Oranga Tamariki doesn't know if kids in care are getting health check-ups - report

By Krystal Gibbens of RNZ

Oranga Tamariki does not know whether children in care are receiving annual health and dental check-ups, a new report by the the Independent Children's Monitor has found.

The report Access to Primary Health Services and Dental Care is the second in-depth review by Aroturuki Tamariki on a specific aspect of the Oranga Tamariki system.

The report, which looked at access to primary health services and dental care for tamariki (children) and rangatahi (young people) in care, found Oranga Tamariki had not yet implemented basic health requirements.

In 2019 the National Care Standards (NCS) Regulations came into effect, setting out the minimum standards required when a child was in care.

The regulations - which apply to Oranga Tamariki and any other agency with custody and care responsibilities - included a requirement that health and dental needs were identified through annual checks.

Aroturuki Tamariki chief executive Arran Jones said while Oranga Tamariki did not provide the health or dental services itself, it did have an obligation to know if it is meeting the regulations and to take reasonable steps to ensure tamariki get what they need.

"That means knowing if tamariki and rangatahi in its care are enrolled with a doctor and getting annual health and dental checks."

Jones said the report found more needed to be done to implement the NCS regulations.

"We heard from tamariki, caregivers and Oranga Tamariki social workers that clearer guidance, and better recording and sharing of this information is needed."

In the 2021/2022 Experiences of Care in Aotearoa report, Oranga Tamariki reported 56 percent of tamariki in its care were enrolled with a primary health organisation (PHO).

"Since we started the review, to their credit Oranga Tamariki has carried out data matching with [Te Whatu Ora] to get a better understanding of enrolment rates."

That data suggested around 93 percent of children in care were enrolled in a PHO.

"However, we note that this data likely over-reports current PHO enrolment rates because it won't necessarily be updated when tamariki and rangatahi move until they re-enrol with a new PHO," the report stated.

"This means, for example, that if tamariki are registered with a PHO in Wellington but then move to the Hawke's Bay and are not registered with a PHO there, they would still show as enrolled with a PHO."

The one-off data match between Oranga Tamariki and Te Whatu Ora also estimated around 70 percent of tamariki had been seen by their doctor, however Oranga Tamariki did not know if they received an annual health check or just had their current health issue (such as a sore foot) addressed.

"We hope that Oranga Tamariki will work quickly to provide clear guidance on what an annual health check requires, and also put systems in place to ensure enrolment and annual health and dental checks are recorded in all case files so social workers and caregivers know who a child's doctor is and where any gaps are," Jones said.

Oranga Tamariki also did not know if the children in its care had an annual dental check. Open Home Foundation data suggested 75 percent of tamariki in its care had received one.

"We also heard a willingness on the part of primary health and dental professionals, who are generally eager to prioritise tamariki and rangatahi in care, but they are not always made aware that the child is in care," Jones said.

Aroturuki Tamariki said it would continue to monitor whether Oranga Tamariki is improving its compliance with the NCS regulations regarding access to primary health and dental care through its annual Experiences of Care in Aotearoa report.