'Shambolic' B4 School scheme faces axe

Health Minister Tony Ryall is questioning the future of the B4 School Check programme, saying its delivery has been patchy and its implementation almost "shambolic".

By early May, only about 5500 (11%) of eligible children had received checks which were supposed to identify health, behavioural, social and developmental issues in 4-year-olds which might affect their ability to learn, Mr Ryall said.

About 17% of those checked were referred for services or further assessment.

In a blunt letter to all district health board chairmen, which will be tabled at the Otago and Southland community and public health advisory committee meeting tomorrow, Mr Ryall says he will make a decision on the future of the programme after evaluating its delivery to the end of this year.

"It is clear that the implementation of this programme across the country was rushed - to the point were it could almost be described as shambolic."

Some boards clearly considered the programme important while others did not, he said.

Boards were being funded at various rates, including up to $400 for a completed check.

(Last year, the programme was allocated $9.9 million in the Budget and was expected to cost $9.4 million yearly for the next four years.)Mr Ryall said unspent funding by the district health boards should be returned, with boards only being paid for what was being delivered.

A table accompanying Mr Ryall's letter showed that in Otago by the start of May only 150 of 1648 eligible children had received the checks and the information recorded on the ministry system, while in Southland the number was 46 out of 1154 children.

Target numbers and funding for both boards had been revised, with Otago now saying it could do 354 checks at a cost of $218,894 instead of 909 for $342,022.

Southland originally said it could do 661 checks for $286,762, but its new target was 595 for $269,556.

All boards were supposed to have begun the programme by September last year.

It began later in Otago, with public health nurses delivering the checks and confusion about who might deliver the service long term.

Earlier this year, regional general manager of planning and funding David Chrisp said the initial slowness had been because management did not think it was fully funded and there were difficulties later with the Ministry of Health systems.

There had also been a low uptake of the voluntary checks, which may have been because it was a "newish" service without the same level of publicity as programmes such as the human papillomavirus vaccination programme.

The boards' community and public health advisory committee wanted the checks to be done by community health services, but Mr Chrisp said uncertainty about future funding meant boards were hamstrung in terms of contracting out the serviceMr Ryall said following ongoing concerns about the performance of the programme, the Ministry of Health met boards to discuss their contracts.

Ten boards affirmed their targets and capacity to achieve them, Otago and Southland agreed to revise their targets and funding and discussions were continuing with the remaining boards, which advised they would not meet agreed targets.

The figures presented by Mr Ryall also suggested there was a discrepancy between the number of checks reported by boards to the end of February this year and those actually registered on the national B4 School Check information system by May 5. elspeth.mclean@odt.co.nz

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