CDHB Perspective on Closure of 198 Youth Health Centre

Canterbury District Health Board would like to make it clear that it had been working for some time with the 198 Youth Health Trust to assist it to continue providing services to young people in Christchurch.

This commitment was re-iterated at CDHB’s December Board meeting after a deputation from YHT.

“We advised our Board that we would meet with the Chair of the Trust and continue to work with YHT for a sustainable solution to its financial problems and this is what we tried to do,’ Carolyn Gullery, CDHB’s General Manager Planning and Funding said.

“The Trust has now said it will cease operation from 30 April 2010 for financial reasons but this is not without a considerable amount of effort having been made by CDHB to assist the service to remain viable. CDHB has also not been the only source of funding for the Trust”

The DHB had been actively working with the Trust since 1998, after it was identified that three-quarters of its patients were also enrolled with a PHO (effectively meaning these patients were being double funded by the health system). 

From July 2009, the DHB began a one-year transition to capitation-based funding for the primary health services provided by YHT. Capitation funding is when funding is provided for each person enrolled with a health provider.  The Youth Health Trust also joined Canterbury Community PHO which meant clients could only be enrolled in one place.

The previous way of block funding the service remained the same until the end of September 2009, when it was planned to be reduced by 25% every three months as patient enrolments and capitation based funding built up.  Funding for two peer support workers was however discontinued from July 2009 because the volume of activity did not justify the continuation of funding.  Similar alternative services were also available.

Mental health services, including alcohol and drug services, have continued to be funded directly from CDHB.

“We will now be working closely with YHT to ensure that the 1,084 people enrolled with the Youth Health Centre have continued access to health care services,” Ms Gullery said.

“A number of Christchurch General Practices provide free or low cost general medical care for under 18s.  In addition, the DHB funds all General Practices to provide free sexual health consultations to all young people under the age of 21 years,*” she said

“The majority of YHT’s primary health service users are however older than 18 and therefore working or eligible for a benefit.  According to recent data, only 18% of YHT’s clients were aged under 18.”

While Canterbury DHB believes the Youth Health Trust (YHT) has been an important provider of health services to young people in Canterbury, it has not been a “Youth One Stop Shop”. 

“A Youth One Stop Shop should provide a range of social and health services under one roof in a holistic model which is responsive to the needs of young people. Canterbury DHB has made a commitment to exploring the viability of a holistic ‘Youth One Stop Shop’ between health and social service providers in Canterbury, “ Ms Gullery said.

ENDS

Notes

*Around 18,000 Christchurch young people access free sexual health consultations every year.  NZ Family Planning, directly funded by the Ministry of Health, provides free sexual health services to those under 21 years old. In Canterbury it has about 2,000 clients up to and including 19 years of age. 

**The change from block funding towards a capitated model in 2008/09 has resulted in a decrease in funding from $491,637 ex GST to $411,000 ex GST (estimated).  However, the majority of this difference resulted from the removal of funding for the discontinued Peer Support service on 30 June 2009 ($73,256 ex GST).  This means funding for core primary and mental health services in 2009/10 is largely the same as in 2008/09.