Minutes of the Community & Public Health Advisory Committee Meeting held on Tuesday, 21 August 2007, commencing at 1.30 pm, in the Board Room, First Floor, Dunedin Hospital Present: Mr P A Barron Acting Chairman Mrs H M Algar Ms B A Long Dr B Sijnja In Attendance: Mr C Fraser Regional General Manager, Planning & Funding Ms G Goodger Communications Officer Ms J Kloosterman Board Secretary 1.0 WELCOME The Acting Chairman welcomed everyone to the meeting of the Community and Public Health Advisory Committee (CPHAC). He advised that, as there was not a quorum for the Disability Support Advisory Committee (DSAC), the DSAC agenda items would be held over until the next meeting. Ms B A Long requested that it be noted in the minutes that the diversity of the discussion would be limited due to the full CPHAC not being present. 2.0 APOLOGIES Apologies were received from Ms M L Rosson, Chairperson, Mrs K N Bowen, Prof S M Dovey, Dr M D H Holdaway, Mrs D R McKay, Dr G T Tipa, Ms P J Wakefield, Mr B Rousseau, Chief Executive Officer, and Dr R Morris, Primary Care Advisor. Moved Mrs H M Algar, seconded Dr B Sijnja, that the apologies be noted. 3.0 MEMBERS DECLARATION OF INTEREST The Acting Chairman called for any adjustments or amendments to the Interests Registers. Action Point 121 The following additions were declared: Mr P A Barron Stewarts Pharmacy Ltd (Shareholder and Director) Mrs H M Algar Super Grans, Oamaru (Trustee) Minutes of the CPHAC & DSAC, 21 August 2007 Page 1
The Acting Chairman asked if Committee members were aware of any agenda items with which they may have a potential conflict and reminded them of their responsibility to advise the meeting immediately should any potential conflict, actual or perceived, arise during discussions. Moved Dr B Sijnja, seconded Ms B A Long, that the Interests Registers be noted. 4.0 PREVIOUS MINUTES Moved Mr P A Barron, seconded Dr B Sijnja, that the minutes of the 17 July 2007 joint meeting of the Community & Public Health and Disability Support Advisory Committees be approved and adopted as a true and correct record. 5.0 MATTERS ARISING Advisory Committee Structure (Action Point 119) It was agreed that evaluation of the combined meeting structure would be held over until the next meeting. Build the Strategic Capability of Our Workforce (Action Point 117) Mr C Fraser, Regional General Manager, Planning & Funding, informed members that a report would be submitted to CPHAC seeking its advice on management engaging with the sector on the long term Primary Care Strategy direction for the Otago and Southland DHBs. He advised that there would be a parallel between this and the proposed discussion on the community health care workforce. 6.0 STRATEGIC PRIORITIES The strategic priorities reports (tabs 3-6) were taken as read. The following items were highlighted during discussion. 1. Reduce Inequalities in Health (tab 3) Child and Adolescent Oral Health Otago Community Oral Health Services Paper The summary of the analysis of the feedback received from consultation on the proposed changes to community oral health services (Attachment 1) was noted. Kaiwhakahaere Hauora Māori In response to a question about the timeframe for appointing to the Kaiwhakahaere Hauora Māori position, Mr C Fraser, Regional General Manager, Planning & Funding, advised that the Southland and Otago DHB Chief Executives were exploring a regional approach to Māori Health in consultation with the local Māori community. In the interim, Māori Health Minutes of the CPHAC & DSAC, 21 August 2007 Page 2
contracts were being managed by a Planning & Funding team member but the relationship component was not being covered. Mahi Hauora Action Point 122 Mr Fraser agreed to follow up what was happening with regard to Mahi Hauora meetings. Moved Dr B Sijnja, seconded Ms B A Long, that the progress report on the strategic priorities to reduce inequalities in health be noted. 2. Promote and Enhance Independence (tab 4) Disability Action Point 123 The Committee requested that the Disability section of the report be held over for consideration at the September meeting. Mental Health Central Otago Mental Health Service Needs Analysis (Action point 112) Mr C Fraser, Regional General Manager, Planning & Funding, advised that the feedback received on the Central Otago Mental Health Service Needs Analysis had been conveyed to the report author and the outcome would be reported back to the Committee. Moved Mr P A Barron, seconded Mrs H M Algar, that the progress report on the strategic priorities to promote and enhance independence be noted. 3. Reduce the Incidence and Impacts of Chronic Disease and Cancer (tab 5) Promote Healthy Lifestyles Healthy Eating, Healthy Action (HEHA) Members expressed an interest in the walking the talk initiative and what would be done within the DHB to support this. Mr C Fraser, Regional General Manager, Planning & Funding, advised that a process of engagement was currently occurring and a recommended policy would be submitted to CPHAC for consideration. He stressed that the emphasis of HEHA was on education to enable people to make the right choices. Action Point 124 In response to a concern that HEHA did not include a focus on parent practice and early childhood centres, Mr Fraser advised that he would ask the HEHA co-ordinator to provide a report on these two issues. Minutes of the CPHAC & DSAC, 21 August 2007 Page 3
Action Point 125 The Committee requested a list of the people and organisations who had been invited to join the HEHA Reference Group. Ms B A Long reported that Otago was doing better than other areas with respect to national targets for breast feeding and acknowledged the role of the DHB in achieving this. Year to date Plunket data showed that the proportion of infants exclusively and fully breastfed at six weeks in Otago is 68% (against a national target of 74%); at three months 60% (57%) and at six months 30% (27%). Moved Dr B Sijnja, seconded Mrs H M Algar, that the progress report on the strategic priorities to reduce the incidence and impacts of chronic disease and cancer be noted. 4.0 Maintain and Enhance our Capability to Deliver Quality Health Services (tab 6) DHB Workforce Strategy Mr C Fraser, Regional General Manager, Planning & Funding, tabled a copy of the Future Workforce Dashboard: June 2007, prepared by the Regional General Manager, Human Resources, and sought the views of the Committee on future HR reporting that it would like to receive. Action Point 126 Members indicated that they would like a strategic overview identifying areas of strength and weakness, and reports on key initiatives such as the UK staff recruitment campaign. Primary Health Organisations (PHOs) The PHO reports were noted as a valuable addition to the agenda papers. Mr Fraser reported that he was very encouraged by the progress being made by PHOs and the direction they were moving in. He advised that, as the DHB was pivotal to what the PHOs wished to achieve, it would be appropriate for the DHB to review the objectives it had set for PHOs and re-engage with them. Otago Pharmaceutical Working Party Mr P A Barron declared a conflict of interest with this item and offered to vacate the chair. Mr Fraser reported that a further meeting of the Otago Pharmaceutical Working Party had been held since that reported in the agenda papers (attachment 3). The terms of reference for the Working Party stipulated that the process would be transparent and minutes disseminated to PHOs, pharmacists and the general public through the CPHAC meeting. Mr Fraser therefore advised that he could see no reason why Mr Barron should not chair the meeting while this item was considered. Minutes of the CPHAC & DSAC, 21 August 2007 Page 4
Moved Mrs H M Algar, seconded Ms B A Long, that the progress report on the strategic priorities to maintain and enhance the DHB s capability to deliver quality health services be noted. 7.0 FINANCIAL REPORT The Funder s financial report as at 30 June 2007 (tab 7) was taken as read and the positive year-end result noted. Mental Health Ringfence Mr C Fraser, Regional General Manager, Planning and Funding, explained the Mental Health funding ringfence. It was noted that part of the Mental Health under-expenditure was due to the DHB s inability to recruit staff, which was a national issue. Prescription Charges In response to a query about the impact of introducing a universal $3 prescription fee, Mr Fraser advised that the Ministry of Health had made a policy decision to ensure that people enrol with a PHO and the financial incentives reflected that. The barrier created by higher fees for hospital prescriptions had been raised at a national level and was one of the issues that would be considered by the Otago Pharmaceutical Working Party but probably not in their first year of operation. Moved Dr B Sijnja, seconded Mrs H M Algar, that the Financial Report be noted. 8.0 CONTRACT PERFORMANCE Provider Arm The Committee noted that elective activity for the year ended 30 June 2007 was 1% above plan and acute activity 1% below plan. Moved Mr P A Barron, seconded Ms B A Long, that the key performance indicators for the Provider Arm (tab 8) be noted. 9.0 OTHER ITEMS Public Health South Report (tab 9) Moved Mrs H M Algar, seconded Dr B Sijnja, that the Public Health South report be noted. DSAC Working Group Report (tab 10) Discussion of this item was held over until the next meeting. Minutes of the CPHAC & DSAC, 21 August 2007 Page 5
Advisory Committee Meeting Structure Discussion of this item was held over until the next meeting. 10.0 INFORMATION ITEMS The following information items were taken as read (tab 11): Letter from the Ministry of Health re timeframe for feedback on Funding Responsibility for Long-term Support Services for People with Chronic Health Conditions Consultation on a proposal to alter the Close Control rule in the Pharmaceutical Schedule A list of Ministry of Health publications Mr C Fraser, Regional General Manager, Planning & Funding, advised that the Otago Pharmaceutical Working Party would be considering a submission on the proposal to alter the Close Control rule in the Pharmaceutical Schedule. Action Point 127 It was suggested that the submission advocate that section (b)(ii)(b) initialled the endorsement in their own handwriting be changed to allow for electronic signatures, eg by adding or other approved means of verification. Moved Mrs H M Algar, seconded Dr B Sijnja, that the information be noted. 11.0 ACTION SHEET Advisory Committee Structure (Action Point 119) The Committee requested that evaluation of the joint CPHAC & DSAC meeting structure be put on the agenda for the next meeting. Mr C Fraser, Regional General Manager, Planning & Funding, informed the Committee that discussion was also occurring on whether CPHAC and DSAC could become regional committees. Moved Ms B A Long, seconded Dr B Sijnja, that the action sheet (tab 12) be noted. 12.0 NEXT MEETING Tuesday, 18 September 2007, 1.30 pm. Minutes of the CPHAC & DSAC, 21 August 2007 Page 6
Moved Mr P A Barron, seconded Dr B Sijnja, that the public be excluded from the meeting to consider the following agenda items: General subject: 1. Confidential Minutes 2. Otago Community Oral Health Services Business Case 3. Risk Register 4. Confidential Meeting Action Sheet Reason for passing this resolution: To allow negotiations and activities to be carried on without prejudice or disadvantage Grounds for passing the resolution: S 34(a), Schedule 4, NZ Public Health and Disability Act 2000 that the public conduct of this part of the meeting would be likely to result in the disclosure of information for which good reason for withholding exists under sections 9(2)(i) and 9(2)(j) of the Official Information Act 1982, that is, the withholding of the information is necessary to enable a Minister of the Crown or any Department or organisation holding the information to carry out, without prejudice or disadvantage, commercial activities and negotiations. The meeting closed at 3.15 pm. Confirmed as a correct record: Chairperson.. Date... Minutes of the CPHAC & DSAC, 21 August 2007 Page 7