Aroturuki Tamariki chief executive Arran Jones said the report found more needed to be done to implement the National Care Standards regulations. Photo: RNZ / Samuel Rillstone
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.
Advocacy group VOYCE Whakarongo Mai wanted Oranga Tamariki to be held accountable for not tracking basic healthcare requirements.
VOYCE Whakarongo Mai national care experienced lead Tupua Urlich said the lack of data held by OT was deeply worrying.
"We know that when children come from backgrounds of trauma, their overall health and wellbeing is already at risk and impacted by their early life experiences. I think it's just totally unacceptable that the government is once again failing to ensure that the healthcare and dental needs are being met for children in their own care," Urlich said.
Urlich, a former child in care, said he himself had experienced issues with healthcare while under the care of Oranga Tamariki.
"Several times I notified caregivers that I wasn't feeling well. That was seen as rubbish and [that I] just didn't want to go to school."
He ended up needing his appendix removed.
OT says its recording systems are 'difficult'
Better data recording and information sharing is something Oranga Tamariki deputy chief executive of quality practice and experiences Nicolette Dickson said it was working on.
"We've been quite open that a lot of our recording systems are difficult to get good information from," she said.
"We have got a substantial program of work to progressively improve both the way we share information with health and can access information directly from health, but also how we improve own case recording systems."
She said improvements were already being seen.
General Practice New Zealand chairperson Dr Bryan Betty said the report reinforced the importance of children in care having access" to good quality, continuous primary care to address issues that arise and to address future health needs."
Dental Association chief executive Mo Amso meanwhile said was surprising that children in care were missing out on dental care as it was free for under 18s.
"The main reason for these children not accessing care I'd imagine is social barriers. And that's usually what Oranga Tamariki will be tasked with, is managing their social barriers. So it's surprising to know that children in the care of, say, a social worker are still not able to access what's already funded care," Amso said.
He said missing these free appointments in early life put children at risk of long term damage and harm to their teeth, and shaped "a child's oral health for the rest of their life".
Later this year the Independent Children's Monitor will release a third report - this time looking at the implementation of recommendations after the review of the Children's System Response to Abuse.