008/09	6,170	6,170	6,170	6,170	6,170
Respite Care	2008/09	1,500	3,000	3,000	3,000	3,000
Workforce Development	2008/09	1,000	2,000	3,000	3,000	3,000
Forecast Funding Track (FFT) and Demographics	2008/09	38,199	38,199	38,199	38,199	38,199
Autism Spectrum Disorder work programme	2008/09	2,500	2,500	2,500	2,500	2,500
Environmental Disability Support Services (ESS)	2008/09	-	990	1,500	1,500	1,500
Enhanced access to hearing aids for Super Gold Card holders	2008/09	4,500	4,500	4,500	4,500	4,500
Forecast Funding Track (FFT)	2007/08	23,338	23,338	23,338	23,338	23,338
Demographics	2007/08	12,809	12,809	12,809	12,809	12,809
Home-Based Support Services for People Aged Over 65 and Implementation of InterRAI (residential Assessment) Tool	2007/08	20,300	20,300	20,300	20,300	20,300
Environmental Support Services	2007/08	14,000	11,000	11,000	11,000	11,000
Residential Services For Disabled People Aged Under 65	2007/08	11,000	11,000	11,000	11,000	11,000
Home-Based Disability Support Services for People Under 65	2007/08	8,000	8,000	8,000	8,000	8,000
Intellectual Disability (Compulsory Care and Rehabilitation) and High and Complex Needs	2007/08	3,000	3,000	3,000	3,000	3,000
Autism Spectrum Disorder Work Programme	2007/08	2,500	2,500	2,500	2,500	2,500
Cochlear Implant Services For Adults and Newborns	2007/08	2,250	2,850	1,800	1,300	1,300
Provide Support For Family Caregivers	2007/08	1,500	1,500	1,500	1,500	1,500
Setting NZ Superannuation and Veterans Pension Rates	2006/07	1,500	1,500	1,500	1,500	1,500
Kimberley Deinstitutionalisation	2005/06	3,132	3,132	3,132	3,132	3,132
Additional Forecast Funding Track	2005/06	5,905	5,905	5,905	5,905	5,905
Additional Funding for Demographic Changes	2005/06	734	734	734	734	734
Demographic change - to fund health services for changes in population numbers, age mix, ethnicity and deprivation	2004/05	9,431	9,431	9,431	9,431	9,431

National Elective Services (M36)#

Scope of Appropriation#

Funding for the purchase of additional elective surgery services.

Expenses#

Expenses - National Elective Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	195,198	185,198	189,898

Reasons for Change in Appropriation#

The just over $5 million decrease in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below).

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Elective Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Services provided in accordance with funding agreements agreed with the Minister	100%	100%	Achieved for each DHB
The quantity, quality and nature of the services provided, as agreed in individual DHB plans, are documented and timeframes specified in these funding agreements	100%	100%	Achieved for each DHB
Reports on the delivery of services provided to the Ministry of Health by the providers in accordance with the provisions of their organisations' funding agreements	100%	100%	Achieved for each DHB
DHBs maintain compliance in all Elective Services Patient Flow Indicators (ESPIs)	100%	100%	Achieved for each DHB
DHB will set an agreed increase in the number of elective service discharges and will provide the level of service agreed	100%	100%	Achieved for each DHB

OR: The performance measures are those contained in the 21 District Health Board 2009/10 Statements of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Elective Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Cardiac Services	2008/09	5,000	10,000	15,000	20,000	20,000
Forecast Funding Track (FFT) and Demographics	2008/09	6,244	6,244	6,244	6,244	6,244
Electives Initiative - additional volumes	2008/09	50,000	40,000	35,000	35,000	35,000
Forecast Funding Track (FFT)	2007/08	4,104	4,104	4,104	4,104	4,104
Demographics	2007/08	2,252	2,252	2,252	2,252	2,252
Additional Elective Surgical Volumes	2007/08	59,000	59,000	59,000	59,000	59,000
Orthopaedics	2004/05	35,111	35,111	35,111	35,111	35,111

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

National Emergency Services (M36)#

Scope of Appropriation#

For the funding and purchase of health emergency services directly by the Crown.

Expenses#

Expenses - National Emergency Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	69,358	69,358	81,194

Reasons for Change in Appropriation#

The increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below).

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Emergency Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Emergency calls are triaged and services dispatched effectively and efficiently Monitoring and evaluation of: Call response times Error rates in dispatch protocol System testing for redundancy and disaster preparedness	N/A	Under Development	Achieved
Ambulance services are provided in a safe and consistent way Monitoring and evaluation of: Ambulance response times National Clinical Advisory Group standard setting and monitoring Ambulance sector engagement with health and emergency services sectors Accidents and health and safety trends Consumer feedback Complaints, both individual cases and trends	N/A	Under Development	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Emergency Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Ambulance Services	2008/09	(7,000)	2,000	2,000	2,000	2,000
Ambulance Services	2009/10	-	10,000	10,000	10,000	10,000
Forecast Funding Track (FFT) and Demographics	2008/09	2,736	2,736	2,736	2,736	2,736
Stabilisation of the ambulance sector	2008/09	6,900	6,900	6,900	6,900	6,900
Forecast Funding Track (FFT)	2007/08	1,924	1,924	1,924	1,924	1,924
Demographics	2007/08	1,056	1,056	1,056	1,056	1,056
Suicide Guidelines for Accident and Emergency Departments	2004/05	204	204	204	204	204

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

These policy initiatives have been shown against their original appropriation, or the current equivalent. Subsequent changes have been made to some of these initiatives by way of fiscally neutral transfers to other appropriations, devolution of funding to DHBs or rephasing of the expenditure through expense transfers.

National Maori Health Services (M36)#

Scope of Appropriation#

For the funding and purchase of Maori health services directly by the Crown.

Expenses#

Expenses - National Maori Health Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	8,562	8,562	8,562

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Maori Health Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
All National Maori Health Service contracts delivered	N/A	Under Development	100%
All National Maori Service contracts provided in accordance with Ministry of Health policies and business processes	N/A	Under Development	100%

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Maori Health Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2008/09	426	426	426	426	426
Forecast Funding Track (FFT)	2007/08	267	267	267	267	267
Demographics	2007/08	147	147	147	147	147

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

National Maternity Services (M36)#

Scope of Appropriation#

For the funding and purchase of maternity services directly by the Crown.

Expenses#

Expenses - National Maternity Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	137,333	133,333	137,483

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Maternity Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Lead maternity carers deliver quality maternity services in compliance with the Section 88 Primary Maternity Services Notice 2007: monitoring of service volumes and compliance with Section 88 Primary Maternity Services Notice monitoring of compliance with Ministry/Provider service agreements	N/A	Under Development	Achieved
Recruitment and retention services for rural midwifery: services are delivered according to criteria specified in Ministry/Provider agreements quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved
Professional development and advice and information: services are delivered according to criteria specified in Ministry/Provider agreements quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Maternity Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
National Maternity Services	2008/09	10,000	10,000	10,000	10,000	10,000
Primary Maternity Care Services	2008/09	17,000	17,000	17,000	17,000	17,000
Primary Maternal Fetal Medicine Centre	2008/09	250	400	400	400	400
Maternity Action Plan	2008/09	795	-	-	-	-
Forecast Funding Track (FFT) and Demographics	2008/09	4,759	4,759	4,759	4,759	4,759
Forecast Funding Track (FFT)	2007/08	3,081	3,081	3,081	3,081	3,081
Demographics	2007/08	1,691	1,691	1,691	1,691	1,691
Rural Support For Primary Maternity Care	2007/08	2,000	2,000	2,000	2,000	2,000

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

These new initiatives have been shown against their original appropriation, or the current equivalent. Subsequent changes have been made to some of these initiatives by way of Fiscally Neutral Transfers to other appropriations, devolvement to DHBs or rephasing of the expenditure through expense transfers.

National Mental Health Services (M36)#

Scope of Appropriation#

For the funding and purchase of mental health services directly by the Crown.

Expenses#

Expenses - National Mental Health Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	55,445	54,045	69,268

Reasons for Change in Appropriation#

The increase of nearly $14 million in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below), devolution of funding to DHBs and rephasing of the expenditure through expense transfers.

Output Performance Measures and Standards#

Output Performance Measures and Standards - National Mental Health Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Mental Health and Addiction Services The number of Mental Health and Addiction Workforce Centres that have developed and delivered work programmes that align directly with Ministry annual directives and strategic priorities	100%	100%	4
The number of District Health Boards would have been trained in key priority workforce areas	100%	100%	21

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - National Mental Health Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(4,200)	(4,200)	(4,200)	(4,200)	(4,200)
Mental Health Blueprint Implementation	2009/10	-	20,000	20,000	20,000	20,000
Effective Interventions	2008/09	7,921	7,941	-	-	-
Mental Health Blueprint Implementation	2008/09	22,222	22,222	22,222	22,222	22,222
Forecast Funding Track (FFT) and Demographics	2008/09	3,612	3,612	3,612	3,612	3,612
Suicide prevention and National Depression Awareness Initiative	2008/09	2,225	2,825	3,025	3,025	3,025
Forecast Funding Track (FFT)	2007/08	1,554	1,554	1,554	1,554	1,554
Demographics	2007/08	853	853	853	853	853
Strengthen Primary Mental Healthcare Response to Mental Illness and Addiction	2007/08	5,100	7,600	4,400	3,900	3,900
Suicide Prevention and National Depression Awareness	2007/08	4,270	4,270	5,590	1,950	1,950
Alcohol and Drug Treatment Services Directory	2005/06	16	16	16	16	16
Central Region - Alcohol and Other Drugs Youth Residential Treatment	2004/05	949	949	949	949	949
Mental Health Blueprint Implementation	2004/05	88,889	88,889	88,889	88,889	88,889
Drug and alcohol services (Christchurch)	2003/04	551	551	551	551	551

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

Mental Health Blueprint Implementation - Annual increases in funding of $22 million per annum beyond 2007/08 in order to make $289 million available in 2016/17 was approved in Budget 2004.

Primary Health Care Strategy (M36)#

Scope of Appropriation#

This appropriation is limited to services to implement and deliver the Primary Health Care Strategy.

Expenses#

Expenses - Primary Health Care Strategy (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	-	-	154,535

Reasons for Change in Appropriation#

Primary Health Care Strategy funding has been transfered from the Health Services Funding appropriation to this new appropriation to better report this strategy. Details of the funding changes are contained in Part 1.4 "Reconciliations of Changes in Appropriation Structure".

Output Performance Measures and Standards#

Output Performance Measures and Standards - Primary Health Care Strategy (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Maintain current access to affordable primary health care services
percentage of children who received free access to Under 6 services	N/A	N/A	80%
percentage of adults who receive access to Very Low Cost Access services	N/A	N/A	30%
The percentage of indicators in the PHO Performance Programme that are achieved by PHOs nationally to improved health outcomes for New Zealanders	N/A	N/A	70%
Reducing amulatory sensitive (avoidable) admissions expressed as a percentage of hospital based activities	N/A	N/A	5% reduction over a three year period
Increase in the percentage of people with diagnosed diabetes who are:
accessing free annual checks	N/A	N/A	55%
on satisfactory or better diabetes management	N/A	N/A	75%
Reducing cardiovascular disease:
the proportion of priority groups having had an absolute CVD risk assessment in the last five years	N/A	N/A	73%

Problem Gambling Services (M36)#

Scope of Appropriation#

Funding to support the research and implementation of strategies to prevent and minimise the harm from gambling, and for the provision of treatment services to problem gamblers and assistance to their families and whanau in accordance with the Gambling Act 2003.

Expenses#

Expenses - Problem Gambling Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	17,719	16,019	17,510

Reasons for Change in Appropriation#

This decrease reflects the expected expenditure profile on problem gambling services during the three-year programme (2007/08 to 2009/10) on which the present problem gambling levy has been assessed.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Problem Gambling Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Services provided within appropriation in accordance with funding arrangements agreed with the Minister	100%	100%	100% of contracts
Services will be provided nationwide. Service will be delivered through both population approaches, and interventions to individuals and their significant others affected by gambling harm	N/A	Under Development	Achieved

Memorandum Account#

Memorandum Account - Problem Gambling Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Opening Balance at 1 July	2,343	2,343	4,043
Revenue	17,719	17,719	17,510
Expenses	17,719	16,019	17,510
Transfers and Adjustments	-	-	-
Closing Balance at 30 June	2,343	4,043	4,043

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Problem Gambling Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Problem Gambling Levy	2007/08	6,762	7,192	6,983	-	-
Problem Gambling Levy	2004/05	10,527	10,527	10,527	10,527	10,527

Public Health Service Purchasing (M36)#

Scope of Appropriation#

Public Health Services funded by the Ministry of Health from DHBs and other public health service providers.

Expenses#

Expenses - Public Health Service Purchasing (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	453,201	445,801	514,781

Reasons for Change in Appropriation#

The increase of nearly $62 million in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below), devolution of funding to DHBs and rephasing of the expenditure through expense transfers.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Public Health Service Purchasing (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Screening services are provided safely and effectively in accordance with Policy and Quality Standards: compliance with expected minimum Policy and Quality standards and working towards achievable higher goals	N/A	Under Development	Achieved
Public health services: reports, including both financial and service delivery information, are provided to the Ministry of Health in a timely manner in accordance with the provisions of funding agreements	N/A	Under Development	Achieved
Reduced the harm caused by tobacco: the increase in the proportion of 'never smokers' among Year 10 students (absolute increase) over 2009/10	N/A	Under Development	by at least 3%
Increased rates of breastfeeding up to three months: the proportion of infants exclusively and fully breastfed	N/A	Under Development	74% at six weeks 57% at three months
Increased levels of physical activity for adults (aged 15 years and over): increase the proportion of the New Zealand adult population who are regularly physically active by undertaking 30 minutes of moderate activity on five more days of the week	N/A	Under Development	50%
Drinking Water Assistance Programme and Sanitary Works Subsidy Scheme All drinking water and sanitary works applications that meet the Ministry of Health's criteria to improve and protect the population's health are forwarded to the Minister for approval	N/A	Under Development	100%
Communicable Disease and Immunisation Fund surveillance, expert analysis and advice on the prevention and control of communicable diseases. Fund mass vaccination programmes of those vaccines on the national immunisation schedule	N/A	Under Development	87% of 2 year olds
Funding agreements with providers specify the nature, level, range and volume of services, the location, access, monitoring arrangements, price, duration, scope for variation, and mechanisms for dispute resolution	N/A	Under Development	100%

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Public Health Service Purchasing (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line by Line Review Savings	2008/09	(15,775)	(10,075)	(8,595)	(7,317)	(7,317)
Emergency Planning	2008/09	2,728	2,728	2,728	2,728	2,728
Improving Control Of Antimicrobial Resistance	2008/09	1,000	1,000	1,000	1,000	1,000
Forecast Funding Track (FFT) and Demographics	2008/09	19,296	19,296	19,296	19,296	19,296
Improving the Quality of Antenatal Screening for Down Syndrome	2008/09	689	5,203	8,032	9,417	9,417
National Drug Policy - Mass media and education campaign on illicit drugs	2008/09	1,250	1,250	1,250	1,250	1,250
Pneumococcal vaccine in National Immunisation Schedule (NIS)	2008/09	10,000	10,000	10,000	10,000	10,000
Sexual health education and reduction of sexually transmitted infections	2008/09	1,100	1,100	1,100	1,100	1,100
Smoking cessation: new pharmaceutical and improved DHB services	2008/09	8,000	8,000	8,000	8,000	8,000
Response to Health Select Committee Inquiry into Obesity and Type 2 Diabetes	2008/09	11,674	11,794	11,794	11,824	11,824
Sanitary Works Subsidy Scheme (SWSS) for Sewerage	2008/09	15,220	12,045	7,245	2,979	2,979
Migrant Health Initiative	2008/09	1,917	1,900	1,900	2,000	2,000
Investing in medicines sector infrastructure	2008/09	2,200	2,200	2,200	2,200	2,200
Treatment services for Victims of Sexual Abuse and Assault	2008/09	1,000	2,000	2,000	2,000	2,000
HPV vaccine immunisation	2008/09	43,517	45,627	39,644	25,512	13,500
Universal Newborn hearing Screening	2007/08	3,350	3,500	3,400	3,050	3,050
Forecast Funding Track (FFT)	2007/08	10,290	10,290	10,290	10,290	10,290
Demographics	2007/08	5,647	5,647	5,647	5,647	5,647
Include Pneumococcal Vaccine In National Immunisation Register	2007/08	17,000	17,000	17,000	17,000	17,000
Healthy Eating - Healthy Action Implementation Plan	2007/08	12,450	12,750	12,750	12,750	12,750
Smoking Cessation Programmes	2007/08	10,600	10,600	10,600	10,600	10,600
Antenatal Downs Syndrome Screening Programme	2007/08	2,900	2,900	2,900	2,900	2,900
Programmes To Prevent Family Violence	2007/08	2,640	2,640	2,640	2,640	2,640
Sexual Health Education and Reducing Sexually Transmitted Infection	2007/08	2,500	3,900	3,400	3,400	2,500
Newborn Metabolic Screening Programme	2007/08	500	500	500	500	500
National Drug Policy - Mass Media and Education Programme On Illicit Drugs	2007/08	250	250	250	250	250
National Drug Policy - Online Drug Data and Information Systems	2007/08	50	200	200	200	200
Healthy Eating, Healthy Action Plan	2006/07	19,033	19,033	19,033	19,033	19,033
Primary Containment 3 Laboratory Capability	2006/07	1,511	1,552	1,552	1,552	1,552
Additional Forecast Funding Track	2005/06	2,367	2,367	2,367	2,367	2,367
Additional Funding for Demographic Changes	2005/06	292	292	292	292	292
Drinking Water Assistance Programme	2005/06	22,222	28,889	28,889	15,555	11,111
Rebranding of Rockquest	2004/05	200	200	200	200	200
Community Action on Drugs	2005/06	735	750	750	750	750
National Depression Awareness	2005/06	2,203	2,083	2,083	2,083	2,083
National Drug Policy - Contestable Pool	2004/05	855	855	855	855	855
One for One Needle and Syringe Exchange	2004/05	889	889	889	889	889
Drug Foundation	2004/05	252	252	252	252	252
Demographic change - to fund health services for changes in population numbers, age mix, ethnicity and deprivation	2004/05	1,583	1,583	1,583	1,583	1,583

Scientific Advice to Support Pest Management Strategies as They Affect Public Health (M36)#

Scope of Appropriation#

Purchasing taxonomic services to support surveillance programmes for exotic mosquitoes of public health significance.

Expenses#

Expenses - Scientific Advice to Support Pest Management Strategies as They Affect Public Health (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	56	56	56

Output Performance Measures and Standards#

Output Performance Measures and Standards - Scientific Advice to Support Pest Management Strategies as They Affect Public Health (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
The Ministry of Health will enter into contracts with non-departmental service providers for the provision of science services as and when it becomes necessary	Achieved	Achieved	Achieved
Quality measures for the provision of science services will be as agreed in these contracts between Ministry of Health and non-departmental service providers	Achieved	Achieved	Achieved

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Scientific Advice to Support Pest Management Strategies as They Affect Public Health (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2008/09	3	3	3	3	3

Summary of Service Providers for Non-Departmental Outputs#

The following table summarises the resources to be allocated through Vote Health to non-departmental providers, along with an indication of the mechanism to be used for reporting actual performance and (where determined) the length of the funding commitment.

Summary of Service Providers - Summary of Service Providers for NonDepartmental Outputs - Health
Provider	2008/09 Budgeted $000	2008/09 Estimated Actual $000	2009/10 Budget $000	Reporting Mechanism
Crown Entities
District Health Boards				Provider's Annual Report
DHB appropriations	9,152,895	9,152,895	9,698,831
Clinical Training Agency (part)	103,327	103,327	Not yet known
National Disability Support Services (part)	155,875	155,875	Not yet known
National Contracted Services - Other (part)	3,290	3,290	Not yet known
National Maori Health Services (part)	4,207	4,207	Not yet known
National Mental Health Services (part)	5,408	5,408	Not yet known
Problem Gambling Services (part)	186	186	Not yet known
Provider Development (part)	4,667	4,667	Not yet known
Public Health Service Purchasing (part)	148,384	148,384	Not yet known
Mental Health Commission				Provider's Annual Report
Monitoring and Protecting Health and Disability Consumer Interests	2,697	2,697	2,962
Health Sponsorship Council				Section 32A report
Problem Gambling Services (part)	1,572	1,572	Not yet known
Public Health Service Purchasing (part)	13,540	13,540	Not yet known
PHARMAC				Provider's Annual Report
National Contracted Services - Other	11,989	11,989	14,449
Health and Disability Commissioner				Provider's Annual Report
Monitoring and Protecting Health and Disability Consumer Interests	8,990	8,990	9,679
Crown Health Financing Agency				Provider's Annual Report
Management of Residual Health Liabilities and District Health Board Term Debt	1,751	1,751	1,700

The above table summarises funding to be allocated through Vote Health to non-departmental providers, along with an indication of the mechanism to be used for reporting actual performance and (where determined) the length of the funding commitment.

Part 5 - Details and Expected Results for Other Expenses#

Part 5.2 - Non-Departmental Other Expenses#

Intended Impacts, Outcomes and Objectives

Intended Impacts, Outcomes and Objectives - Part 5.2 NonDepartmental Other Expenses - Health
Intended Impacts, Outcomes or Objectives of Appropriations	Appropriations
Funding is provided to the Australian and New Zealand Dialysis and Transplant Registry	Australian Kidney Foundation
Funding is provided for New Zealand's membership to the World Health Organisation and grants of extra budgetary contributions are provided to specific World Health Organisation projects	International Health Organisations
Funding is provided for costs associated with defence of legal claims and for the settlement of legal claims against the Crown	Legal Expenses
Funding support and assistance is provided for the development of third-party health and service workforce that targets specific population groups	Provider Development

International Health Organisations (M36)

Scope of Appropriation

Funding for New Zealand's membership to the World Health Organisation (WHO), and the contribution to specific WHO projects.

Expenses

Expenses - International Health Organisations (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	3,483	3,483	2,570

Reasons for Change in Appropriation

The change in this appropriation arises from Current and Past Policy Initiative funding changes (see table below).

Expected Results

Expected Results - International Health Organisations (M36) - Health
	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Briefings provided to government on the performance of WHO as an organisation and on individual projects that it undertakes	Annual	Achieved	Annual

Current and Past Policy Initiatives

Current and Past Policy Initiatives - International Health Organisations (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
NZAID Water Quality Capacity Building	2008/09	-	222	-	-	-
NZAID Projects	2008/09	1,253	118	-	-	-

Legal Expenses (M36)#

Scope of Appropriation#

Funding for the defence and settlement of legal claims against the Crown.

Expenses#

Expenses - Legal Expenses (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	1,778	1,778	1,778

Reasons for Change in Appropriation#

Expected Results - Legal Expenses (M36) - Health
	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Funding made available	As required		As required

Provider Development (M36)#

Scope of Appropriation#

Funding support and provide assistance for the development of the third party health service workforce, in particular, Maori and Pacific people's providers.

Expenses#

Expenses - Provider Development (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	19,289	19,289	19,289

Expected Results#

Expected Results - Provider Development (M36) - Health
	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Support the sustainability of viable Maori providers for improving access and quality of services	N/A	Under Development	90%
Increase and retain Maori health professional in the health workforce	N/A	Under Development	85%
Support the sustainability of viable Pacific providers for improving access and quality of services	N/A	Under Development	90%

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Provider Development (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Maori Nursing workforce development	2008/09	-	3,000	3,000	3,000	3,000
Pacific Health Provider and Workforce Development	2008/09	-	2,400	2,400	2,400	2,400

Reporting Mechanisms#

Reporting Mechanisms - Reporting Mechanisms - Health
Appropriation	Reporting Mechanism
Australian Kidney Foundation	Reporting of these non-departmental appropriations for expenditure incurred by the Crown will be undertaken under the provisions of section 32A of the Public Finance Act 1989.
International Health Organisations
Legal Expenses
Provider Development

The above table indicates the mechanisms to be used for reporting actual performance for each non-departmental other expenses appropriation.

Part 6 - Details and Expected Results for Capital Expenditure#

Part 6.1 - Departmental Capital Expenditure#

Intended Impacts, Outcomes and Objectives

Intended Impacts, Outcomes and Objectives - Part 6.1 Departmental Capital Expenditure - Health
Intended Impacts, Outcomes or Objectives of Appropriations	Appropriations
To purchase and develop assets by and for the use of the Ministry of Health	Ministry of Health - Capital Expenditure PLA

Ministry of Health - Capital Expenditure PLA (M36)

Scope of Appropriation

This appropriation is limited to the purchase or development of assets by and for the use of the Ministry of Health, as authorised by section 24(1) of the Public Finance Act 1989.

Capital Expenditure

Capital Expenditure - Ministry of Health Capital Expenditure PLA (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Forests/Agricultural	-	-	-
Land	-	-	-
Property, Plant and Equipment	9,705	9,705	10,410
Intangibles	25,750	25,750	25,000
Other	-	-	-
Total Appropriation	35,455	35,455	35,410
Forests/Agricultural	-	-	-
Land	-	-	-
Property, Plant and Equipment	9,705	9,705	10,410
Intangibles	25,750	25,750	25,000
Other	-	-	-
Total Appropriation	35,455	35,455	35,410

Expected Results - Ministry of Health Capital Expenditure PLA (M36) - Health
	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
To maintain and enhance the Ministry's infrastructure so it can support its own operations and those of the wider Health sector	18,537	8,139	28,022

Reasons for Change in Appropriation

The appropriation is consistent with the previous year.

Part 6.2 - Non-Departmental Capital Expenditure#

Intended Impacts, Outcomes and Objectives#

Intended Impacts, Outcomes and Objectives - Part 6.2 NonDepartmental Capital Expenditure - Health
Intended Impacts, Outcomes or Objectives of Appropriations	Appropriations
To maintain and improve Health sector assets, including hospitals and other infrastructure	Equity for Capital Projects for DHBs and the New Zealand Blood Service Loans for Capital Projects Health Sector Projects Response to Significant Health Emergencies
To maintain the Government's equity interest in District Health Boards	Deficit Support for DHBs
To enable District Health Boards to replace private sector debt with Crown debt	Refinance of DHB Private Debt
To enable older people moving into residential care to access interest free loans rather than sell their homes if they're are above the asset thresholds	Residential Care Loans

Equity for Capital Projects for DHBs and the New Zealand Blood Service (M36)#

Scope of Appropriation

Capital contributions to DHBs and the New Zealand Blood Service to cover new investments and reconfiguration of their balance sheets.

Capital Expenditure

Capital Expenditure - Equity for Capital Projects for DHBs and the New Zealand Blood Service (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	99,918	61,923	272,377

Reasons for Change in Appropriation

The $172 million increase in appropriation arises from Current and Past Policy initiative changes (see table below), fiscally neutral transfers to other appropriations and or rephasing of the expenditure through expense transfers.

Expected Results

Expected Results - Equity for Capital Projects for DHBs and the New Zealand Blood Service (M36) - Health
	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Drawdown of equity for capital projects and the reconfiguration of balance sheets by District Health Boards and the New Zealand Blood Service	99,918	61,923	272,377

Current and Past Policy Initiatives

Current and Past Policy Initiatives - Equity for Capital Projects for DHBs and the New Zealand Blood Service (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Health Capital Envelope	2009/10	-	50,377	50,000	70,000	75,000
Re-Appropriations	2008/09	7,200	-	52,786
Child/Adolescent Oral Health	2008/09	-	-	16,000
Government contribution to the Health Capital Envelope in Advance of Budget 2004	2006/07	38,000
Government contribution to the Health Capital Envelope in Budget 2006	2006/07	28,000	65,000	23,000	-	-
Government contribution to the Health Capital Envelope in Budget 2007	2010/11				60,000
Government contribution to the Health Capital Envelope in Budget 2008	2011/12	-	-	-	-	50,000

Loans for Capital Projects (M36)#

Scope of Appropriation#

Provision of new loans to DHBs for the purpose of facilities redevelopment and other purposes agreed by the Crown including balance sheet reconfiguration.

Capital Expenditure#

Capital Expenditure - Loans for Capital Projects (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	89,923	70,000	24,900

Reasons for Change in Appropriation#

The funding for capital projects and balance sheet reconfiguration in the Health sector is generally appropriated in the first instance to the 'Equity for Capital Projects for DHBs and the New Zealand Blood Service' capital appropriation. Once the DHB's or the New Zealand Blood Service's preference for debt for particular requirements (in full or part) is established and approved, the necessary funds are transferred to this appropriation so they can be drawn down.

Expected Results#

Expected Results - Loans for Capital Projects (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Provision of new loans to DHBs for the purpose of facilities redevelopment and other purposes agreed by the Crown including balance sheet reconfiguration	89,923	70,000	24,900

Project details for non-departmental capital expenditure are not available at this time as the business cases have yet to be approved by Ministers.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Loans for Capital Projects (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Contribution from Government in advance of Budget 2004	2006/07	58,000	-	-	-	-

Residential Care Loans (M36)#

Scope of Appropriation#

Funding to provide interest-free loans to people entering into aged residential care facilities.

Capital Expenditure#

Capital Expenditure - Residential Care Loans (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	15,000	12,000	15,000

Expected Results#

Expected Results - Residential Care Loans (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Funding for residential care loans	15,000	12,000	15,000

Reporting Mechanisms#

Reporting Mechanisms - Reporting Mechanisms - Health
Appropriation	Reporting Mechanism
Equity for Capital Projects for DHBs and the New Zealand Blood Service	Annual reports of District Health Boards
Loans for Capital Projects	Annual reports of District Health Boards
Health Sector Projects	Annual reports of District Health Boards
Response to Significant Health Emergencies	Annual reports of District Health Boards
Deficit Support for DHBs	Annual reports of District Health Boards
Refinance of DHB Private Debt	Annual reports of District Health Boards
Residential Care Loans	Nil

The above table indicates the mechanisms to be used for reporting actual results for each non-departmental capital expenditure appropriation.

Statement of Forecast Service Performance#

The Statement of Forecast Service Performance of the department included in the Health Sector comprises the service performance information for all departmental output expense appropriations that are proposed to be used by that department. In this context, service performance information comprises the scope, expenses and revenue, and output performance measures and standards for each class of outputs within those departmental appropriations, as set out in Part 2.1 of the Performance Information for appropriations in each Vote.

The following table identifies the classes of outputs incorporated in the Statement of Forecast Service Performance for the department in the Health Sector.

Classes of outputs incorporated in the Statement of Forecast Service Performance for each department
Department	Composition of Statement of Forecast Service Performance
Ministry of Health	The service performance information in Part 2.1 for the classes of outputs within all the departmental output expense appropriations in Vote Health.

Forecast Financial Statements of Department#

Statement of Common Accounting Policies#

These accounting policies have been applied in the forecast financial statements of all departments and Offices of Parliament except as outlined in the statement of entity-specific accounting policies for individual departments or Offices of Parliament.

These forecast financial statements are prepared in accordance with section 41(1)(a)-(f) of the Public Finance Act 1989. The purpose of the forecast financial statements is to facilitate Parliament's consideration of appropriations for, and planned performance of departments and offices of Parliament. Use of this information for other purposes may not be appropriate. It is not intended that these forecast financial statements be updated subsequent to publication.

Statement of Compliance

These forecast financial statements for the year ended 30 June 2009 comply with FRS-42 Prospective Financial Statements.

Specific Accounting Policies#

The accounting policies set out below have been applied consistently to all periods presented in these statements. These statements have been prepared on a going-concern basis. The measurement base applied is historical cost modified by the revaluation of certain assets and liabilities as identified in this statement of accounting policies.

The accrual basis of accounting has been used unless otherwise stated. These financial statements are presented in New Zealand dollars, which is the entity's functional currency. All financial information presented has been rounded to the nearest thousand.

Judgements and Estimations#

The preparation of forecast financial statements in conformity with FRS-42 requires judgements, estimates and assumptions that affect the application of policies and reported amounts of assets and liabilities, income and expenses. The estimates and associated assumptions are based on historical experience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates and these variations may be material.

Revenue#

Revenue is derived through the provision of outputs to the Crown and from services to third parties. Revenue is recognised in the forecast statement of financial performance when earned.

Leases#

Operating Leases

Where substantially all of the risks and rewards of ownership are retained by the lessor, leases are classified as operating leases.

Lease payments under operating leases are recognised as an expense on a straight-line basis over the lease term.

Finance Leases

Leases which effectively transfer to the department substantially all the risks and rewards incidental to ownership of the leased items are classified as finance leases. These are capitalised at the lower of the fair value of the asset or the present value of the minimum lease payments. The leased assets and the corresponding lease liabilities are recognised in the statement of financial position. The leased assets are depreciated over the period the department is expected to benefit from their use. The interest expense component of finance lease payments is recognised in the statement of financial performance.

Borrowing Costs#

Borrowing costs are recognised as an expense when incurred.

Property, Plant and Equipment#

Property, plant and equipment, other than land and buildings, is stated at cost less accumulated depreciation and impairment losses. Land and buildings are stated at fair value as determined by an independent registered valuer. Fair value is determined using market-based evidence. Land and buildings are revalued with sufficient regularity to ensure that carrying value is not materially different from fair value at the end of the reporting period. Additions between revaluations are recorded at cost. Any capitalisation thresholds applied are set out in the statement of entity-specific accounting policies.

Depreciation#

Depreciation is provided on a straight-line basis so as to allocate the cost [or valuation] of an item of property, plant and equipment, less any estimated residual value, over its estimated useful life.

The estimated useful lives are set out in the statement of entity-specific accounting policies.

Leasehold improvements are capitalised and the cost is amortised over the unexpired period of the lease or the estimated useful life of the improvements, whichever is shorter.

Items under construction are not depreciated. The total cost of a capital project is transferred to the appropriate asset class on its completion and then depreciated.

Intangible Assets#

Intangible assets with finite useful lives (such as computer software) are recorded at cost less accumulated amortisation and impairment losses.

Any capitalisation thresholds applied are set out in the statement of entity-specific accounting policies.

Amortisation is charged to the statement of financial performance on a straight-line basis over the estimated useful life of the asset.

The estimated useful lives are set out in the statement of entity-specific accounting policies.

Intangible assets with indefinite useful lives are not amortised, but are tested at least annually for impairment.

Where there is an active market for an intangible asset, the asset is recorded at a revalued amount, being fair value less any subsequent accumulated amortisation and accumulated impairment losses.

Cash and Cash Equivalents#

Cash includes cash on hand and funds on deposit with banks with a maturity of 3 months or less from date of acquisition.

Debtors and Other Receivables#

Debtors and other receivables are initially measured at fair value and subsequently measured at amortised cost using the effective interest rate, less impairment charges. Allowances for estimated irrecoverable amounts are recognised when there is objective evidence that the asset is impaired.

Inventories#

Inventories held for sale or use in the production of goods and services on a commercial basis are recorded at the lower of cost and net realisable value. The cost of purchased inventory is determined using the weighted average cost method.

Inventories held for distribution for public benefit purposes are recorded at cost (calculated using the weighted average cost method) adjusted when applicable for any loss of service potential. Where inventories are acquired at no cost, or for nominal consideration, the cost is the current replacement cost at the date of acquisition.

Employee Entitlements#

Pension Liabilities

Obligations for contributions to defined contribution retirement plans are recognised in the statement of financial performance as they fall due.

Other Employee Entitlements

Employee entitlements to salaries and wages, annual leave, sick leave, long service leave, retiring leave and other similar benefits are recognised in the statement of financial performance when they accrue to employees. Employee entitlements to be settled within 12 months are reported at the amount expected to be paid. Long-term employee entitlements are reported at the present value of the estimated future cash outflows.

Termination Benefits

Termination benefits are recognised in the statement of financial performance only when there is a demonstrable commitment to either terminate employment prior to normal retirement date or to provide such benefits as a result of an offer to encourage voluntary redundancy. Termination benefits to be settled within 12 months are reported at the amount expected to be paid. Other termination benefits are reported at the present value of the estimated future cash outflows.

Onerous Contracts#

Where the benefits to be derived from a contract are lower than the unavoidable costs of meeting the obligation under the contract, a provision is recognised. The provision is stated at the present value of the future net cash outflows expected to be incurred in respect of the contract.

Foreign Currency#

Foreign currency transactions are reported at the New Zealand dollar exchange rate at the date of the transaction.

Statement of Cash Flows#

The following are definitions of the terms used in the statement of cash flows:

cash and cash equivalents include cash on hand, cash in transit, bank accounts and deposits with a maturity of no more than three months from date of acquisition
investing activities are those activities relating to the acquisition and disposal of non-current assets
financing activities comprise capital injections by, or repayment of capital to, the Crown, and
operating activities include all transactions and other events that are not investing or financing activities.

Taxation#

Departments and Offices of Parliament are exempt from income tax as public authorities. Accordingly no charge for income tax has been provided for.

Goods and Services Tax#

These forecast financial statements are GST exclusive, except for receivables and payables in the statement of financial position, which are stated on a GST inclusive basis. Where GST is not recoverable as input tax, then it is recognised as part of the related asset or expense.

The net amount of GST owing to or from the Inland Revenue Department at balance date is included as part of receivables or payables (as appropriate) in the statement of financial position.

Commitments#

Future expenses and liabilities to be incurred on contracts that have been entered into at balance date are disclosed as commitments to the extent that there are equally unperformed obligations.

Contingent Liabilities and Contingent Assets#

Contingent liabilities are disclosed if the possibility that they will crystallise is not remote. Contingent assets are disclosed if it is probable that the benefits will be realised.

Changes in Accounting Policies#

Any changes in accounting policies since the date of the last audited financial statements prepared under New Zealand generally accepted accounting practice are described in the statement of entity-specific accounting policies. The last audited financial statements (30 June 2008) were prepared in accordance with NZ IFRS (New Zealand Equivalents to International Financial Reporting Standards) as appropriate for public benefit entities.

Forecast Financial Statements Ministry of Health#

Statement of Forecast Comprehensive Income for the year ending 30 June 2010#

Statement of Forecast Comprehensive Income for the year ending 30 June 2010 - Health
		2007/08	2008/09		2009/10
	Note	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Income
Crown		199,077	213,162	201,504	200,968
Department(s)		2,799	1,897	1,897	1,897
Other revenue	1	15,749	12,396	14,593	14,384
Gains		49	-	-	-
Interest		-	-	-	-
Total Income		217,674	227,455	217,994	217,249
Expenses
Personnel		124,716	129,415	124,716	124,716
Operating	2	75,470	81,294	70,827	75,175
Depreciation and amortisation		8,654	14,200	14,137	14,033
Capital charge		1,402	2,546	2,014	3,325
Finance costs		-	-	-	-
Other		-	-	-	-
Total Expenses		210,242	227,455	211,694	217,249
Net Surplus / (Deficit)		-	-	6,300	-
Other comprehensive income		1,350	-	-	-
Total Comprehensive Income		8,782	-	6,300	-

Statement of Forecast Changes in Taxpayers' Funds for the year ending 30 June 2010#

Statement of Forecast Changes in Taxpayers' Funds for the year ending 30 June 2010 - Health
		2007/08	2008/09		2009/10
	Note	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Balance at 1 July
General funds		18,623	33,951	18,623	32,390
Revaluation reserve		-	-	1,350	1,350
Other reserves		-	-	-	-
Taxpayers' Funds Opening Balance		18,623	33,951	19,973	33,740
Changes in Taxpayers' Funds
Comprehensive income for the period		8,782	-	6,300	-
Repayment of surplus		(7,432)	-	(6,300)	-
Capital contribution		-	24,578	13,767	10,594
Capital withdrawal		-	-	-	-
Other		-	-	-	-
Total Changes in Taxpayers' Funds		1,350	24,578	13,767	10,594
Balance at 30 June
General funds		18,623	58,529	32,390	42,984
Revaluation reserve		1,350	-	1,350	1,350
Other reserves		-	-	-	-
Taxpayers' Funds Closing Balance		19,973	58,529	33,740	44,334

Forecast Statement of Financial Position as at 30 June 2010#

Forecast Statement of Financial Position as at 30 June 2010 - Health
		2007/08	2008/09		2009/10
	Note	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Assets
Current Assets
Cash and cash equivalents		9,537	8,395	16,141	16,158
Debtors and other receivables	3	15,792	13,439	20,605	3,605
Prepayments		1,201	540	1,201	1,201
Inventories		-	-	-	-
Other current assets		-	-	-	-
Total Current Assets		26,530	22,374	37,947	20,964
Non-current Assets
Property, plant and equipment	5	22,380	28,550	26,518	31,849
Intangible assets	6	14,982	28,034	32,062	48,008
Other non-current assets		-	-	-	-
Total Non- current Assets		37,362	56,584	58,580	79,857
Total Assets		63,892	78,958	96,527	100,821
Liabilities
Current Liabilities
Creditors and other payables		21,418	7,914	41,418	41,418
Repayment of surplus		7,432	-	6,300	-
Employee entitlements		7,837	5,783	7,837	7,837
Other current liabilities		5,676	5,000	5,676	5,676
Total Current Liabilities		42,363	18,697	61,231	54,931
Non-current Liabilities
Provisions		-	-	-	-
Employee entitlements		1,556	1,732	1,556	1,556
Other non-current liabilities		-	-	-	-
Total Non-current Liabilities		1,556	1,732	1,556	1,556
Total Liabilities		43,919	20,429	62,787	56,487
Taxpayers' Funds
General funds		18,623	58,529	32,390	42,984
Revaluation reserve		1,350	-	1,350	1,350
Other reserves		-	-	-	-
Total Taxpayers' Funds		19,973	58,529	33,740	44,334
Total Liabilities and Taxpayers' Funds		63,892	78,958	96,527	100,821

Statement of Forecast Cash Flows for the year ending 30 June 2010#

Forestry Statement of Forecast Cash Flows for the year ending 30 June 2010 - Health
		2007/08	2008/09		2009/10
	Note	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Cash Flows from Operating Activities
Receipts from:
Crown		198,726	221,162	192,340	205,968
Department(s)		2,799	1,897	1,897	1,897
Other		16,914	12,396	14,593	14,384
Interest		-	-	-	-
Payments to:
Suppliers		(67,593)	(111,294)	(46,990)	(63,689)
Employees		(131,255)	(129,415)	(124,202)	(124,202)
Capital charge		(1,402)	(2,546)	(2,014)	(3,325)
Goods and services tax (net)		244	-	-	-
Other operating activities		-	-	-	-
Net Cash from Operating Activities		18,433	(7,800)	35,624	31,033
Cash Flow from Investing Activities
Receipts from:
Sale of property, plant and equipment		88	240	100	100
Sale of intangible assets		-	-	-	-
Sale of other non-current assets		-	-	-	-
Purchase of:
Property, plant and equipment		(10,204)	(8,145)	(9,705)	(10,410)
Intangible assets		-	-	(25,750)	(25,000)
Other non-current assets		-	-	-	-
Net Cash from Investing Activities		(10,116)	(7,905)	(35,355)	(35,310)
Cash Flow from Financing Activities
Capital contribution		-	24,578	13,767	10,594
Other financing cash inflows		-	-	-	-
Repayment of surplus		(457)	(9,293)	(7,432)	(6,300)
Capital withdrawal		-	-	-	-
Other financing cash outflows		-	-	-	-
Net Cash from Financing Activities		(457)	15,285	6,335	4,294
Net Increase / (Decrease) in Cash		7,860	(420)	6,604	17
Cash at the beginning of the year		1,677	8,815	9,537	16,141
Cash at the end of the year		9,537	8,395	16,141	16,158

Statement of Significant Assumptions#

These forecast financial statements have been compiled on the basis of existing government policies and Ministerial expectations at the time the statements were finalised.

The main assumptions are as follows:

The Ministry's activities will remain substantially the same as for the previous year.
Operating costs are based on historical experience. The general historical pattern is expected to continue.
Estimated year end information for 2008/09 is used as the opening position for the 2008/09 forecasts.

These assumptions are adopted as at 24 April 2009.

Factors that could lead to material differences between the forecast financial statements and the 2008/09 actual financial statements include:

Changes to the baseline budget through new initiatives, or technical adjustments.

Statement of Entity-Specific Accounting Policies#

Department - Specific Accounting Policies

The Ministry of Health has applied the accounting policies set out in Statement of Accounting Policies Standard included in this document, except as stated below.

Reporting Entity

These are the prospective financial statements of Ministry of Health, prepared in accordance with section 38 of the Public Finance Act 1989.

Ministry of Health is a Government Department as defined by section 2 of the Public Finance Act 1989. For the purposes of financial reporting Ministry of Health is a public benefit entity.

Statement of Entity Specific Accounting Policies

Depreciation

Depreciation is charged on a straight-line basis at rates calculated to allocate the cost or valuation of an item of property, plant and equipment, less any estimated residual value, over its estimated useful life. Typically, the estimated useful lives of different classes of property, plant and equipment.

Property, plant and equipment - estimated lives - Health
	Useful life	Depreciation rate
Buildings	40 years	2.5%
Motor vehicles	5 years	20%
Furniture and fittings	5-10 years	10-20%
Machinery	5 years	20%
Leasehold improvements	5-10 years	10-20%
IT equipment	3-5 years	20-33.3%
Scientific equipment	5-10 years	10-20%

Intangible assets

Intangible assets with finite lives are subsequently recorded at cost less any amortization and impairment losses. Amortisation is charged to the Statement of Financial Performance on a straightline basis over the useful life of the asset. Typically, the estimated useful lives of these assets are as follows:

Intangible Assets - estimated lives - Health
	Useful life	Amortisation rate
Software - internally generated	3-5 years	20-33.3%
Software - other	3-5 years	20-33.3%

Cost allocation

Direct costs are those costs directly attributed to an output. Indirect costs are those costs that cannot be identified in an economically feasible manner with any one specific output.

Direct costs are charged directly to outputs while indirect costs are charged to outputs based on the level of activity associated with relevant cost drivers.

Depreciation is charged to Business Units on the basis of asset utilisation with the balance being charged as indirect costs. Direct personnel costs are allocated to the output expenses with the balance being charged as indirect costs.

Notes to the Financial Statements#

Note 1 - Other Revenue

Note 1 - Other Revenue - Health
	2007/08	2008/09		2009/10
	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Medicines registration	9.297	9,000	9,000	9,000
Service fees	4,064	3,500	3,500	3,291
Annual licence and registration fees	1,721	1,700	1,700	1,700
State Sector Retirement Saving Scheme recovery	2,025	1,897	1,897	1,897
Other departmental revenue	774	-	-	-
Other	668	393	393	393
Total	18,549	16,490	16,490	16,281

Note 2 - Operating Expenses#

Note 2 - Operating Expenses - Health
	2007/08	2008/09		2009/10
	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Operating expenses include:
Consulting expenses	8,909	8,909	8,909	8,909
Overseas Travel	1,160	1,195	1,195	1,195
Domestic travel	7,673	7,645	7,645	7,645
Other	57,729	41,892	53,592	57,940
Total	75,471	59,641	71,341	75,689

Note 3 - Debtors and Other Receivables#

Note 3 - Debtors and Other Receivables - Health
	2007/08	2008/09		2009/10
	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Debtor - Crown	14,187	19,000	19,000	2,000
Debtors - Other	1,605	1,605	1,605	1605
Total	15,792	20,605	20,605	20,605

Note 4 - Reconciliation of Net Surplus to Net Cash Flows from Operating Activities for the year ending 30 June 2010#

Note 4 - Reconciliation of Net Surplus to Net Cash Flows from Operating Activities for the year ending 30 June 2010 - Health
	2007/08	2008/09		2009/10
	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Net surplus/(deficit)	7,432	18,000	6,300	-
Add/(less) non-cash items:
Depreciation and amortisation expense	8,654	14,137	14,137	14,033
Add/(less) items classified as investing or financing activities:
(Gains)/losses on disposal of property, plant and equipment	(49)	-	-	-
Add/(less) movements in working capital items:
(Inc)/dec in debtors and receivables	(165)	-	-	5,000
(Inc)/dec in debtor Crown	(351)	-	-	17,000
(Inc) dec in prepayments	(661)	-	-	-
Inc/(dec) in creditors and payables	1,550	(4,813)	15,187	(5,000)
Inc/(dec) in provIsions	1,319	-	-	-
Inc/(dec) in employee entitlements	704	-	-	-
Net Movements in working capital items	2,396	(4,813)	15,187	17,000
Net Cash from operating activities	18,433	27,324	35,624	31,033

Note 5 - Property, Plant and Equipment#

Note 5 - Property, Plant and Equipment - Health
	Land $000	Buildings $000	Leasehold improvements $000	Furniture/office equipment $000	Other $000	Total $000
Cost or revaluation
Balance as at 1 July 2009	5,350	7,840	-	9,771	49,751	72,712
Additions by purchase	-	900	-	810	8,700	10,410
Additions internally developed	-	-	-	-	-	-
Revaluation increase	-	-	-	-	-	-
Transfers between classes	-	-	-	-	-	-
Disposals	-	-	-	(30)	(70)	(100)
Balance as at 30 June 2010	5,350	8,740	-	10.551	58,381	83,022
Accumulated depreciation and impairment losses
Balance as at 1 July 2009	-	4,273	-	5,674	36,247	46,194
Depreciation expense	-	578	-	931	3,470	4.979
Eliminate on disposal	-	-	-	-	-	-
Eliminate on revaluation	-	-	-	-	-	-
Transfers between classes	-	-	-	-	-	-
Impairment losses	-		-	-	-	-
Balance as at 30 June 2010	-	4,851	-	6,605	39,717	51,173
Carrying amount as at 30 June 2010	5,350	3,889	-	3,946	18,664	31,849

Note 6 - Intangible Assets#

Note 6 - Intangible Assets - Health
	2007/08	2008/09		2009/10
	Actual $000	In 2008 Budget $000	Estimated Actual $000	Budgeted $000
Opening balance	10,558	14,982	14,982	32,062
Additions	7,982	25,750	25,750	25,000
Amortisation	(3,558)	(8,670)	(8,670)	(9,054)
Total	14,982	32,062	32,062	48,008

Purpose of Information Supporting the Estimates#

The Information Supporting the Estimates provides members of Parliament with information on expected performance to:

support their examination of the appropriations and other authorities requested by the Government in the first Appropriation Bill for the forthcoming financial year, and
provide a base against which they can later assess the actual performance of each individual department and Office of Parliament over that financial year.

The Information Supporting the Estimates is organised into 10 volumes by sector, each of which covers one or more Votes. The scope of each sector and the allocation of Votes to a sector reflect a balancing of three desired characteristics - namely that each volume should, where possible:

reflect natural sectors
keep together Votes administered by the same department, and
keep together Votes allocated to a particular select committee of the House of Representatives for examination.

The number of sectors and coverage of each sector is set in consultation with the Finance and Expenditure Committee. The 10 sectors are:

Economic Development and Infrastructure Sector
Education and Science Sector
Environment Sector
External Sector
Finance and Government Administration Sector
Health Sector
Justice Sector
Māori, Other Populations and Cultural Sector
Primary Sector
Social Development and Housing Sector.

Votes and Departments in Each Sector#

Votes and Departments in Each Sector
Votes by Sector	Departments by Sector
Economic Development and Infrastructure Sector - B.5A Vol.1
Vote Economic Development Vote Commerce Vote Communications Vote Consumer Affairs Vote Energy Vote Tourism	Ministry of Economic Development
Vote Transport	Ministry of Transport
Vote Labour Vote ACC Vote Employment Vote Immigration	Department of Labour
Education and Science Sector - B.5A Vol.2
Vote Education	Ministry of Education
Vote Crown Research Institutes (this Vote is administered by the Treasury, which is in the Finance and Government Administration Sector.)
Vote Education Review Office	Education Review Office
Vote Research, Science and Technology	Ministry of Research, Science and Technology
Environment Sector - B.5A Vol.3
Vote Environment Vote Climate Change	Ministry for the Environment
Vote Conservation	Department of Conservation
Vote Local Government (this Vote is administered by the Department of Internal Affairs, which is in the National Identity Sector)
Vote Parliamentary Commissioner for the Environment	Parliamentary Commissioner for the Environment
External Sector - B.5A Vol.4
Vote Foreign Affairs and Trade Vote Official Development Assistance	Ministry of Foreign Affairs and Trade
Vote Defence	Ministry of Defence
Vote Defence Force Vote Veterans' Affairs - Defence Force	New Zealand Defence Force
Vote Customs	New Zealand Customs Service
Finance and Government Administration Sector - B.5A Vol.5
Vote Prime Minister and Cabinet	Department of the Prime Minister and Cabinet
Vote Communications Security and Intelligence	Government Communications Security Bureau
Vote Security Intelligence	New Zealand Security Intelligence Service
Vote State Services	State Services Commission
Vote Finance Vote State-Owned Enterprises	The Treasury
Vote Revenue	Inland Revenue Department
Vote Ministerial Services (this Vote is administered by the Department of Internal Affairs, which is in the National Identity Sector)
Vote Office of the Clerk	Office of the Clerk of the House of Representatives
Vote Ombudsmen	Office of the Ombudsmen
Vote Parliamentary Service	Parliamentary Service
Vote Audit	Office of the Auditor-General
Health Sector - B.5A Vol.6
Vote Health	Ministry of Health
Justice Sector - B.5A Vol.7
Vote Justice Vote Courts	Ministry of Justice
Vote Corrections	Department of Corrections
Vote Police	New Zealand Police
Vote Serious Fraud	Serious Fraud Office
Vote Attorney-General	Crown Law Office
Vote Parliamentary Counsel	Parliamentary Counsel Office
Māori, Other Populations and Cultural Sector - B.5A Vol.8
Vote Arts, Culture and Heritage Vote Sport and Recreation	Ministry for Culture and Heritage
Vote Statistics	Statistics New Zealand
Vote National Archives	Archives New Zealand
Vote National Library	National Library of New Zealand
Vote Māori Affairs	Te Puni Kōkiri
Vote Treaty Negotiations (this Vote is administered by the Ministry of Justice, which is in the Justice Sector)
Vote Pacific Island Affairs	Ministry of Pacific Island Affairs
Vote Women's Affairs	Ministry of Women's Affairs
Vote Internal Affairs Vote Community and Voluntary Sector Vote Emergency Management Vote Racing	Department of Internal Affairs
Primary Sector - B.5A Vol.9
Vote Agriculture and Forestry Vote Biosecurity	Ministry of Agriculture and Forestry
Vote Fisheries	Ministry of Fisheries
Vote Food Safety	New Zealand Food Safety Authority
Vote Lands	Land Information New Zealand
Social Development and Housing Sector - B.5A Vol.10
Vote Social Development Vote Senior Citizens Vote Veterans' Affairs - Social Development Vote Youth Development	Ministry of Social Development
Vote Housing	Department of Building and Housing

Purpose and Nature of Appropriations#

An appropriation is a statutory authority from Parliament allowing the Crown or an Office of Parliament to incur expenses or capital expenditure.

Neither the Crown nor an Office of Parliament can legally incur any expense or capital expenditure - as those terms are defined in the Public Finance Act 1989 (PFA) - unless it is expressly authorised by or under an Act of Parliament.

Limits Created by Appropriations#

Each appropriation is allocated to, and managed as, one of six types of appropriation.

Each appropriation has a defined scope that limits the uses or activities for which the expenses or capital expenditure can be incurred. The scope should be sufficient on its own to establish the nature and extent of the authority to incur expenses or capital expenditure. The wording of the appropriation scope should achieve the balance between being sufficiently precise to act as an effective constraint against non-authorised activities and not so specific that it inadvertently limits activity intended to be authorised.

In most cases an appropriation also limits the amount of expenses or capital expenditure that can be incurred, and the time period within which those expenses or capital expenditure can be incurred.

Aside from the very limited exclusions provided for in the PFA, the amount of expense or capital expenditure authorised by an appropriation is measured in accordance with generally accepted accounting practice.

As generally accepted accounting practice does not normally treat GST as an expense, appropriation amounts also generally exclude GST. Prior to 2005/06, however, appropriations included applicable GST. All prior-year appropriation data, such as in the Summary of Trends table in the Estimates and the Summary of Financial Activity Table for each Vote in Information Supporting the Estimates - have been adjusted to exclude GST to allow appropriate comparison.

Responsibility for Appropriations#

Each appropriation is the responsibility of a designated Minister, who controls the right to use that appropriation within the limits authorised by Parliament. A department is also assigned to administer that appropriation in accordance with the Minister's wishes concerning its use.

A Vote is a group of appropriations (and can be a single appropriation) administered by a single department. Different appropriations within a Vote may be the responsibility of different Ministers.

Types of Appropriation#

The PFA provides for six types of appropriation. Four appropriation types authorise the incurring of expenses; one type authorises the incurring of capital expenditure; and the remaining type authorises both.

These appropriation types can be further differentiated by whether the expenses or capital expenditure are departmental or non-departmental transactions.

Types of Appropriation
Appropriation Type	Transaction Status	Description
Output Expenses	Departmental	Authorises expenses to be incurred by a department or an Office of Parliament in supplying a specified category of outputs (goods and services).
Output Expenses	Non-Departmental	Authorises expenses to be incurred by the Crown (excluding departments) in purchasing a specified category of outputs (goods and services) from Crown entities or other third parties.
Benefits and Other Unrequited Expenses	Non-Departmental	Authorises expenses to be incurred by the Crown (excluding departments) in transferring resources (generally to individuals for their personal benefit) for which the Crown receives nothing directly in return. Examples include the Unemployment Benefit, student allowances and various scholarships and awards.
Borrowing Expenses	Departmental	Authorises the incurring of interest or other financing expenses for loans made to a department or an Office of Parliament, or public securities (undertakings that represent part of the public debt) issued by a department or an Office of Parliament. In practice, limitations on the rights of departments to borrow or issue securities mean that these are likely to be incurred only by Offices of Parliament.
Borrowing Expenses	Non-Departmental	Authorises the incurring of interest or other financing expenses for loans made to the Crown (excluding departments), or public securities (undertakings that represent part of the public debt) issued by the Crown. Crown debt management is centralised, which means that most debt-servicing expenses appear in Vote Finance.
Other Expenses	Departmental	Authorises expenses to be incurred by a department or an Office of Parliament that are not either output expenses or borrowing expenses. Other expenses should be used only for events that cannot be related back to output production, such as redundancy costs arising from a government decision to cease purchasing certain types of outputs, or a loss on sale of assets made surplus by departmental restructuring.
Other Expenses	Non-Departmental	Authorises expenses to be incurred by the Crown (excluding departments) that are not structured or managed as output expenses, benefits and unrequited expenses, or borrowing expenses. Other expenses is the residual appropriation type, which should not be used where an appropriation could be better classified or managed as one of the other appropriation types (eg, as output expenses). Examples include disposal of an asset for less than market value, grants to community organisations, subscriptions for membership of international bodies and remuneration of independent statutory officers.
Capital expenditure	Departmental	Authorises capital expenditure to be incurred by a department or an Office of Parliament to acquire or develop assets for the use of the department.
Capital expenditure	Non-Departmental	Authorises capital expenditure to be incurred by the Crown (excluding departments) to acquire or develop Crown assets, including the purchase of equity, or making a loan to a person or organisation that is not a department.
Expenses or Capital expenditure incurred by an intelligence and security department	Departmental	Authorises both expenses and capital expenditure to be incurred by the New Zealand Security Intelligence Service or the Government Communications Security Bureau.

Types of Output Expense Appropriations#

A number of variations are possible for output expense appropriations. In particular, the constraint on the amount of expense that can be incurred is not always a fixed amount; and an output expense appropriation can cover more than one class of outputs.

Types of Output Expense Appropriations
Output Expense Appropriation Type and Authority	Description, Constraints on Form and Typical Application
Standard Output Expense Appropriations (section 7(1), Public Finance Act 1989)	Departmental or non-departmental: Authorise a department or an Office of Parliament to incur expenses in supplying a specified class of outputs (goods and services), or the Crown (excluding departments) to incur expenses to purchase a specified class of outputs. Annual or multi-year: The authority lapses at the end of the financial year or multi-year period specified. Single output class only: The scope is limited to a single class of outputs (defined as a grouping of similar outputs). Amount limited by Appropriation Act: The amount of a standard output expense appropriation is limited to a set amount of NZ dollars specified in an Appropriation Act. Typical application: The normal or default form for an output expense appropriation, used for a wide range of outputs for which the flexibility offered by the other types of output expense appropriation is not required.
Multi-Class Output Expense Appropriations (MCOA) (section 7(3)(b), Public Finance Act 1989)	Departmental or non-departmental: Authorise a department or an Office of Parliament to incur expenses in supplying more than one specified class of outputs (goods and services), or the Crown (excluding departments) to incur expenses to purchase more than one specified class of outputs. A proposed MCOA must be approved by the Minister of Finance before it is presented in the Estimates. The information supporting the Estimates must explain why the Minister has allowed those classes of outputs to be grouped in one appropriation. Annual or multi-year: The authority lapses at the end of the financial year or multi-year period specified. Multiple output classes: The scope of an MCOA is determined by the combined scope of each of the output classes included in that appropriation. Amount limited by Appropriation Act: The amount of an MCOA is limited to a set amount of NZ dollars specified in an Appropriation Act. The amount of expense that can be incurred in relation to each component output class is flexible within the total amount of the MCOA, although expenses must be separately forecast and reported for each individual class in the Estimates, Information Supporting the Estimates, Supplementary Estimates and the department's annual report. Typical application: An MCOA is used where it is appropriate to give the responsible Minister or department ongoing discretion over the output mix across two or more classes of outputs. Such discretion will most commonly be sought where the output classes contribute to a common outcome, or use a common or closely related set of inputs or processes, and the circumstances that determine the appropriate output choice or mix are likely to vary during the appropriation period.
Revenue-Dependent Appropriations (RDA) (section 21(1), Public Finance Act 1989)	Departmental only: Authorise a department or an Office of Parliament to incur expenses in supplying a specified a class of outputs (goods and services) that are not paid for directly by the Crown. A proposed RDA must be approved by the Minister of Finance, before it is presented in the Estimates. Each class of outputs for which an RDA is approved is listed in an Appropriation Act for the relevant financial year. Annual only: The authority lapses at the end of the financial year specified. Single output class only: The scope of an RDA is limited to a single class of outputs (defined as a grouping of similar outputs). Amount limited by amount of revenue earned: The amount of an RDA is limited tothe amount of revenue earned by a department or an Office of Parliament from other departments or from parties other than the Crown during a financial year. The Minister of Finance can further direct a department to incur expenses to a level lower than the amount of revenue earned, though such directions have been rare. Typical application: An RDA provides flexibility to respond to unanticipated changes in the level of external demand for a class of outputs, where the full cost of the outputs is met by external parties and not the Crown.
Department-to-Department Appropriation (DDA) (section 20(2), Public Finance Act 1989)	Departmental only: Authorise a department or an Office of Parliament to incur expenses in supplying specified outputs (goods and services) paid for by another department. Creation of a DDA requires an agreement between two departments. Implicitly it also requires the approval of the Minister who will become responsible for the appropriation - namely, the Minister responsible for the supplying department - as the agreement has implications for the scope and risk of that department's operations. Annual or multi-year: The period of a DDA will depend on the negotiated terms of the agreement. Single or multiple output class(es): The scope of a DDA (and hence whether it covers one or more classes of outputs) will depend on the way in which the agreement defines what is to be delivered. In most cases, an agreement that provides for a range of different outputs is better treated as creating several single-class DDAs. Amount limited by departmental agreement: The amount of a DDA is limited to either the amount of revenue earned from the commissioning department, or the cost incurred by the supplying department in providing those outputs (if that cost is less than the amount of revenue earned under the agreement). Typical application: DDAs are intended to make collaboration between departments easier by reducing the time and effort required to obtain / adjust the relevant appropriations while also allowing a commissioning department to retain full control over the resources it provides. The use of a DDA is not confined to bilateral agreements. A set of related DDAs could be used to enable one department to co-ordinate and manage the work of several departments that must work together to contribute to providing an integrated service to third parties, or to pool contributions from several departments to enable another department to provide a specific service to or on behalf of those departments.

Appropriation Period#

The length of the appropriation period affects how appropriations are presented in the Estimates and Supplementary Estimates. Three kinds of appropriation can be distinguished on the basis of period - annual and multi-year (as referred to in the above table on types of output expense appropriations), and permanent:

Annual Appropriations - Most appropriations listed in the Estimates and Supplementary Estimates allow expenses or capital expenditure to be incurred only during a particular financial year. The annual amounts, for which parliamentary authority is normally sought, are shown in bold type in Details of Annual and Permanent Appropriations in the Estimates and Supplementary Estimates for each Vote. The amounts for RDAs and annual DDAs are forecasts only, and so are not shown in bold type.
Multi-Year Appropriations (MYAs) - The PFA also permits appropriations that allow expenses or capital expenditure to be incurred during a specified period that spans the whole or parts of more than one financial year, but no more than five financial years. The details of each MYA, including its commencement date and expiry date, are specified in Details of Multi-Year Appropriations in the Estimates and Supplementary Estimates for relevant Votes.
Permanent Appropriations (sometimes referred to as permanent legislative authorities or PLAs) -Permanent appropriations are authorised by legislation other than an Appropriation Act and continue in effect until revoked by Parliament. Generally the authorising legislation will impose limits on the scope of the appropriation and not its amount. For those appropriations that with limits set in cash terms, section 11(2) of the Public Finance Act 1989 requires that they be reported on an accrual basis. The usual legislative wording allows for expenses or capital expenditure to be incurred for the purpose specified in the legislation “without further appropriation than this section”. Details of permanent appropriations are included in Details of Annual and Permanent Appropriations in the Estimates and Supplementary Estimates for each Vote for completeness, though the amount specified is a forecast rather than a limit. The amounts of permanent appropriations are therefore not shown in bold type. The scope of a permanent appropriation will reference the relevant section of the authorising legislation.

Guide to Reading Information Supporting the Estimates#

The Information Supporting the Estimates for each of the 10 sectors comprises five components, each of which is briefly described, below.

1 Sector Overview Information#

The first component of the Information Supporting the Estimates may include a statement, agreed by all Ministers responsible for appropriations in each Vote included in the sector, that presents an overview of the sector and a high-level summary of the government's expectations and priorities. The Overview also includes Ministerial and Chief Executive Statements of Responsibility for the information provided in the Information Supporting the Estimates.

2 Performance Information Relating to Appropriations in Each Vote#

The second component of the Information Supporting the Estimates presents performance information relating to each appropriation.

The title pages for each Vote specify the Minister(s) responsible for existing and proposed appropriations in the Vote, and the Responsible Minister for the department. The performance information meets the requirements of sections 15 and 41(1)(e) of the PFA and contains up to six parts. If particular information is not applicable to the Vote or a specific appropriation or type, or is otherwise unavailable, the relevant heading is not included.

Part 1 - Summary of the Vote#

The Summary of the Vote comprises:

Part 1.1 Overview of the Vote - A plain-language summary of the focus of the appropriations through a brief explanation of the Vote. The Overview also appears at the start of the Vote in the Estimates.
Part 1.2 High-Level Objectives of the Vote - The objectives for the Vote presented through links and relationships and high-level priorities and outcomes to which they contribute. Where applicable, priorities and outcomes are drawn from the priorities and desired outcomes and published strategy documents. Links are also made to specific government strategies. Links may also be made to specific Government objectives.
Part 1.3 Trends in the Vote - A presentation of the actual and estimated trends in the Vote, comprising:
- Summary of Financial Activity - A table showing financial information over the preceding five years (actual, budgeted or estimated actual), the current year (Budget) and the following three years (estimated) for the type of appropriations and Crown revenue and capital receipts.
- New Policy Initiatives - A table showing how new initiatives (and the associated expenses or capital expenditure) are allocated to appropriations in the Vote. References are included where appropriations in other Votes are affected by the same initiative.
- Analysis of Significant Trends - High-level analysis of appropriations and Crown revenue and capital receipts by type over the nine financial years covered by the Summary of Financial Activity table, explanations of significant changes and may also contain graphical presentations.

Part 1.4 Reconciliation of Changes in Appropriation Structure - a table providing a reconciliation and explanation of any changes in the structure or classification of appropriations made in the Budget year. These changes are restated for the previous financial year to facilitate comparison.

Part 2 - Details and Expected Performance for Output Expenses#

This Part provides further detail about appropriations and expected performance for output expenses.

Part 2.1 Departmental Output Expenses - Intended impacts, outcomes and objectives are presented for departmental output expense appropriations in the Vote. This is followed by information on each appropriation, including its scope, a table showing expenses and revenue (distinguishing the revenue sources between the Crown and others), a statement of reasons for change in the appropriation (if material), and tables detailing performance measures and standards for significant aspects of expected output performance, any conditions on use of appropriation, any memorandum accounts (which record accumulated surpluses and deficits incurred in the provision of outputs on a full cost-recovery basis), and any current and past policy initiatives affecting the appropriation.
- Information on impacts and outcomes or objectives to which the outputs contribute is provided. Further information on the relationships between outputs, impacts, and outcomes or objectives is outlined in Part 1.2 and the Statement of Intent. Conditions on use include administrative criteria and processes contained in legislation, regulation and Government decisions, which may be reference in scope statement or performance measures. The current and past policy initiatives tables provides a five-year history of announced initiatives that impact on the Budget year, the preceding year and the following three years.
- For MCOA, an explanation is provided as to why the classes of outputs have been grouped under a single appropriation, and the scope statement, expenses and revenue, and performance information is presented for each output class.
- Information provided for MYAs enables the original appropriation to be reconciled to the adjusted level if changes have been approved or are proposed, and the balance remaining to be derived taking account of actual or estimated expenses incurred to date.
- The appropriation scope, expenses and revenue, and output performance measures and standards match information required to be included in a department's Statement of Forecast Service Performance with respect to departmental output expense appropriations used by the department.
Part 2.2 Non-Departmental Output Expenses - This sub-part contains comparable information to that presented in Part 2.1 on departmental output expense appropriations. The main differences are that details of third parties’ other revenue is not relevant and a summary of service providers is included.
- The service providers table shows Crown entities and non-governmental organisations providing outputs funded through the Vote, and (where applicable) the mechanism for reporting actual performance to Parliament and the expiry of the Government's resource commitment. The reporting mechanisms are typically an entity's annual report or a report by the responsible Minister required by section 32A of the PFA. Where the provider is a Crown entity that is required to produce a Statement of Intent, its annual report may contain more detailed performance information at the output class or output level. ‘Section 32A' reports include a statement of service performance in relation to the appropriation.

Part 3 - Details for Benefits and Other Unrequited Expenses#

Part 3 provides performance information about appropriations for benefits and other unrequited expenses incurred by the Crown. No departmental transactions arise under this appropriation type.

Part 3.2 Non-Departmental Benefits and Other Expenses - Information on each appropriation includes impacts and outcomes intended to be achieved, a scope statement, expense components, reasons for material changes, any conditions of use, and details of any current and past policy initiatives over the five years up to and including the Budget year.

Part 4 - Details for Borrowing Expenses#

This Part provides detail about appropriations for borrowing expenses. No departmental borrowing expense appropriations exist at present.

Part 4.2 Non-Departmental Borrowing Expenses - The set of performance information is the same as that for non-departmental benefits and other expenses, except that conditions on use are no specified.

Part 5 - Details and Expected Results for Other Expenses#

Part 5 provides detail about appropriations for:

Part 5.1 Departmental Other Expenses - It is uncommon for this category of appropriation to be utilised. In the few cases where it occurs, the performance information is the same as that for non-departmental other expense appropriations except for a summary of reporting mechanisms.
Part 5.2 Non-Departmental Other Expenses- Information on other expenses incurred by the Crown covers intended impacts and outcomes, appropriation scope, expenses analysed by component, reasons for material changes in the appropriation, expected results and standards, any conditions on use, any current and past policy initiatives, and a summary of mechanisms for reporting actual performance to Parliament.

Part 6 - Details and Expectations of Capital Expenditure#

This Part provides further details about appropriations for capital expenditure.

Part 6.1 Departmental Capital Expenditure - The purchase or development of assets by a department is made under a permanent appropriation authorised by section 24(1) of the PFA. Capital expenditure is defined in section 2 as the cost of assets acquired or developed, including tangible, intangible or financial assets, and any ownership interest in entities, but excluding inventories. The appropriation appears in the Vote that contains appropriations belonging to the department's Responsible Minister.
- Information is provided on intended impacts and outcomes of the appropriation, its scope, expenditure analysed by standard asset categories, reasons for material changes in the appropriation, and expected results. The scope statement is in a standard form for all departments. The performance information relates to the department as a whole and is not limited to any specific capital injection.
Part 6.2 Non-Departmental Capital Expenditure - Performance information for capital expenditure incurred by the Crown is the same as that for departmental capital expenditure except for not detailing asset categories and the addition of any conditions on use of the appropriation, any current and past policy initiatives, and a summary of the mechanism for reporting to Parliament.
- The scope statement indicates the form of interest or asset acquired by the Crown, such as a capital injection (equity), loan or shares.

The following table summarises the performance information that is required for a ‘standard' appropriation in each sub-part.

Summary of performance information that is required for a ‘standard' appropriation
Standard Appropriations	Part 2.1	Part 2.2	Part 3.1	Part 3.2	Part 4.1	Part 4.2	Part 5.1	Part 5.2	Part 6.1	Part 6.2
For each sub-part:
Intended impacts, outcomes or objectives	√	√	√	√	√	√	√	√	√	√
For each appropriation:
Scope of appropriation	√	√	√	√	√	√	√	√	√	√
Expenses and revenue	√	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Expenses	N/A	√	√	√	√	√	√	√	N/A	N/A
Capital expenditure	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	√	√
Reasons for change in appropriation	√	√	√	√	√	√	√	√	√	√
Output performance measures and standards	√	√	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Expected results	N/A	N/A	N/A	N/A	N/A	N/A	√	√	√	√
Conditions on use of appropriation	√	√	√	√	N/A	N/A	√	√	N/A	√
Memorandum account	√	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Current and past policy initiatives	√	√	√	√	√	√	√	√	N/A	√
Summary of service providers	N/A	√	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Reporting mechanism	N/A	√	N/A	N/A	N/A	N/A	N/A	√	N/A	√

Information on reasons for change, conditions on use, current and past policy initiatives, and reporting mechanisms appears where applicable or material. Memorandum accounts are relevant only in Part 2. Some variations exist for non-standard appropriations, including MCOAs in Parts 2.1 and 2.2 and MYAs in Parts 2.2, 5.2 and 6.2. Furthermore performance information may not be available for some appropriations.

3 Statement of Forecast Service Performance of Departments#

The third component of the Information Supporting the Estimates of Appropriations comprises the Statement of Forecast Service Performance for each department included in the sector, by reference to material already set out in Part 2.1 of Votes containing appropriations proposed to be used by the department.

4 Forecast Financial Statements of Departments#

The fourth component of the Information Supporting the Estimates begins with a Statement of Common Accounting Policies applicable to all departments. The forecast financial statements for the forthcoming financial year for each department covered by the sector includes a:

Statement of Forecast Comprehensive Income
Statement of Forecast Changes in Taxpayers' Funds
Forecast Statement of Financial Position
Statement of Forecast Cash Flows
Statement of Significant Assumptions.

Each department will include a Statement of Entity- Specific Accounting Policies detailing policies for any matters not addressed by the Statement of Common Accounting Policies (such as a “going concern” statement) or where its policies are more specific than the common policies (such as capitalisation thresholds and estimated useful lives of individual classes of assets). Notes to the Financial Statements provide additional details to assist interpretation of the accounts and to meet disclosure requirements outlined in legislation and accounting standards.

5 Statements of Intent of Departments#

The final component of the Information Supporting the Estimates presents the Statements of Intent of the departments covered by each sector. These statements contain the information required by section 40 of the PFA. They focus on the medium term and generally cover:

Nature and scope of the department's functions - A brief high-level description of the department's functions, addressing its role(s) and purpose and how it intends fulfilling them.
Strategic direction - impacts and outcomes - A brief high-level overview of the department's strategic direction covering both the impacts and outcomes the department is seeking to achieve (or contribute to) and the strategic environment in which the department operates through, in particular, its responses to the government's priorities.
Operating intentions - Information that describes how the department intends to achieve (or contribute to) those desired impacts and outcomes through its operations. This section should also include the main measures and standards the department will use to assess and demonstrate what it has achieved, including measures of outcome achievement, impact and cost effectiveness.
Managing in a changeable operating environment - Information on the risks to achievement of the desired outcomes and priorities, and the department's mitigation strategies.
Assessing organisational health and capability - The department's intentions for building and strengthening its internal capability, including its responses to the development goals for the State Services and its strategic approach to managing its asset base and forecast capital expenditure in the medium term. If capital expenditure is significant, it is in a separate section.
Additionalinformationand statutory reporting requirements - As required either by the responsible Minister or Minister of Finance, or by specific legislation.

Terms and Definitions#

The table below contains terms that are used in the Supplementary Estimates and the Information Supporting the Supplementary Estimates.

Terms and Definitions
Appropriation	An appropriation is a parliamentary authorisation for the Crown or an Office of Parliament to incur expenses or capital expenditure.
Appropriation scope	One of the defining terms of an appropriation that establishes limits on the activities for which the Crown or an Office of Parliament is authorised to incur expenses or capital expenditure under that appropriation.
Capital expenditure	The cost of assets acquired or developed including any ownership interest in entities, but excluding inventory.
Crown revenue and capital receipts	Flows accounted for as revenue and capital receipts on behalf of the Crown rather than as departmental revenue.
DDA	Department-to-department appropriation - as authorised by section 20(2) of the PFA.
Department	Generally references to Departments also include an Office of Parliament as provided in section 26E(4) of the PFA.
Expenses	Amounts consumed or losses of service potential or future economic benefits, other than those relating to capital withdrawals, in a financial year. Expenses are an accrual concept measured in accordance with generally accepted accounting practice.
GST	Goods and services tax. Appropriations are stated GST- exclusive.
MCOA	Multi-class output expense appropriation.
MYA	Multi-year appropriation.
N/A	Not applicable.
Outcomes	States or conditions of society, the economy or the environment, including changes in those states or conditions.
Outputs	Goods or services supplied by departments and other entities to external parties. Outputs are a variety of types, including policy advice, administration of contracts and grants, and the provision of specific services.
PFA	Public Finance Act 1989
PLA	Permanent legislative authority - a traditional term for a permanent appropriation, ie, one that is authorised for an indefinite period by legislation other than an Appropriation Act.
Minister	The Minister responsible for specific appropriations being sought within a Vote. As several Ministers may now hold appropriations within a single Vote, each appropriation will have a tag (M1, M2, etc) identifying the Minister responsible for that line item.
RDA	Revenue-dependent appropriation - as authorised by section 21(1) of the PFA 1989.
Responsible Minister	The Minister responsible for the financial performance of a department or Crown entity. In relation to an Office of Parliament, the Office of the Clerk of the House of Representatives, and the Parliamentary Service, the Speaker is the Responsible Minister.
Revenue from the Crown	Revenue earned by a department from the Crown for the provision of outputs to or on behalf of the Crown. These flows are accounted for as departmental revenue. Revenue from the Crown is eliminated for purposes of reporting the Crown's overall financial performance and position.
Revenue from Others	Revenue earned by a department from other departments and from third parties. Revenue from other departments is eliminated for purposes of reporting the Crown's overall financial performance and position.
Vote	A grouping of one or more appropriations that are the responsibility of one or more Ministers of the Crown and are administered by the one department.

Useful Links#

The suite of Budget 2009 documents can be accessed in the Budgets section of the website: www.treasury.govt.nz/budget/2009. Documents providing guidance on the PFA and the public sector financial management system can be accessed in the Public Finance Overviews section of the Treasury's website: www.treasury.govt.nz/publications/guidance/publicfinance.

Sector Overview#

Ministerial Statement of Responsibility#

I am satisfied that the information on future operating intentions provided by my department and included in the Information Supporting the Estimates for the Health Sector is in accordance with sections 38 and 41 of the Public Finance Act 1989 and is consistent with the policies and performance expectations of the government.

Hon Tony Ryall
Responsible Minister for the Ministry of Health
22 April 2009

Chief Executive Statement of Responsibility#

Ministry of Health#

In signing this statement, I acknowledge that I am responsible for the information contained in the Information Supporting the Estimates for the Health Sector relating to the Ministry of Health and for the Vote for which the Ministry of Health is the administering department. Specifically, this information is contained in the Ministry of Health's statement of forecast service performance, forecast financial statements and statement of intent.

This information has been prepared in accordance with the Public Finance Act 1989. It is also consistent with the proposed appropriations set out in the Appropriation (2009/10 Estimates) Bill, as presented to the House of Representatives in accordance with section 13 of the Public Finance Act 1989, and with existing appropriations and financial authorities.

Stephen McKernan
Director-General of Health
Ministry of Health
22 April 2009

Richard Morris
Chief Financial Officer
Ministry of Health
22 April 2009
Counter-signed

Performance Information for Appropriations Vote Health#

MINISTER(S) RESPONSIBLE FOR APPROPRIATIONS: Minister of Health (M36)

ADMINISTERING DEPARTMENT: Ministry of Health

MINISTER RESPONSIBLE FOR MINISTRY OF HEALTH: Minister of Health

Part 1 - Summary of the Vote#

Part 1.1 - Overview of the Vote

The Minister of Health is responsible for appropriations in the Vote for the 2009/10 financial year totalling just under $12,978 million, an increase of $899 million or 7.4% from 2008/09 (Supplementary Estimates) and covering the following:

Departmental Operating Appropriations

A total of just over $217 million (1.7% of the Vote) relates to the functions of the Ministry of Health for: policy advice, administering the purchasing of national health services, performance monitoring of the funders and providers of health and disability services, developing and administering legislation and regulations related to health service facilities, providers and public safety, ministerial servicing, and information services.

Non-Departmental Operating Appropriations

A total of nearly $12,406 million (95.6% of the Vote) is for operating expenses to be incurred on behalf of the Crown and is intended to be spent as follows:

Output Expenses

These total just over $12,382 million (95.5% of the Vote) and are to fund the purchases of health services as follows:

Nearly $9,700 million (74.8% of the Vote) to fund health services from DHBs through the DHB appropriations.
Just over $895 million (6.9% of the Vote) to purchase national disability support services.
Nearly $515 million (4.0% of the Vote) to purchase public health services.
Almost $841 million (6.5% of the Vote) to purchase national health services and provide clinical training for health professionals.
Nearly $242 million (1.9% of the Vote) to manage health sector risks.
Just over $154 million (1.2% of the Vote) to purchase primary health care services.
Nearly $36 million (0.3% of the Vote) to fund other health and disability services.

Other Expenses Incurred by the Crown

A total of nearly $24 million (0.2% of the Vote) is for other expenses to fund provider development, legal expenses and international health obligations including World Health Organisation (WHO) membership.

Capital Expenditure

A total of nearly $355 million (2.7% of the Vote) is to provide capital funding and will be spent as follows:

Just over $304 million (2.3 % of the Vote) is to provide debt or equity for District Health Boards (DHBs) or the New Zealand Blood Service to cover new investments or for other purposes agreed by the Crown including balance sheet restructuring, or to invest in specific health sector assets.
$15 million (0.1% of the Vote) is to provide interest-free loans to assist people in long term care.
Just over $35 million (0.3% of the Vote) is to purchase or develop assets for use by the Ministry of Health.

In 2009/10 the appropriations in Vote Health have been changed by creating an appropriation for Primary Care Services funding for which was previously held in Health Services Funding.

Details of these appropriations are set out in Parts 2-6 below.

Part 1.2 - High-Level Objectives of the Vote#

The Government's objective for Vote Health is to provide a 'Better, Sooner, More Convenient' health system to the New Zealand public. Over the next three years, the Government intends to make the health and disability system more adaptive, innovative and forward looking. It will be looking to improve services today while building the resilience to meet tomorrow's challenges.

Government Priorities and Outcomes - Links to Appropriations

Vote Health appropriations contribute to the Government's outcomes, impacts and objectives as described in the Statement of Intent.

The Ministry appropriations contribute to the Government's outcomes impacts and objectives as described in the State of Intent. - Health
Government Priorities	Government Outcomes	Appropriations
All New Zealanders lead longer, healthier and more independent lives Service delivery is better, sooner and more convenient The health and disability system is adaptive, innovative and continually improving	More services delivered locally in the community and in primary care centres Faster access to high quality hospital services Every dollar is spent in the best way to improve health and disability outcomes Systems and services are designed around those who need care The right mix of health workers with the right skills in the right places Leadership and planning are clear, effective and coordinated	All Appropriations

Part 1.3 - Trends in the Vote#

Summary of Financial Activity#

Summary of Financial Activity - Health
	Actual $000	Actual $000	Actual $000	Actual $000	Budgeted $000	Estimated Actual $000	Departmental Transactions Budget $000	Non- Departmental Transactions Budget $000	Total Budget $000	Estimated $000	Estimated $000	Estimated $000
	2004/05	2005/06	2006/07	2007/08	2008/09		2009/10			2010/11	2011/12	2012/13
Appropriations
Output Expenses	9,349,649	9,051,315	9,838,251	10,750,223	11,695,199	11,622,499	217,249	12,382,270	12,599,519	12,540,306	12,501,081	12,486,457
Benefits and Other Unrequited Expenses	-	-	-	-	-	-	N/A	-	-	-	-	-
Borrowing Expenses	-	-	-	-	-	-	-	-	-	-	-	-
Other Expenses	16,699	48,288	19,347	22,113	24,550	24,550	-	23,637	23,637	23,297	23,297	23,297
Capital Expenditure	224,925	492,211	318,188	268,969	358,861	272,943	35,410	319,149	354,559	367,506	166,739	114,343
Intelligence and Security Department Expenses and Capital Expenditure	-	-	-	-	-	-	-	N/A	-	-	-	-
Total Appropriations	9,591,273	9,591,814	10,175,786	11,041,305	12,078,610	11,919,992	252,659	12,725,056	12,977,715	12,931,109	12,691,117	12,624,097
Crown Revenue and Capital Receipts
Tax Revenue	-	-	-	-	-	-	N/A	-	-	-	-	-
Non-Tax Revenue	393,926	401,958	471,150	539,480	490,462	490,462	N/A	628,500	628,500	657,859	689,826	724,716
Capital Receipts	26,070	36,825	61,779	24,477	36,499	36,499	N/A	36,499	36,499	51,299	36,499	36,499
Total Crown Revenue and Capital Receipts	419,996	438,783	532,929	563,957	526,961	526,961	N/A	664,999	664,999	709,158	726,325	761,215

New Policy Initiatives#

Budget Policy Intiatives - Health
Policy Initiative	Appropriation	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	DHB appropriations (M36) Non-Departmental Output Expenses	-	439,525	439,525	439,525	439,525
Forecast Funding Track (FFT) and Demographics	Health Services Funding (M36) Non-Departmental Output Expense	-	85,841	83,841	83,841	83,841
DHB Deficit Support	Health Services Funding (M36) Non-Departmental Output Expense	-	53,332	38,332	23,332	8,332
Mental Health Blueprint Service Development	National Mental Health Services (M36) Non-Departmental Output Expense	-	20,000	20,000	20,000	20,000
Maternity (Birth Rates)	National Maternity Services (M36) Non-Departmental Output Expense	10,000	10,000	10,000	10,000	10,000
Maternity (Birth Rates)	Health Services Funding (M36) Non-Departmental Output Expense	(10,000)	-	-	-	-
Intellectual Disability (Compulsory Care and Rehabilitation)	National Disability Support Services (M36) Non-Departmental Output Expense	-	7,800	9,800	9,800	9,800
Boost Funding for Subsidised Medicines	National Contracted Services - Other (M36) Non-Departmental Output Expense	-	8,900	11,200	13,000	13,800
Funding PlunketLine	National Child Health Services (M36) Non-Departmental Output Expense	1,750	3,500	3,500	3,500	3,500
Voluntary Bonding Scheme	Health Services Funding (M36) Non-Departmental Output Expense	-	-	-	6,728	8,526
Supplementary Funding For Price Pressures and Government Commitments	DHB appropriations (M36) Non-Departmental Output Expenses	-	93,310	93,310	93,310	93,310
Boosting GP Training	Clinical Training Agency (M36) Non-Departmental Output Expense	-	2,500	5,000	5,000	5,000
GP Training and Upskilling In Primary Maternity Care	Clinical Training Agency (M36) Non-Departmental Output Expense	-	150	300	300	300
Boost Hospice Care	National Contracted Services - Other (M36) Non-Departmental Output Expense	-	15,000	15,000	15,000	15,000
Training 800 Health Professionals To Support New Elective Surgery Theatres	Health Services Funding (M36) Non-Departmental Output Expense	-	10,000	20,000	20,000	20,000
GP/Lead Maternity Carer Optional Visit	Health Services Funding (M36) Non-Departmental Output Expense	-	1,408	2,816	2,816	2,816
Encouraging More Training In Rural and Provincial Areas	Health Services Funding (M36) Non-Departmental Output Expense	-	500	1,500	1,000	1,000
Total Operating New Initiatives		1,750	751,766	754,124	747,152	734,750
Funding To Address Specific Government Priorities - Departmental Line by Line Review Savings	Administration of Legislation and Regulations National (M36) Departmental Output Expense	(2,368)	(1,260)	(274)	(224)	(224)
	Funding and Performance of Crown Entities (M36) Departmental Output Expense	(1,173)	(467)	(101)	(83)	(83)
	Administration of Funding and Purchasing of Health and Disability Support Services (M36) Departmental Output Expense	-	(1,041)	(226)	(185)	(185)
	Information Services (M36) Departmental Output Expense	(9,758)	(2,605)	(565)	(464)	(464)
	Payment Services (M36) Departmental Output Expense	(930)	(756)	(164)	(135)	(135)
	Servicing of Ministers and Ministerial Committees (M36) Departmental Output Expense	(587)	(457)	(99)	(81)	(81)
	Strategy, Policy and System Performance (M36) Departmental Output Expense	(3,942)	(1,885)	(409)	(336)	(336)
Total Departmental Line-by-Line Savings		(18,758)	(8,471)	(1,838)	(1,508)	(1,508)
Funding To Address Specific Government Priorities - Non- Departmental Line by Line Review Savings	Health Services Funding (M36) Non-Departmental Output Expense	(16,564)	(7,959)	(5,584)	(5,534)	(5,534)
	National Child Health Services (M36) Non-Departmental Output Expense	(500)	-	-	-	-
	National Contracted Services - Other (M36) Non-Departmental Output Expense	(12,650)	(5,746)	(5,746)	(5,746)	(5,746)
	National Emergency Services (M36) Non-Departmental Output Expense	(7,000)	2,000	2,000	2,000	2,000
	National Maternity Services (M36) Non-Departmental Output Expense	(795)	*	*	*	*
	National Mental Health Services (M36) Non-Departmental Output Expense	(4,200)	(4,200)	(4,200)	(4,200)	(4,200)
	Public Health Service Purchasing (M36) Non-Departmental Output Expense	(15,775)	(10,075)	(8,595)	(7,317)	(7,317)
Sector Risk Management	Health Services Funding (M36) Non-Departmental Output Expense	(27,023)	(51,226)	(47,181)	(36,375)	(18,437)
Total Non-Departmental Operating Line-by-Line Savings and Risk Pool Reduction		(84,507)	(77,206)	(69,306)	(57,172)	(39,234)
Health Capital Envelope	Equity for Capital Projects for DHBs and the New Zealand Blood Service M36) Capital Expenditure to be incurred by the Crown	-	57,249	50,000	70,000	68,128
Total Operating Initiatives		(101,515)	666,089	682,980	688,472	694,008
Total Capital Initiatives		-	57,249	50,000	70,000	68,128
Total Initiatives		(101,515)	723.338	732,980	758,472	762,136

$750 Million Allocation#

The Budget 2009 health package has been based on allocation parameters of $750 million per annum. The package includes new funding for several votes as some outputs to advance the Government's health priorities are most appropriately purchased through votes other than Vote Health. Some of the $750 million allocation has been appropriated as capital and phased across years according to the anticipated spending profile. The health package consists of $3 billion of new spending over the forecast period, as shown below:

The health package consists of $3 billion of new spending over the forecast period, as shown below - Health
	$(000) - increase/(decrease)
	2008/09	2009/10	2010/11	2011/2012	2012/13 & Outyears
Operating
Vote Health	(101,515)	666,089	682,980	688,472	694,008
Vote Education	-	1,040	3,089	5,252	7,525
Vote Social Development	-	248	647	1,019	1,401
Vote Revenue	-	-	(17)	(6)	(128)
Vote Energy	-	25,000	25,000	25,000	25,000
Total Operating	(101,515)	692,377	711,699	719,683	727,806
Capital
Vote Health Capital Envelope	-	57,249	50,000	70,000	68,128
Vote Revenue	-	-	(2)	(72)	(159)
Vote Social Development	-	374	92	1,478	2,052
Total Capital	-	57,623	50,900	71,406	70,021
Total Health Package	(101,515)	750,000	762,599	791,089	797,827
Four Year Total					3,000,000

Analysis of Significant Trends#

Total Vote: All Appropriations

Trends in comparative voted and actual total expenses (including capital) for Vote Health are shown in Figure 1 below.

A significant proportion of the new allocations are used to maintain existing services by enabling the sector to manage the impact of price pressures as well as demographic and technological change. This funding, known as the forecast funding track (FFT) and demographics, amounts to some $525 million of the $709 million allocation in Budget 2009, with the balance of the funding used for various new initiatives.

The demographic funding is allocated to DHBs based on their population shares and Department of Statistic's population projections.

Trends in total voted and actual expenses (capital and operating): Source: Ministry of Health

Departmental Output Expenses

Departmental Output Expenses: Source: Ministry of Health

The impacts of Budget policy initiatives from earlier Budgets on individual departmental output expense appropriations are detailed in Part 2.1.

Non-Departmental Output Expenses

Non-Departmental Output Expenses: Source: Ministry of Health

The increase in non-departmental output expenses in 2009/10 is due to additional funding provided for new initiatives in Budget 2008 as shown in the Budget Policy Initiatives table above, and the rephasing of expenditure for various programmes between years.

The impacts of Budget policy initiatives from earlier Budgets on individual departmental output expense appropriations are detailed in Part 2.2.

Non-Departmental Other Expenses

The non-departmental other expenses comprise around 0.2% of Vote Health and provide funding for provider development, to defend the Crown in legal claims, fund legal settlements and contribute to various international health organisations eg, the World Health Organisation.

The impact of Budget policy initiatives from earlier Budgets on individual departmental other expense appropriations are detailed in Part 5.

Departmental Capital

Further details are provided in Part 6.1.

Non-Departmental Capital

Non-Departmental Capital: Source: Ministry of Health

In 2009/10, these appropriations are largely being used to provide equity and debt for District Health Boards to develop or purchase capital assets.

Significant appropriations existed up until 2007/08 to rollover existing Crown loans held by DHBs (ie, on the basis these loans were repaid then redrawn) or refinance private sector loans held by DHBs with Crown debt.

A decision in July 2007 to extend the criteria whereby existing Crown debt could be renewed for longer terms meant appropriations are no longer required to rollover loans in 2007/08 or 2008/09 (the $392 million initially provided for this purpose in 2007/08 was returned to the Crown).

The following table details the funding for capital projects, the refinancing and rollover of existing loans held by DHBs and other capital funding requirements since 2004/05:

Actual and estimated capital expenditure by funding stream

Actual and estimated Capital Expenditure by Funding Stream - Health
Actual and Estimated Capital Expenditure $(millions)	2004/05 Actual	2005/06 Actual	2006/07 Actual	2007/08 Actual	2008/09 Estimated	2009/10 Estimated
Capital Projects	67	136	200	158	208	297
Debt Rollover or Refinancing	68	288	92	70	-	-
Equity Injections and Deficit Support	59	41	2	30	100	-
Residential Care Loans	21	14	10	11	15	15
Total Capital Expenditure	214	479	304	269	323	312

Part 1.4 - Reconciliation of Changes in Appropriation Structure#

Reconciliation of Changes in Appropriation Structure - Health
2008/09 Structure - Appropriations that have been Changed	2008/09 (Current) $000	Appropriations to which Expenses (or Capital Expenditure) have been Transferred	Amount Moved $000	2009/10 Structure - Appropriations affected by the Changes in Appropriation Structure	2008/09 (Restated) $000	2009/10 $000
Heath Services Funding	175,204	Transferred to Primary Health Care Strategy	(154,535)	Health Services Funding	20,669	242,539
		Transferred from Health Services Funding	154,535	Primary Health Care Strategy	154,535	154,535
Total	175,204		-		175,204	397,074

Explanations of the reasons for changing the appropriation structure are noted in the details of each appropriation in Parts 2-6.

Part 2 - Details and Expected Performance for Output Expenses#

Part 2.1 - Departmental Output Expenses#

Intended Impacts, Outcomes and Objectives

Intended Impacts, Outcomes and Objectives - Part 2.1 Departmental Output Expenses - Health
Intended Impacts, Outcomes or Objectives of Appropriations	Appropriations
Impacts: Contribute to system outcomes by funding and purchasing health and disability support services on behalf of the Crown. The services funded and purchased will include some disability support services, public health services, specified screening services, mental health services, national personal health services, Maori health services and post graduate clinical education and training. Objectives: This departmental output expense enables the Ministry to provide: Leadership of the broader health sector through implementation of Ministerial and Cabinet decisions, policy and strategy development, and enhanced sector accountability. Planning to identify and balance priorities and obligations to determine the broad spread of purchasing, and service development to describe relevant and appropriate services, ensuring an outcome focus while being clear on minimum input requirements. A purchasing process that ensures the identification and contracting of the most appropriate service provider, this includes renewed use of existing providers upon contract expiry where supported. Performance management to ensure the best possible service is delivered by the contracted provider, and evaluation to determine whether the outcomes are being achieved and to provide advice for improvement. The incorporation of improved outcomes for disadvantaged groups into the delivery of services.	Administration of Funding and Purchasing of Health and Disability Support Services on behalf of the Crown
Impacts: Contribute to system outcomes by administering legislation and regulations and meeting legislative requirements. This is required to administer and enforce statutory obligations, and meet health-specific legislative requirements. Objectives: This departmental output expense enables the Ministry to: Maintain relationship between the Ministry and OECD, UN, WHO, APEC, Commonwealth Secretariat, the Australian Health Ministers' Conference, the Australian Health Ministers Advisory Council (officials), and the Commonwealth Fund. Administer the Medicines Act 1981 to assure safety, quality, efficacy or performance of therapeutic products. Provide leadership to Designated Officers in DHBs/Public Health Units, and strengthen networks/collaboration with other sectors. Develop and maintain systems for communicational with and amongst DHBs, and with other government agencies in major regional and national emergencies. Implement and evaluate health emergency exercise programme. Manage enforcement/complaints made under Health and Disability Services (Safety) Act 2001. Initiate and engage with other government agencies in workshops and advisory groups to enhance all of government responses to emergencies. Lead health emergency planning and response to meet statutory obligations. Administer legislation, currently these are Intellectual Disability Compulsory Care and Rehabilitation Act 2003 and Part 4A of the NCSP Register. Licensing of persons to use irradiating apparatus and/or radioactive material under the Radiation Protection Act 1965.	Administration of Legislation and Regulations
Impacts: Contribute to system and societal outcomes by providing advice and sector-wide leadership on the ownership and performance of Crown Entities. Objectives: This departmental output expense enables the Ministry to provide: (a) DHB and Crown entity ownership advice Developing advice to DHBs on funding and planning. Monitoring, influencing and advising on employment relations in the health sector. Advice on ministerial appointments to the governing bodies of DHBs and other Crown entity and on the expectations of board members. Developing advice to DHBs and other Crown Health entities on funding and planning. Managing DHBs' Crown Funding Agreements. Provide non-financial monitoring of DHBs including: Ministry assessment, feedback, re-assessment, performance advice to the Minister, snapshot reports, reports to Treasury and Production reports. (b) DHB and Crown entity performance management Administer the Monitoring and Intervention Framework committee in its assessment and evaluation of DHB performance against the monitoring and intervention framework, and in its response to material changes in DHB performance. Monitor DHBs directly accountable for achievement of DAPs and relevant nationwide health policies and targets via the MIF process and conduct DHB reviews where applicable. (c) Improving elective services Central Purchasing and monitoring of additional elective surgery, assessments and procedures. Monitoring of Elective Services Patient Flow and improvement of the integrity of the National Booking System.	Funding and Performance of Crown Entities
Impacts: Contribute to system and societal outcomes by collecting and analysing health information services. Objectives: This departmental output expense enables the Ministry to: Monitor the health of the New Zealand population by managing the 'New Zealand Health Monitor', National Population Health Survey Programme. Provide Information from National Collections to the health and disability system and to the public to better inform their decision making. Manage the National Health and Disability Information Infrastructure by providing foundations to support the sharing of information, the establishment and effective functioning of clinical networks, planning, funding and delivery of healthcare in New Zealand. Manage a sustainable and effective health information architecture and investment framework by providing a blueprint for an improved ability to target IT investments across the sector and encouraging use of shared services, common systems and processes.	Information Services
Impacts: Contribute to system and societal outcomes by administering and monitoring service agreements and payments for health benefits and service agreements. Objectives: This departmental output expense enables the Ministry to provide: A national shared service for processing all DHB and National Services Agreements. All appropriately completed agreements will be processed within agreed timeframes (up to a volume of 11,000 agreements). A national shared service for processing all DHB and National Services Payments. All appropriately completed payments will be processed within agreed timeframes (up to a volume of 90 million transactions).	Payment Services
Impacts: Contribute to system and societal outcomes by providing servicing of the Minister of Health, Associate Ministers of Health and Parliament. Objectives: These services allow the Ministry to provide: A timely 'no surprises' policy by consistently informing Ministers in advance of matters of media or public interest that are, or may be, entering the public domain. Providing advice to the health Ministerial team to support enhanced sector-wide leadership and accountability. Other advice to ministers not related to interventions planned for the other departmental output expenses but which is either requested by ministers or is of such significance that a minister would be at risk if s/he was not briefed on the matter at hand. Preparation of draft responses to ministerial correspondence, parliamentary questions, requests for briefing reports and speeches. Replies to questions asked by the Health Select Committee in relation to the Estimates and Financial Review examinations, responses to petitions, select committee inquiries, and advice to select committees in their consideration of bills. Advice on appointments to ministerial and occupational statutory bodies and committees. Administrative and advisory services to Ministerial advisory committees serviced by the Ministry.	Servicing of Ministers and Ministerial Committees
Impacts: Contribute to system and societal outcomes by progressing identified areas of focus. Objectives: This departmental output expense enables the Ministry to deliver initiatives that progress the Minister's priorities of: More services delivered locally in the community and in primary care centres. Faster access to high quality hospital service. Every dollar is spent in the best way to improve health and disability outcomes. Systems and services are designed around those who need care. The right mix of health workers with the right skills in the right places. Leadership and planning are clear, effective and coordinated.	Strategy, Policy and System Performance

Administration of Funding and Purchasing of Health and Disability Support Services (M36)

Scope of Appropriation

Administration of the funding and purchasing of health and disability support services on behalf of the Crown, including post-clinical education and training. Services funded and purchased include some national personal health services, Maori health services, disability support services, mental health services, public health services and national screening services.

Expenses and Revenue

Expenses and Revenue - Administration of Funding and Purchasing of Health and Disability Support Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	28,822	27,822	23,614
Revenue from Crown	28,541	28,541	23,593
Revenue from Other	281	281	21

Reasons for Change in Appropriation

The increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below).

Output Performance Measures and Standards

Output Performance Measures and Standards - Administration of Funding and Purchasing of Health and Disability Support Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Planning
An annual service plan by NDE output expense	N/A	Not achieved	Quantity: One per year (with constituent parts for each NDE class or sub-class) Quality: The relevant sectors have been involved in developing the plan Timeliness: Plan completed for the forthcoming financial year by 30 June
Service Development
An annual programme of activity to improve the outcomes of the services that are purchased	Quantity: One programme of activity with all services being purchased clearly described and with a purchase plan Quality: Purchase plans conform to MoH standards Relevant users and sector groups will be involved in the process of developing the service specifications Timeliness: Purchase plans will be completed before service purchasing commences Where they are prompted by a contract expiring a purchase plan will be completed before that expiry	Achieved	Quantity: One programme of activity with all services being purchased clearly described and with a purchase plan Quality: Purchase plans conform to MoH standards Relevant users and sector groups will be involved in the process of developing the service specifications Timeliness: Purchase plans will be completed before service purchasing commences Where they are prompted by a contract expiring a purchase plan will be completed before that expiry
Purchase Management
Services are purchased (repurchased) according to the relevant purchase plan	Quantity: All funded services as they come up for contract renewal and all new services Quality: Sound contracts awarded through a transparent process that conforms to Ministry standards, and includes the involvement of the relevant users or their representatives and the relevant sector representatives Timeliness: Services are contracted for according to the timeframes within the relevant purchase plan	Achieved	Quantity: All funded services as they come up for contract renewal and all new services Quality: Sound contracts awarded through a transparent process that conforms to Ministry standards, and includes the involvement of the relevant users or their representatives and the relevant sector representatives Timeliness: Services are contracted for according to the timeframes within the relevant purchase plan
Performance Management
For each contract and provider; contract is managed, relationship is managed, issues are managed	Quantity: 100% of contracts Quality: All contracts are monitored; all complaints acted on, active management of relationships with all providers, management of issues as they arise Timeliness: Ongoing through the life of the contract	Achieved	Quantity: 100% of contracts Quality: All contracts are monitored; all complaints acted on, active management of relationships with all providers, management of issues as they arise Timeliness: Ongoing through the life of the contract
Meeting the needs of disadvantaged groups
The incorporation of improved outcomes for disadvantaged groups into the delivery of services	Quantity: The service plan, service descriptions and purchase plans all identify outcomes and measures for disadvantaged groups Quality: Strategic inequality outcomes and targets are agreed	Achieved	Quantity: The service plan, service descriptions and purchase plans all identify outcomes and measures for disadvantaged groups Quality: Strategic inequality outcomes and targets are agreed

Memorandum Account

Memorandum Account - Administration of Funding and Purchasing of Health and Disability Support Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Problem Gambling
Opening Balance at 1 July	1,108	1,108	1,108
Revenue	1,378	1,378	1,378
Expenses	1,378	1,378	1,378
Transfers and Adjustments	-	-	-
Closing Balance at 30 June	1,108	1,108	1,108

The Crown cost of these appropriations are offset by levies collected by IRD from the gambling industry.

Current and Past Policy Initiatives

Current and Past Policy Initiatives - Administration of Funding and Purchasing of Health and Disability Support Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Savings	2009/10	-	(1,041)	(226)	(185)	(185)
Autism Spectrum Disorder Work Programme	2008/09	-	45	45	45	45
Improving the Quality of Antenatal Screening for Down's Syndrome	2008/09	-	43	262	-	-
National Drug Policy - Mass media and education campaign on illicit drugs	2008/09	-	25	25	25	25
Suicide prevention and National Depression Initiative	2008/09	-	75	75	75	75
Primary Health Care Strategy Implementation	2008/09	-	510	510	510	510
Response to Health Select Committee Inquiry into Obesity and Type 2 Diabetes	2008/09	-	1,326	1,206	1,206	1,176
Youth access to health services	2008/09	-	180	80	80	80
Migrant Health Initiative	2008/09	-	83	100	100	-
HPV vaccine and immunisation social marketing campaign	2008/09	2,417	4,137	927	927	927
Pacific Health Provider and Workforce Development	2008/09	-	200	200	200	200
Sanitary Works Subsidy Scheme (SWSS) for Sewerage	2008/09	-	280	280	280	280 *
Additional Elective Surgical Volumes	2007/08	500	500	500	500	500
Environmental Support Services	2007/08	370	290	330	330	330
Smoking Cessation Programmes	2007/08	300	300	300	300	300
Support for Complementary Medicines and Medical Devices Sectors During Transition to the Australia-New Zealand Therapeutic Products Authority	2007/08	7,980	10,390	10,440	8,460	8,530
Problem Gambling Levy	2007/08	253	681	311	-	-
Antenatal Down's Syndrome Screening Programme	2007/08	2,100	2,100	2,100	2,100	2,100
Suicide Prevention and National Depression	2007/08	310	310	210	210	210
Develop the Australia-New Zealand Therapeutics Products Authority	2007/08	4,500	-	-	-	-
Transitional Funding For Primary Healthcare Initiatives	2007/08	100	100	-	-	-
Programmes To Prevent Family Violence	2007/08	160	160	160	160	160
Autism Spectrum Disorder Work Programme	2007/08	120	135	135	135	135
Cochlear Implant Services For Adults and Newborns	2007/08	60	80	50	30	30
Provide Support For Family Caregivers	2007/08	100	100	100	100	100
AIMHI Health Community Schools - Nurse Component and Project Evaluation	2007/08	175	100	100	40	40
National Drug Policy - Mass Media and Education Programme On Illicit Drugs	2007/08	25	25	25	25	25
Review of Emergent Screening Technology	2007/08	100	100	100	100	100
Meningococcal Vaccine Ongoing Delivery	2006/07	228	250	-	-	-
Drinking Water Assistance Programme	2005/06	356	356	356	356	356
Community Action on Drugs	2005/06	53	53	53	53	53
National Depression Awareness	2005/06	133	133	133	133	133
Orthopaedics	2004/05	444	444	444	444	444
Suicide Guidelines for Accident and Emergency Departments	2004/05	18	18	18	18	18

Administration of Legislation and Regulations (M36)#

Scope of Appropriation#

Implementation, enforcement and administration of health legislation and regulations.

Expenses and Revenue#

Expenses and Revenue - Administration of Legislation and Regulations (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	34,879	34,579	36,724
Revenue from Crown	20,221	20,221	21,317
Revenue from Other	14,658	14,658	15,407

Reasons for Change in Appropriation#

The change in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below).

Output Performance Measures and Standards#

Output Performance Measures and Standards - Administration of Legislation and Regulations (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Administration of New Zealand's international and WHO obligations
Maintain relationship between the Ministry and OECD, UN, WHO, APEC, Commonwealth Secretariat, the Australian Health Ministers' Conference, the Australian Health Ministers Advisory Council (officials), and the Commonwealth Fund	Quality: Support New Zealand's membership of WHO Executive Board Effective functioning of national focal point for IHR Timeliness: Ongoing, as required	Achieved	Quality: Support New Zealand's membership of WHO Executive Board Timeliness: Ongoing
Administration of the Medicines Act 1981 and accompanying regulations
Administration of the Medicines Act 1981 to assure safety, quality, efficacy or performance of therapeutic products.	N/A	Achieved	Quantity: Medsafe will complete an evaluation of approximately (demand driven) 290 new medicine applications (NMAs) in the 12 month period. Approximately (demand driven) 1,500 changed medicine notifications (CMNS) will be evaluated Quality: Completed evaluations are reviewed against Medsafe's guidelines, policies and procedures in accordance with Medsafe's quality system. Timeliness: Evaluations will be completed within the timeframes specified in the Medsafe Quality System 100% of CMNs will be responded to within 45 days
An effective legislative and policy environment for improving, promoting and protecting public health
Provide leadership to designated officers in DHBs/Public Health Units (PHUs), and strengthen networks/collaboration with other sectors	Quantity: Provide professional leadership to the designated officers in DHBs/PHUs Provide advice to other key agencies on actions to improve public health	Achieved	Quantity: Provide professional leadership to the designated officers in DHBs/PHUs Provide advice to other key agencies on actions to improve public health
Critical national communications and reserve supplies
Develop and maintain systems for communications with and amongst DHBs, and with other government agencies in major regional and national emergencies	N/A	Achieved	Quantity: Maintain WebEOC and satellite phone networks on a 24/7 basis for emergency communications Quality: Exercise WebEOC and satellite phone networks locally and nationally in real time a minimum of ten times, and modify procedures as required
Exercise responses to critical emergencies at national and local levels
Implement and evaluate health emergency exercise programme	N/A	Under development	Quantity: Implement and/or participate in a minimum of ten emergency exercises involving DHBs, ambulance providers and/or government agencies Quality: Lessons learned from exercises are analysed and supplied to participating agencies in order to inform better planning
HealthCert
Management of enforcement/complaints made under Health and Disability Services (Safety) Act 2001	Quantity: An estimated 135 responses (demand driven) Quality: 95% of responses responded to within 7 days 95% of reports completed within 30 working days of an investigation audit being completed and obtaining all relevant information obtained	Achieved	Quantity: An estimated 135 responses (demand driven) Quality: 95% of responses responded to within 7 days 95% of reports completed within 30 working days of an investigation audit being completed and obtaining all relevant information obtained
Intersectoral emergency planning and response
Initiate and engage with other government agencies in workshops and advisory groups to enhance all of government responses to emergencies	N/A	Achieved	Quantity: Develop health advice and input into 20 action plans, exercises, coordination meetings or strategies Convene two meetings of the Intersectoral Pandemic Planning Group Quality: Written health advice provided by MoH is internally peer reviewed, and adapted as relevant following input from other agencies
Lead health sector response to emergencies
Lead health emergency planning and response to meet statutory obligations	N/A	Achieved	Quantity: A minimum of three regional meetings per annum are maintained in each of the Auckland, Midland, Central and Southern regions Quality: Evaluation of outcomes of meetings by participants
Legislation and policy
Administration of the Intellectual Disability Compulsory Care and Rehabilitation Act 2003 and Part 4A of the NCSP Register	Quantity: Service capacity is maintained so that services are available for persons subject to compulsory care orders under the Acts Quality: Legislative requirements met Timeliness: Ongoing as required by orders of the court	Achieved	Quantity: Service capacity is maintained so that services are available for persons subject to compulsory care orders under the Acts Quality: Legislative requirements met Timeliness: As required by orders of the court
Radiation protection services and emergency management
Radiation Protection Act 1965: Licensing of persons to use irradiating apparatus and/or radioactive material	Quantity: An estimated 3,300 licences per year Quality: 95% to be completed within 10 days of receipt of all required information	Achieved	Quantity: An estimated 3,300 licences per year Quality: 95% to be completed within 10 days of receipt of all required information

Memorandum Account#

Memorandum Account - Administration of Legislation and Regulations (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
National Radiation Laboratory: Licensing fees account
Opening Balance at 1 July	591	305	336
Revenue	757	747	747
Expenses	737	659	654
Transfers and Adjustments	-	(57)	(57)
Closing Balance at 30 June	611	336	372
Medsafe fees
Opening Balance at 1 July	1,096	1,147	2,097
Revenue	8,869	9,336	7,469
Expenses	8,221	8,386	9,386
Transfers and Adjustments	-	-	-
Closing Balance at 30 June	1,744	2,097	1,180

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Administration of Legislation and Regulations (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(2,386)	(1,260)	(274)	(224)	(224)
Increase fraud and investigations capacity	2008/09	-	1,000	1,000	-	-
Problem Gambling	2003/04	698	698	698	698	698

Funding and Performance of Crown Entities (M36)#

Scope of Appropriation#

Administration of funding to DHBs and Crown Entities and the provision of advice on planning and performance, supporting and monitoring the implementation of strategic plans, assistance to meet legislative obligations and regulatory frameworks and advice on governance issues to Ministers and Crown Entities.

Expenses and Revenue#

Expenses and Revenue - Funding and Performance of Crown Entities (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	8,548	8,548	9,109
Revenue from Crown	8,433	8,433	9,099
Revenue from Other	115	115	10

Reasons for Change in Appropriation#

The increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below) and the reallocation of costs between appropriations.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Funding and Performance of Crown Entities (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
DHB and Crown entity ownership advice
Developing advice to DHBs and other Crown Health entities on funding and planning	Quantity: Funding package distributed and advice on all DAPs and SOIs provided Quality: Robust and timely advice Timeliness: 30/06/09	Achieved	Quantity: Funding package distributed and advice on all DAPs and SOIs provided Quality: Robust and timely advice Timeliness: Annually
Monitoring, influencing and advising on employment relations in the health sector	N/A	Achieved	Quantity: Health Reports and verbal briefings as required Quality: Robust and timely advice Timeliness: As required
Advice on ministerial appointments to the governing bodies of DHBs and other Crown entity and on the expectations of board members	Quantity: Health Reports and verbal briefings as required Quality: Robust and timely advice Timeliness: As required	Achieved	Quantity: Health Reports and verbal briefings as required Quality: Robust and timely advice Timeliness: As required
Managing DHBs' Crown Funding Agreements	Quantity: Main agreements updated Four omnibus rounds completed Timeliness: 30/06/09	Achieved	Quantity: Main agreements updated Four omnibus rounds completed Timeliness: Quarterly
Provide non-financial monitoring of DHBs including: Ministry assessment, feedback, re-assessment, performance advice to the Minister, snapshot reports, reports to Treasury and production reports	N/A	Achieved	Quantity: As relevant, four quarterly reports produced for the Minister, ad hoc reports as required and other reports to agreed frequency Timeliness: Quarterly
DHB and Crown entity performance
Administer the MIF committee in its assessment and evaluation of DHB performance against the Monitoring and Intervention Framework (MIF), and in its response to material changes in DHB performance	Quantity: Ten meetings per year Quality: MIF meetings are held on programme and recommendations dealt with in a timely manner Timeliness: Regularly	Achieved	Quantity: Ten meetings per year Quality: MIF meetings are held on programme and recommendations dealt with in a timely manner Timeliness: Responses are sent within eight weeks of confirmed material deterioration of DHB performance
Improving elective services
Central purchasing and monitoring of additional elective surgery, assessments and procedures	N/A	Under development	Quantity: A 20% increase above DHB base levels representing an average of 4000 extra discharges from the total Elective Discharges
Monitoring of elective services patient flow and improvement of the integrity of the national booking system	N/A	Achieved	Quantity: Monthly Reports provided, including monitoring of variations in categories of planned and staged, and active review

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Funding and Performance of Crown Entities (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(1,173)	(467)	(101)	(83)	(83)

Information Services (M36)#

Scope of Appropriation#

Provision of national health information services.

Expenses and Revenue#

Expenses and Revenue - Information Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	61,921	59,921	62,859
Revenue from Crown	61,220	61,220	62,451
Revenue from Other	701	701	408

Reasons for Change in Appropriation#

The increase in this appropriation is caused mainly by funding changes from current and past policy initiatives (almost $11 million) see below. This increase is partly offset by a reallocation of costs between departmental output appropriations.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Information Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Health Information Architecture and Investment Framework
A blueprint for a sustainable and effective health and disability information management and technology environment, providing improved ability to target IT investments.	N/A	Under development	Quantity: National health and disability information architecture is system wide Approved IT investment framework Approved framework for the development and use of shared services Quality: Evidence of clinical leadership and sector and community engagement in the development of the architecture and framework Evidence of sector uptake of the National systems architecture Evidence of increased use of shared services, common systems and processes Investments will have an accompanying advice as to their priority and benefits
Monitoring the health of New Zealand population
The New Zealand Health Monitor National Population Health Survey Programme	Quantity: Main survey and data collection commences for New Zealand adult nutrition, tobacco use and oral health surveys Quality: Milestones and reports delivered within agreed timeframe and budget	Achieved	Quantity: Main survey and data collection commences for New Zealand adult nutrition, tobacco use and oral health surveys Quality: Milestones and reports delivered within agreed timeframe and budget
National Collections and Reporting to support Patient Safety and Quality of Care
Provision of information from national collections to the Health and Disability System and to the public to better inform their decision making	N/A	Achieved	Quality: Rationalisation and simplification of information, payments and agreements systems Information is provided as per standards detailed in the OPF (Operational Policy Framework) and DHB MoU
National Health and Disability Information Infrastructure
Provide foundations of national health and disability information infrastructure to support the sharing of information, the establishment and effective functioning of clinical networks, planning, funding and delivery of healthcare in New Zealand	N/A	Achieved	Quantity: Delivery of: secure portal; data centre hosting and transition; information collection and analysis stage 1 business case; self service agreements management; connected health directory, recipient identity and business fields data service; provider identity, roles and relationships Quality: Clinical support for projects Rationalisation and simplification of information, payments and agreements systems Projects will be delivered within agreed timeframes, budget and quality performance measures.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Information Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(9,758)	(2,605)	(565)	(464)	(464)
Key Directions	2008/09	7,100	3,800	900	900	900
Connected Health Information System	2008/09	-	10,000	10,000	10,000	10,000
Develop Integrated Data Management Systems - Tranche One	2007/08	17,700	14,700	14,700	14,700	14,700
National Drug Policy - Online Drug Data and Information Systems	2007/08	100	100	100	-	-

Payment Services (M36)#

Scope of Appropriation#

Provision of health sector payments and the administration of contracts and payments.

Expenses and Revenue#

Expenses and Revenue - Payment Services (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	20,042	19,542	19,937
Revenue from Crown	19,897	19,897	19,932
Revenue from Other	145	145	5

Reasons for Change in Appropriation#

The decrease in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below) and cost allocations between appropriations.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Payment Services (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Health Agreements
A national shared service for processing all DHBs and national services agreements (demand driven)	N/A	Achieved	Quantity: All appropriately completed agreements will be processed (expected maximum volume of 11,000 agreements) Quality: All appropriately completed agreements will be processed with error rates within agreed limits Timeliness: All appropriately completed agreements will be processed within agreed timeframes (up to a volume of 11,000 agreements)
Health Payments
A national shared service for processing all DHBs and national services payments (demand driven)	N/A	Achieved	Quantity: All appropriately completed payments will be processed (expected maximum volume of 90 million) Quality: All appropriately completed payments will be processed with error rates within agreed limits Timeliness: All appropriately completed payments will be processed within agreed timeframes (up to a volume of 90 million transactions)

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Payment Services (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(930)	(756)	(164)	(135)	(756)

Servicing of Ministers and Ministerial Committees (M36)#

Scope of Appropriation#

Provision of administrative and advisory support services to the Minister and Associate Ministers of Health and ministerial advisory committees.

Expenses and Revenue#

Expenses and Revenue - Servicing of Ministers and Ministerial Committees (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	15,629	15,129	15,431
Revenue from Crown	15,515	15,515	15,402
Revenue from Other	114	114	29

Reasons for Change in Appropriation#

The decrease in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below) and through the reallocation of costs between appropriations.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Servicing of Ministers and Ministerial Committees (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Policy Advice
Policy advice to Ministers	Reconfigured measure	Achieved for 2008/09 policy measures	Quantity: All advice and briefings provided as agreed between the Minister and the Ministry Quality: in accordance with the Statement of Objectives Timeliness: Completed within the requested timeframes
Servicing of Ministers, Ministerial Committees and Parliament
Draft replies to Parliamentary questions	Quality: All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 95% of draft replies completed within required timeframe	Achieved	Quality: All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 95% of draft replies to parliamentary questions completed within required timeframe
Draft responses to Ministerial correspondence	Quality: All draft replies peer reviewed and signed out in accordance with delegated authority; and 93% of replies signed off at first draft Timeliness: 90% of draft replies to Parliamentary questions completed within the required time frame	Achieved	Quality: All draft replies peer reviewed and signed out in accordance with delegated authority 93% of replies signed off at first draft Timeliness: 90% of draft replies to Ministerial correspondence completed within the required time frame
Make appointments to Ministerial committees and statutory bodies and committees, and support Ministerial Advisory Committees	Quality: All appointments made in accordance with the New Zealand Public Health and Disability Act 2000, DPMC and SSC requirements Timeliness: 30/06/09	Achieved	Quality: All appointments made in accordance with the New Zealand Public Health and Disability Act 2000, DPMC and SSC requirements
Provide Ministers with briefing papers and speeches	Quality: All advice and briefings will meet the quality standards for the provision of policy advice and briefings set out in the Statement of Objectives All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 95% completed within the required time frame	Achieved	Quality: All advice and briefings will meet the quality standards for the provision of policy advice and briefings set out in the Statement of Objectives All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 95% completed within the required time frame
Provide responses to requests for official information	Quality: All decisions made in accordance with the provisions of the Official Information Act 1982 All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 100% of requests for official information completed within the required time frames	Not achieved	Quality: All decisions made in accordance with the provisions of the Official Information Act 1982 All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 100% of requests for official information completed within the required time frames
Provide responses to written questions from Select Committee	Quality: All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 100% of written responses provided within the time frame requested by the Minister of Health and the Health Committee	Achieved	Quality: All draft replies peer reviewed and signed out in accordance with delegated authority Timeliness: 100% of written responses provided within the time frame requested by the Minister of Health and the Health Committee
Statutory and Ministerial Advisory Committee Support
Support the work of statutory and Ministerial advisory committees	Reconfigured measure	Achieved	Quantity: Provide support as required

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Servicing of Ministers and Ministerial Committees (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(587)	(457)	(99)	(81)	(81)
National Health Epidemiology and Quality Assurance Committee	2007/08	500	500	500	500	500
National Drug Secretariat	2004/05	124	124	124	124	124
National Drug Intelligence	2003/04	133	133	133	133	133

Strategy, Policy and System Performance (M36)#

Scope of Appropriation#

Provision of health policy advice, leadership for the health and disability sector, and research and evaluation of long term strategic plans and regulatory frameworks.

Expenses and Revenue#

Expenses and Revenue - Strategy, Policy and System Performance (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	48,153	46,153	49,575
Revenue from Crown	47,677	47,677	49,174
Revenue from Other	476	476	401

Reasons for Change in Appropriation#

The increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below) and through the reallocation of costs between appropriations.

Output Performance Measures and Standards#

Output Performance Measures and Standards - Strategy, Policy and System Performance (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Bowel Cancer Programme
Complete the development of the bowel cancer screening pathway and development of interim bowel cancer screening programme quality standards	N/A	Under development	Quantity: All parts of the screening pathway have been informed by stakeholder engagement and detailed policy work Quality: The agreed pathway is consistent with international best practice and is supported by key stakeholders
Better primary and community services that meet people's needs
Cabinet paper detailing primary health care strategy achievements in 2009	N/A	Achieved	Quantity: Annual Cabinet paper
Clinical Services Development
Implementation of an action plan to support DHBs to make improvements against the national ED length of stay	N/A	Under development	Quantity: Data is collected to monitor the national ED length of stay for people who present to emergency departments transfer, discharge or admitted within six hours Quality: Priority activities in DHB plans are identified and implementation started
Establish strategic frameworks for health workforce
Work with sector to boost the number of funded GP registrar training places.	N/A	Under development	Quantity: Boost the number of funded GP registrar training places by 50 places
Work with Universities and training colleges to boost the number of funded medical student places.	N/A	Under development	Quantity: The number of funded medical student places increased by 60 places
Healthy Eating - Healthy Action (HEHA)
Implementation of a revised work programme to increase physical activity and reduce obesity	N/A	Under development	Quantity: A revised work programme is developed to reflect the Government's priority areas of work Quality: DHBs are adequately supported in implementing the Government's priorities for increasing physical activity and reducing obesity
Improve prioritisation of additional funding to Vote Health
Budget process input includes prioritisation process for new initiatives	Quantity: Vote Health prioritisation process Quality: New initiatives prioritised considering government and Minister's priorities and Health Targets	Achieved	Quantity: Vote Health prioritisation process Quality: New initiatives prioritised considering government and Minister's priorities and Health Targets
Improve the position of the medicines sector to deliver excellent health and disability support outcomes.
Strategic implementation of Actioning Medicines New Zealand	Quantity: Examine the process for setting the community pharmaceutical budget	Not achieved	Quantity: Implement Actioning Medicines New Zealand
Improving interface of addiction treatment services with Justice sector
The Ministry will work with the Justice sector (Ministry of Justice, Police, and Corrections) to reduce offending by improving the interface with addiction treatment services in the community	N/A	Under development	Quantity: Assist all DHBs and the relevant government agencies Quality: Consultation undertaken with key stakeholders
Long Term Health Services Planning
Finalise options for a coherent policy framework to guide comprehensive long term service planning at regional and national levels, aligned with Government's priorities	N/A	Under development	Quantity: Service planning policy framework, guidelines and tolls and methods developed
Managing the Ministry's responsibilities under the Gambling Act 2003
The Ministry will develop, consult on and obtain Cabinet approval for a revised integrated strategy for the prevention and minimisation of gambling harm	N/A	Achieved	Quantity: Strategic plan 2010-2016 Service plan 2010-2013 A problem gambling levy for the 2010-2013 period Quality: Strategy completed
Maori Innovations
Continued implementation of the Maori Provider Development Scheme	N/A	Achieved	Quantity: All DHBs will be involved in the assessment of their regional provider applications Quality: MPDS supports provider growth
Meeting the needs of particular at risk groups
Monitoring how effectively the Ministry of Health work programme is improving Maori health	N/A	Achieved	Quantity: Monitoring report completed
National Alcohol Action Plan
Development of interagency action plans to guide Government responses to reducing alcohol related harm	Quantity: Two action plans produced Quality: Develop a draft action plan and undertake public consultation prior to seeking Cabinet agreement	Achieved	Quantity: A new National Alcohol Action Plan A new action plan focusing on Fetal Alcohol Spectrum Disorder Quality: Develop a draft action plan and undertake public consultation prior to seeking Cabinet agreement
National Cancer Programme
Implementation of work plan for reducing cancer wait times	N/A	Achieved	Quantity: Wait time indicators for medical oncology and surgery are developed, medical oncology and radiation wait time measures are monitored and future sector capacity requirements to reduce wait times are identified Quality: All relevant DHBs are supported to collect and report data reliably
National Immunisation Programme
a) Deliver the National Immunisation Programme b) Review the design of the National Immunisation Register c) Simplify and streamline contracts for immunisation services	N/A	Achieved	Quantity: 87% of 2-year olds fully immunised by July 2010 (95% by July 2012) Quality: Ministry and DHBs agree to a set of functions needed and the division between national and district functions Timeliness: c) Agreed set of functions by 30/12/2009, new contracts in place by 30/06/2010
Nursing Innovations
Commence implementation of an agreed nursing workforce plan	N/A	Under development	Quantity: The development of a nursing workforce plan Quality: Forecast and data collection to monitor changes to the nursing workforce
Oral Health
Continued implementation of a work programme for improving child and youth oral health	N/A	To be reforecast	Quantity: Quarterly monitoring and feedback to 21 DHBs on the progress of their business case implementation Quality: DHBs' business case implementation progressing in accordance with agreed plans and service models
Pacific Innovations
Implementation of the new PPDF Purchasing plan for 2009/10 to 2010/11	N/A	Achieved	Quantity: Collection of Pacific providers' workforce baseline data from 100% (all) of the clinical Pacific health service providers Quality: Priority is given to the 3 DHBs with the largest Pacific populations (Auckland DHBs)
Primary Health Care
Continued implementation of a work programme to reduce ambulatory sensitive (avoidable) admissions	N/A	To be reforecast	Quantity: There will be a decline in admissions to hospital that are avoidable or preventable by primary health care across all population groups Quality: Services are shifted from secondary care to primary health care inline with DHBs' 2009/10 District Annual Plans and policy development to support the establishment of Integrated Family Health Centres is completed
Primary Mental Health Care Service Delivery
A guidance document for the sector on primary mental health care service delivery	N/A	Under development	Quality: Document approved by Minister
Quality Improvement
Implementation of a work programme that supports quality improvement and innovations in DHBs with a focus on improving stroke services	N/A	Under development	Quantity: The development of agreed quality improvement initiatives and a stroke service improvement plan Quality: DHBs are adequately supported in implementing quality improvement and a stroke service plan
Tobacco
Continued implementation of a work programme to reduce harm caused by tobacco with a focus on increasing cessation	N/A	To be reforecast	Quantity: Active clinical leadership across all DHBs, majority of health workforce trained in ABC, support in implementation for DHBs to meet cessation health target, and preparation to support transfer of local funding for tobacco control to DHBs completed Quality: Success indicators for ABC are trending up towards targets

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Strategy, Policy and System Performance (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Line-by-Line Review	2008/09	(3,942)	(1,885)	(409)	(336)	(336)
Assisted Human Reproduction	2005/06	444	444	444	444	444

Part 2.2 - Non-Departmental Output Expenses#

Intended Impacts, Outcomes and Objectives#

Intended Impacts, Outcomes and Objectives - Part 2.2 NonDepartmental Output Expenses - Health
Intended Impacts, Outcomes or Objectives of Appropriations	Appropriations
Outcome: Develop an appropriately skilled workforce to meet the workforce's needs of health and disability services to New Zealanders. Impact/Objectives: Post-entry clinical training for the health and disabilities profession, including medical specialists, GPs, public health doctors, nurses, Maori health professionals, and midwives is delivered. Training delivered contributes to the workforce's needs within the health and disability sector.	Clinical Training Agency
Outcome: Manage fiscal risks in the Sector. Impact/Objectives: Enable Sector risks to be met within Vote Health.	Health Services Fund
Outcome: DHBs are responsible for both the provision of health care services to geographically defined populations and the running of hospital services. Impact/Objectives: Enable DHBs to provide Health and Disability Service in New Zealand.	Health and Disability Support Services - DHBs
Outcome: Through the Crown Health Financing Agency, DHBs have an efficient and effective debt provisioning facility and the Crown's residual health sector liability is managed effectively and efficiently. Impact/Objectives: Providing and managing Crown term loan facilities for DHBs, including refinancing of maturing private bank debt and new loan facilities for major capital works. Managing residual area heath board liabilities, including contingent liabilities arising in relation to the acts or omissions of an Area Health Board prior to 1 July 1993, patient trust funds, and residual property leases. To provide independent advice to the Minister on the credit worthiness and financial sustainability of DHBs.	Management of Residual Health Liabilities and District Health Board Term Debt
Outcome: Reduction of meningococcal in children. Impact/Objectives: To immunise newborns alongside the Child Immunisation Schedule, with opportunistic vaccination offered to the eligible population who have not completed the full schedule of vaccine.	Meningococcal Vaccine Programme
Outcome: Health and Disability Service provision in New Zealand is safe and of high quality, including those services used by people with mental illness, their families and caregivers. Impact/Objectives: Education, advocacy, complaints resolution and proceeding services on behalf of users of health and disability services in accordance with the Health and Disability Commissioner Act 1994. Provision of services as described in the Mental Health Commission Act 1998. District inspectors inquire into the status and management of psychiatric patients in accordance with the Mental Health (Compulsory Assessment and Treatment) Act 1992. Review tribunal services to consider the condition of patients who seek reviews, or on whose behalf a review has been sought, in accordance with the Mental Health (Compulsory Assessment and Treatment) Act 1992. Mental health tribunals review and arbitrate on the committal status of those that come before it, in accordance with the Mental Health (Compulsory Assessment and Treatment) Act 1992.	Monitoring and Protecting Health and Disability Consumer Interests
Outcome: Gathering of evidence-based information to inform policy development and implementation. Impact/Objectives: To obtain sector intelligence, enhancing links to the sector and dissemination of information.	National Advisory and Support Services
Outcome: To assist families and whanau to improve and protect their children's health. Impact/Objectives: Well Child/Tamariki Ora Framework services are delivered including seven core Well Child contacts for every enrolled child, and specified additional contacts for first time and high needs parents. Information and advisory services to support the Well Child/Tamariki Ora Framework are delivered. Plunket to provide Well Child/Tamariki Ora services according to the schedule to approximately 85 percent of New Zealand children. B4 School Check: to undertake the 8th and final Well Child free health and development check for 4 year olds to identify behavioural, developmental, or health concerns that may adversely affect a child's ability to succeed in school (Impact). To ensure timely and appropriate referrals to improve the health and educational outcomes and reduce those at risk. To fund the progressive implementation of school-based health services to students in decile 1-3 secondary schools, teen parent units, alternative education facilities, and kura kaupapa schools.	National Child Health Services
a) PHARMAC and Health Research Council Outcome: To fund a number of national and regional personal health services such as complex burns, mobile surgical services, telephone advice services and sexual and reproductive health services. PHARMAC Impact/Objectives: New Zealanders in need of pharmaceuticals receive the best health outcomes that are reasonably achievable from pharmaceutical treatment, and from within the amount of funding provided. Health Research Council Impact/Objectives: The health sector is well-informed on current health research issues and has confidence that research is conducted safely and ethically. The Government and health sector are provided with strategic advice on health research issues, and regulatory activities and safety monitoring are conducted through the HRC Ethics Committee. b) Nationally purchased personal health Outcome: Personal health gain through nationally purchased health services (as determined by Government). Impact/Objectives: Telephone triage and health advice services, sexual and reproductive health services, mobile surgical services, services associated with the implementation of the Oral Health and Cancer Control Strategies, and hospital chaplaincy services; are delivered.	National Contracted Services - Other
Outcome: Eligible clients are supported to live and participate in their home and community in the same way other New Zealanders do. Delivery of disability support services includes: service provision; service development; evaluations and audits required to support the provision of quality services; services as required by the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 (IDCC&R). Eligible clients are those who have a long-term physical, intellectual or sensory disability (or a combination of these), which is likely to continue for a minimum of six months and make the person less independent and in need of ongoing support. Impact/Objectives: Accessible, understandable and reliable information about disability support services is available to people. Needs assessment and service co-ordination services are delivered. Disability Support Services are available. Disability Support Services are developed and enhanced. Compulsory care and rehabilitation services are provided for people who are subject to the IDCC&R Act.	National Disability Support Services
Outcome: To purchase a number of national elective surgical services under the orthopaedic, cataract and new elective services initiatives. Impact/Objectives: To purchase additional elective surgery services.	National Elective Services
Outcome: Community-based medical emergencies services are provided in a consistent and reliable way. Impact/Objectives: emergency calls are triaged and services dispatched effectively and efficiently ambulance services are provided in a safe and consistent way.	National Emergency Services
Outcome: To purchase a number of national Maori health services. These services will be funded on behalf of Maori spanning across DHBs. Impact/Objectives: To fund the purchase of Maori health services directly by the Crown.	National Maori Health Services
Outcome: Quality primary maternity services that are accessible, available and safe Impact/Objectives: lead maternity carers deliver quality maternity services in compliance with the Section 88 Primary Maternity Services Notice 2007 recruitment and retention services for rural midwifery professional development and advice and information.	National Maternity Services
Outcome: National provision of Mental Health Services. Impact/Objectives: Contract with NGO providers and District Health Boards for the provision of mental health and addiction services including the development of mental health and addiction workforce initiatives.	National Mental Health Services
Outcome: To provide better, sooner, more convenient primary health care services. Impact/Objectives: To provide a high quality, person centred primary health care system that contributes to better management of long term conditions, more continuity of care, greater accessibility and early intervention.	Primary Health Care Strategy
Outcome: Prevention and minimisation of harm from problem gambling. Impact/Objectives: To fund and coordinate a range of services and activities for individuals and across populations, that prevents and minimise the harm caused by problem gambling.	Problem Gambling Strategy
Outcome: Improved health of all New Zealanders by supporting communities, whanau and individuals to: live, work and learn in a healthy and safe environment make healthy choices in respect of lifestyle factors that influence health outcomes, such as physical activity, nutrition, tobacco, alcohol and other drugs access screening services for early detection of some cancers as well as other conditions that can affect babies be free of communicable diseases understand their mental health and know where to get early help. Impact/Objectives: Public health services are provided (within scope) and based on the best available evidence of effectiveness. The services clearly identify the needs of priority populations and demonstrate strategies to address barriers to accessibility and acceptability for target populations. Screening services are provided safely and effectively in accordance with Policy and Quality Standards. Access to services for the prevention of, and protection from health threats, for all New Zealanders, in particular vulnerable or at risk groups and communities. Funding of services and activities for communicable disease, immunisation, and to maintain healthy environments (including water supplies and sewerage).	Public Health Service Purchasing
Outcome: Surveillance programmes for exotic mosquitoes of health significance. Impact/Objectives: Scientific analysis and advice to support the Ministry's policy advice to the Minister of Health; including the purchase of services for identification of mosquitoes and science services to support surveillance programmes and responses to incursions and interceptions of exotic mosquitoes of health significance.	Scientific Advice to Support Pest Management Strategies as They Affect Public Health

Clinical Training Agency (M36)#

Scope of Appropriation

Provision of clinical training for doctors, nurses, dentists and other health professionals.

Expenses

Expenses - Clinical Training Agency (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	122,271	115,271	125,692

Reasons for Change in Appropriation

The slightly more than $3 million increase in this appropriation arises from Current and Past Policy Initiative funding changes (see Current and Past Policy Initiatives table below).

Output Performance Measures and Standards

Output Performance Measures and Standards - Clinical Training Agency (M36) - Health
Performance Measures	Budgeted Standard	Estimated Actual Standard	Budget Standard
	2008/09		2009/10
Post-entry clinical training for the health and disabilities profession, including medical specialists, GPs, public health doctors, nurses, Maori health professionals, and midwives is delivered Services are delivered according to criteria specified in Ministry/Provider agreements Quality of services are measured and improved through the annual programme of evaluation	N/A	Under Development	Achieved
Training delivered contributes to the workforce's needs within the health and disability sector The target number of trainees are trained as agreed and published (or subsequently renegotiated) in the Clinical Training Agency's purchasing intention plan	N/A	Under Development	Achieved

Current and Past Policy Initiatives

Current and Past Policy Initiatives - Clinical Training Agency (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
GP Training & Upskilling in Primary Maternity Care	2009/10	-	150	300	300	300
Boost GP Training	2009/10	-	2,500	5,000	5,000	5,000
Palliative Medicine Registrar Training	2008/09	150	300	300	300	300
Medical Physics Training	2008/09	53	105	105	105	105
Maternity Action Plan	2008/09	1,125	1,775	1,775	1,775	1,775
New Medical Registrations	2008/09	724	1,242	2,062	3,404	4,584
Forecast Funding Track (FFT) and Demographics	2008/09	4,957	4,957	4,957	4,957	4,957
Workforce development	2008/09	7,610	7,610	10,000	10,000	10,000
Forecast Funding Track (FFT)	2007/08	2,993	2,993	2,993	2,993	2,993
Demographics	2007/08	1,643	1,643	1,643	1,643	1,643

Health and Disability Support Services - Auckland DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Auckland DHB.

Expenses#

Expenses - Health and Disability Support Services Auckland DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	881,337	881,337	941,884

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($27.116 million), demographics ($24.633 million) and funding to advance Government priorities ($8.729 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Auckland DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Supplementary Funding for Price Pressures and Government Commitments (Auckland DHB)	2009/10	-	8,729	8,729	8,729	8,729
Forecast Funding Track (FFT) and Demographics (Auckland DHB)	2009/10	-	51,749	51,749	51,749	81,749
Forecast Funding Track (FFT) (All DHBs)	2008/09	250,401	250,401	250,401	250,401	250,401
Demographics (All DBs)	2007/08	137,428	137,428	137,428	137,428	137,428
Financial Reporting Standard 3 (FRS3) Revaluations (All DHBs)	2006/07	64,423	64,423	64,423	64,423	64,423
Industrial Negotiations (All DHBs)	2006/07	15,000	15,000	15,000	15,000	15,000
Industrial Settlements (All DBS)	2004/05	149,169	149,169	149,169	149,169	149,169
Holidays Act (All DHBs)	2004/05	44,720	44,720	44,720	44,720	44,720
Disability Support for Older People (All DHBs)	2004/05	32,518	32,518	32,518	32,518	32,518
Additional Forecast Funding Track (All DHBs)	2005/06	64,798	64,798	64,798	64,798	64,798
Additional Funding for Demographic Changes (All DHBs)	2005/06	8,016	8,016	8,016	8,016	8,016
Demographics (All DHBs)	2004/05	16,800	16,800	16,800	16,800	16,800
Demographic change - to fund health services for changes in population numbers, age mix, ethnicity and deprivation (All DHBs)	2004/05	36,578	36,578	36,578	36,578	36,578
Financial Reporting Standards No. 3 (All DHBs)	2003/04	97,911	97,911	97,911	97,911	97,911
Funding for DHBs to recognise increased accident costs (All DHBs)	2003/04	20,199	20,199	20,199	20,199	20,199

Note - As Indicated above, in prior years the table above related to current and past policy initiatives for all 21 appropriations for District Health Boards, and not only the Auckland DHB. However, as indicated in last year's Estimates, the current policy initiatives for each DHB have been separately reported in each DHB's appropriation.

Funding for FFT and Demographics provided in Budgets 2003, 2005 and 2006 is shown in the National Contracted Services - Other appropriation.

Health and Disability Support Services - Bay of Plenty DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Bay of Plenty DHB.

Expenses#

Expenses - Health and Disability Support Services Bay of Plenty DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	491,430	491,430	522,467

Reasons for Change in Appropriation#

The increase in this appropriation largely arises from new funding in the 2009 Budget for Forecast Funding Track ($15.370 million), demographics ($10.291 million) and funding to advance Government priorities ($5.048 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Bay of Plenty DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	25,661	25,661	25,661	25,661
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	5,048	5,048	5,048	5,048

Health and Disability Support Services - Canterbury DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Canterbury DHB.

Expenses#

Expenses - Health and Disability Support Services Canterbury DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	1,027,024	1,027,024	1,078,053

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($32.028 million), demographics ($8.140 million) and funding to advance Government priorities ($10.485 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Canterbury DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	40,168	40,168	40,168	40,168
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	10,485	10,485	10,485	10,485

Health and Disability Support Services - Capital and Coast DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Capital and Coast DHB.

Expenses#

Expenses - Health and Disability Support Services Capital and Coast DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	536,775	536,775	569,843

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($16.723 million), demographics ($10.451 million) and funding to advance Government priorities ($5.459 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Capital and Coast DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	27,174	27,174	27,174	27,174
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	5,459	5,459	5,459	5,459

Health and Disability Support Services - Counties-Manukau DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Counties-Manukau DHB.

Expenses#

Expenses - Health and Disability Support Services CountiesManukau DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	932,041	932,041	999,265

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($29.314 million), demographics ($27.608 million) and funding to advance Government priorities ($9.583 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services CountiesManukau DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	56,922	56,922	56,922	56,922
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	9,583	9,583	9,583	9,583

Health and Disability Support Services - Hawkes Bay DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Hawkes Bay DHB.

Expenses#

Expenses - Health and Disability Support Services Hawkes Bay DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	358,708	358,708	377,914

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($11.198 million), demographics ($4.004 million) and funding to advance Government priorities ($3.674 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Hawkes Bay DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	15,202	15,202	15,202	15,202
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	3,674	3,674	3,674	3,674

Health and Disability Support Services - Hutt DHB (M36)#

Scope of Appropriation#

Funding of personal and mental health services including services for the health of older people, provision of hospital and related services and management outputs from Hutt DHB.

Expenses#

Expenses - Health and Disability Support Services Hutt DHB (M36) - Health
	2008/09		2009/10
	Budgeted $000	Estimated Actual $000	Budget $000
Total Appropriation	287,506	287,506	307,500

Reasons for Change in Appropriation#

The increase in this appropriation mainly arises from new funding in the 2009 Budget for Forecast Funding Track ($9.021 million), demographics ($7.721 million) and funding to advance Government priorities ($2.960 million).

Output Performance Measures and Standards#

The performance measures are those contained in the Crown entity's Statement of Intent.

Current and Past Policy Initiatives#

Current and Past Policy Initiatives - Health and Disability Support Services Hutt DHB (M36) - Health
Policy Initiative	Year of First Impact	2008/09 Budgeted $000	2009/10 Budget $000	2010/11 Estimated $000	2011/12 Estimated $000	2012/13 Estimated $000
Forecast Funding Track (FFT) and Demographics	2009/10	-	16,742	16,742	16,742	16,742
Supplementary Funding For Price Pressures and Government Commitments - New Initiative	2009/10	-	2,960	2,960	2,960	2,960