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WAIRARAPA DISTRICT HEALTH BOARD ANNUAL REPORT 2005

Well Wairarapa

� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | �

1 HIGHLIGHTSOFTHEYEAR

2 CHAIRMAN&CHIEFEXECUTIVE’SREVIEW

4 KEYACHIEVEMENTS

8 STATISTICS

9 GOVERNANCE

10 BOARDMEMBERPROFILES

12 STATEMENTOFRESPONSIBILITY

13 STATEMENTOFACCOUNTINGPOLICIES

16 FINANCIALSTATEMENTS

20 NOTESTOTHEFINANCIALSTATEMENTS

32 STATEMENTOFOBJECTIVESANDSERVICEPERFORMANCE

48 AUDITREPORT

49 DIRECTORY

CON

TEN

TS

VISION Well Wairarapa – Better health for all

Wairarapa ora – Hauora pai mo te katoa

MISSION To improve, promote and protect the health status of the people of the Wairarapa, and the independent living of those with disabilities, by supporting and encouraging healthy choices.

VALUES Respect – Whakamana Tangata According respect, courtesy and support to all

Integrity – Mana Tu Being inclusive, open, honest and ethical

Self determination – Rangatiratanga Determining and taking responsibility for one’s actions

Co-operation – Whakawhanaungatanga Working collaboratively with other individuals and organisations

Excellence – Taumatatanga Striving for the highest standards in all that we do

� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | �

HIGHLIGHTS OF THE YEAR• UnderaMemorandumofUnderstanding,theWairarapaDHBandTeHauoraoTeKaruoTeIka(MaoriHealthCollective)workedmorecloselytosupportintersectorialcollaboration.Bothpartiesprovidedopportunitiesforjointtraining,consultationondischargeplanningandsupportingcommunitybasedhealthprograms.

• ConstructionofthenewWairarapaHospitalbeganinJanuary2005andremainsontrackforcompletioninMarch2006,withinbudget.

• Forthefirsttimeinmanyyearsourhospitalandcommunityservicesnotonlydeliveredtocontractbutdelivered$258,000moreservicesthantheywerecontractedfor,whilekeepingwithintheirbudget.

• WairarapaDHBwasjust$273,000indeficitattheendofthefinancialyear,againstaplanneddeficitofaround$1million.

• Newworkprocessesweredevelopedwithsignificantinputfromstaffinpreparationforthemovetothenewhospital.Thechangesmadewillensurethatservicesareclinicallysafe,sustainableandaffordable.

• PrimaryhealthserviceswereexpandedthroughtheWairarapaCommunityPHOtoincludethefreeorlow-costCarePlusschemeandafreesexualhealthservice.GPconsultationsincreasedby16%.

• NewspecialistservicesbecameavailableintheWairarapa–earnoseandthroat,plastics,endocrinology,rheumatology,audiology,oncologyandurology.Visitingspecialistsincreasedfrom16to22duringtheyear.

• AllWairarapaDHBservicesachievedaccreditationandcertificationandallWairaraparesthomesachievedcertification–recognitionthattheymeetnationally-recognisedhealthstandardsandarecontinuallyworkingtoimprovestandardsofcare.

• Thenewmentalhealthstrategywasimplemented,bringingmentalhealthservicestogetherinaco-ordinatedwaysotheycanbettermeettheneedsofWairarapapeople.

� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | �� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | �

A year of change & co-operation

Changeandcommunityco-operationstoodoutasthemesinanexcitingandchallengingyearfortheWairarapaDHBinwhichmuchwasachieved.

Wecontinuedtomakegoodprogressinkeyhealthareasthroughthedevelopment,introductionandimprovementofhealthservices.Thishasbeenachievedwithagreatdealofinputandco-operationfromtheWairarapacommunity;healthserviceproviders,otheragencies,localauthorities,communitygroups,schools–thelistgoeson.

Manygroupshaveworkedtogethertodevelopandimprovehealthservicesandaccesstothem.Togiveoneexample;atransportservicetohelppeoplegettothedoctororhospitalwassetupbylocalauthorities,theDHBandthePHO,theRedCrossandTrustHouse.Inanotherexampleweachieved100%returnofMeningococcalBconsentformsfromschoolsthankstothejointeffortsoftheprojectteam,SalvationArmystaff,schoolsandtheMaoriWomen’sWelfareLeague.

Throughincreasedco-operationwithneighbouringDHBsmoreservicesbecameavailablelocally,reducingtheneedforpatientstotraveloutsideoftheregion.Thenumberofvisitingspecialistsincreasedfrom16to21,withear,noseandthroat,plasticsanddentalsurgerynowavailablelocally.Eyeandbladdersurgeryalsoincreasedthroughtheworkofvisitingspecialists.

Thereisnodoubtthatthesekindsofpartnershipsamongsthealthprovidersandcommunitygroupsaremakingadifference.

Overthepastyearourhospitalhasundergonethemostsignificantchangethatitwillevergothrough.ConstructionofthenewWairarapaHospitalstartedinJanuary2005anditisontracktoopeninMarch2006,ontimeandonbudget.Thishasbeenaremarkablefeatfortheprojectteamandallinvolved.

CHAIRMAN & CHIEF EXECUTIVE’S REVIEW


Inconjunctionwiththedevelopmentofthenewhospitalamajorchangeprocesswasundertakentodevelopnewandsustainablewaysofdeliveringhealthservices.Everypartoftheorganisationwasreviewedinaprocessthatinvolvedextensiveinputfrombothstaffandunions.Whilechallenging,thiswasanessentialpartofretainingclinicallyandfinanciallysustainableservicesintheWairarapa.Thecontributionfromstaffduringthisprocesswasfantastic.

Staffingestablishmentshavebeenfinalisedfollowingextensivebenchmarkingandstaffconsultation.Inaddition,morethan350usergroupmeetingsinvolvingstaffandhealthplannershavedeterminedtheshapeofthenewhospital.

Forthefirsttimeinmanyyears,hospitalandassociatedcommunityservicesnotonlydeliveredoncontractbutdelivered$258,000moreservicesthancontractedfor,whilekeepingwithinthebudget.Thismajormilestonewasachievedduringaperiodofuncertainlyformanystaffandwasacredittothecommitmentandprofessionalismofallinvolved.

AsignificantachievementthroughtheyearwastheaccreditationofWDHBProviderServicesforthefirsttime.Thegrantingofaccreditationforthemaximumthree-yearperiodreflectedtheprofessionalismandhardworkofallstaffattheDHB.Itwasalsoagreataccomplishmentthatallresthomeproviderswerecertifiedagainstnewhealthcarestandards.

Wairarapa’ssecondHealthStatusReportwascompletedduringtheyear.ThereportpresentedamultitudeofinformationaboutthehealthstatusandindicatorsfortheWairarapapopulation.Itprovidesaninformedbaseforsounddecision-makingandplanning,notonlybytheDHBbutbyarangeofotherWairarapaorganisations,inparticularthelocalauthoritiesintheirLongTermCouncilCommunityPlans.

CHAIRMAN & CHIEF EXECUTIVE’S REVIEW

DuringtheyearthecostofservicessuppliedtoWairarapapeopleoutsideoftheregionbyotherDHBsexceededthosebudgetedforby$1.3million.Theseweremostlycomplexservicessuchasheart,kidneyandbrainsurgery.Thefinancialimpactofthiswasoffsetbysavingsresultingfromtherevaluationofbuildings,lowerthanexpectedinterestchargesandnon-clinicalsupplycosts.

Welookforwardtothenext12monthswithgreatanticipation.ItisayeartobuildonoursuccessesandmoveintothenewWairarapaHospital.

Particularchallengeswefaceincludeensuringtheongoingviabilityoftheagedcaresector,themanagementofservicesprovidedoutsideofourregionandthebringingtolifeofthePrimaryHealthCareStrategythroughthePHO.

WelookforwardtoworkingtogetherwithotheragenciesandthecommunitytomoveclosertoourvisionofaWellWairarapa.

DougMatheson DavidMeates Chairman ChiefExecutive WairarapaDHB WairarapaDHB


Improving the health of older people

Arangeofserviceswasdevelopedincaringforolderpeople.

• Extratransportisnowavailableandwillhelpolderpeoplegettomedicalappointments.

• Manyolderpeoplearelivinginwarmer,healthierhomesthankstotheWairarapaHealthyHomesinsulationprojectwhichhasinsulatedmorethan250homes.

• Followingthepilotin2003/04theHealthRecoveryProgrammeassisted42olderpeopletoreturnhomefromhospital,whentheywerewellenough,butnotsafeenoughtogostraighthome.Therewerefewerornorepeathospitaladmissionsforthosewhocompletedtheprogramme.

• TheEarlyInterventionServiceforKorouaandKuiawasestablished.Itprovidesarangeofactivitiestoassistwellnessaswellastransportforthosewhoneedit.

• Supportforlivingathomeincreased,with9%morepeoplereceivinghouseholdmanagementandpersonalcares.

• 80%ofolderpeopleinresidentialcarereceivedaFluvaccination.

• AllWairarapaagedcareresidentialhomesreceivedcertificationthattheymeetNZhealthanddisabilitysectorstandards.

KEY ACHIEVEMENTS

Primary health initiatives

TheeffectsofarangeofPrimaryHealthOrganisationinitiativesstartedtoshowthrough.

• GPconsultationsincreasedby16%.

• Thenewsexualhealthserviceresultedinearlierandgreateraccessforyouth,throughmorethan2,800freeconsultations.

• TheCarePlusschemeprovided4,112freeorlow-costconsultationsforpeoplewithhighhealthneeds.

• 3,000GPvisitsweremadeunderanewschemetoimproveaccesstohealthcare–40%ofthesewerefromMaoriandPacificpeople.

• ThecostofGPvisitsforpeopleagedover65and18-24yearsreducedbybetween40%and50%–resultinginmorepeopleinthesegroupsseeingtheirGP.

• Around2,000peoplewereassistedwiththeirprescriptioncosts.

• Apilotprojecttoprovideextrasupportsinprimarycareforpeoplewithmildtomoderatementalhealthneedswasagreed.

• Wairarapaledthecountrywithits100%returnrateforconsentformsforschool-agechildren,witha92.7%consentrateforthisgroup.

Child and youth health WairarapaDHBmadeadramaticimprovementinthePaediatricSociety’s‘nationalscorecard’whichcomparesDHBsontheavailabilityandresponsivenessoftheirservicesforchildrenandyoungpeople.WairarapatoppedthesmallerDHBs,andwasranked4thoverall,asignificantturn-aroundfromlastyearwhenitwas20th.


Addressing Maori health WorkcontinuedinavarietyofareastoaddressthehealthneedsofMaori,whohavepoorerhealththananyothergroupintheWairarapa.

• TheKuraGPClinicatTeKuraKaupapaMaorioWairarapacontinuedtoencourageMaorifromtheircommunitytohaveregularcontactwithaGP.Theclinicprovided613consultationsduringtheyear.

• WhaioraWhanuiincreasedtheservicestheyprovidewiththeadditionoftheFamilyStartprogram,MeNZBcampaignandgrowthinTamarikiOra.ThisenabledWhaioratoemploytworegisterednursesandacommunityhealthworker.

• TheoutreachimmunisationserviceprovidedbyWhaioraWhanuiwasexpanded.TheservicehelpsidentifypeoplewhohavenotbeenimmunisedattheirGPandimmunisesthemintheirownhome.

• TheMaorihealthcollective,TeHauoraoTeKaruoTeIka,sawMaorihealthprovidersshareexpertiseandaddressissuessuchasmentalhealth,drugandalcohol,childhealthandfamilysupport.

• MaoriareenteringUCOLnurse’strainingingreaternumbers,with12Maoristudentsinthe2005Year1programme.

• ThepartnershipbetweentheBoardandManaWhenuawasreviewedandendorsedthisyearwithNgatiKahungunu,RangitaaneIwiandtheDHBcontinuingtoworktogetheronMaorihealthissues.TheMaoriHealthCommitteealsometbi-monthlytosupportandadviseDHBmanagement.

• TikangabestpracticeguidelineswereintroducedtodeliverservicesthatareresponsivetoMaoriculturalrites,rights,needsandcustoms.Thesehavebeensharedwithprimaryhealthservices,communitygroupsandotherDHBs.

• TheMaoriWomen’sWelfareLeagueplayedakeypartinachieving100%returnofMeningococcalBimmunisationconsentforms.

• MainstreamservicesareincreasinglyresponsivetoMaori.

Managing chronic disease

Excellentprogresswasmadeinimprovingthehealthofpeoplewithdiabetes.

• During2004,10%morepeoplewithdiabeteshadanannualreview.Maoriwithpoorlycontrolleddiabetesreducedby32%.Ofallpeoplechecked,15%fewerhadpoorlycontrolleddiabetes.

• WairarapamovedfromhavingthehighestrateofamputationsfordiabetesintheDHBCentralRegiontobeingbelowtheregionalaverage.

• TheDoctorsMastertondevelopedaprogrammeforassessingandmonitoringchronicdiseaserisktoenablebetterhealthoutcomes.Thereisgreatinterestinthisaward-winningprogrammefromaroundNewZealand.ItislikelytoberolledoutacrossotherWairarapaGPpracticesinthefuture.

Improvedservicesforpeoplewithrespiratorydiseasestartedtoshowresults.

• AllGPpracticesnowoffertrained‘QuitCoaches’forsmokingandmorepeopletookpartinquitsmokingactivityprogrammes.

• TheWDHBappointmentofaSpecialistRespiratoryNursefocusingonworkforceeducationandcomplexcasemanagementbegantoshowanimpact.

• AnewPulmonaryRehabilitationprogrammeresultedinfewerhospitalre-admissionsforcomplicationsfromrespiratorydisease.


Mental health services

Mentalhealthserviceswerere-shapedandbroughttogetherinaco-ordinatedwaysotheycanbettermeettheneedsofWairarapapeople.

• ThenewwayofworkingrecognisesthebenefitsofbothWDHBandcommunity-basedmentalhealthservicesworkingtogethertosupportpeopleintheirownenvironments.

• Servicesarefocusedonrecoveryandhope,improvedresponsivenesstoMaoriandimprovedco-ordinationandpartnershipbetweenservices.

• The24-hourMentalHealthAccessCentrewassetupasasinglepointofentryandenquirytospecialistmentalhealthservices.

• TheWDHBMentalHealthTeamcontinuestoprovideawiderangeofclinicalserviceswithafocusonintensivecommunitysupport,crisisinterventionandrespitecare.

• MastertonHospitalcloseditsinpatientunit.Acute/intensiveinpatientcareisnowprovidedbyneighbouringDHBsatHuttandPalmerstonNorthhospitals.

• TherelocationoftheChild,AdolescentMentalHealthService(CAMHS)tocentralMastertonimprovedbothaccessandacceptabilityoftheservice.

• AlcoholandDrugserviceswerebroughttogetheratWairarapaAddictionServicestoprovideafullrangeofaddictionservicesneeded.

More local hospital services

FewerWairarapapeoplenowhavetotraveloutoftheregionforhealthservicesthankstoanincreaseinvisitingspecialistsfromneighbouringDHBs.

• ThenumberofspecialistsfromneighbouringDHBsvisitingMastertonHospitalortheSouthWairarapaincreasedfrom16to22duringtheyear.

• Visitingspecialistservicesnowincludeearnoseandthroat(includinggrommets),plastics,endocrinology,rheumatology,audiology,oncologyandurology.

• BringingplasticsurgerytotheWairarapahasbeenparticularlysignificant,asmostpeopleneedingtheseservicesareelderlyandmanycan’tordon’tdrive.

• Thehospitalmovedtodigitalx-ray,dramaticallyimprovingreportingtimes.

• Laboratoryserviceswereestablishedatthehospitalandnewpracticesintroduced.

• PlanswerecompletedfortheMobileSurgicalBustobeginregularvisitstotheWairarapaearlyin05/06.


Elective surgery

• WairarapaDHBwasranked4thinthecountryformanagingpatientsawaitingelectivesurgery.

• AhigherproportionofpeoplereceivedoperationsintheWairarapathanineachofourneighbouringareasandacrossNewZealand.

• WaitingtimesforfirstspecialistappointmentsandelectivesurgerywereshorterintheWairarapathaninneighbouringDHBareasandinNZasawhole.Thereisstillroomforimprovementandwewillcontinuetoworkhardtoshortenwaitingtimes.

• MastertonHospitalachievedexcellentresultsinnationalcomparisonswithotherDHBs.Theseincludedcommunicatingwellwithpatients,assessingthemeffectivelyandtreatingthemwithintheexpectedtimeframe.

Wairarapa’s new hospital

Thelastyearhasbeenanunprecedentedperiodofchangeforourhospital.

• Followingapprovalfortheconstructionofthenew$30millionhospitalcampusinOctober2004,siteworkbeganinJanuary2005.WairarapaHospitalwillopeninMarch2006.

• WairarapaHospitalwillbeamodern,purpose-built,92-bedhospital.Itwillprovideincreasedsecondaryhealthservicesintheregion.

• Significantchangesareunderwayinthewayhealthcareservicesaredeliveredthatwillensuretheyareclinicallyandfinanciallysustainable.

• Over350usergroupmeetingswereheldensuringsignificantstaffinputintothedesignandlayoutofthenewhospital.

• Arangeofnewclinicalequipmentwaspurchasedthankstotheclearanceofthefinancialdeficitfromthelastdecadeandcertaintyabouthospitalservices.Thisincludedtheatretables,portableultra-soundmachines,monitors,labequipment,sterilisingequipmentandelectricbeds.

Professional development • Analysisoftheskillsneededinthefuturewaspartoftheworkforceredesignundertakenduringtheyear.WairarapaDHBworkedwithitsownandneighbouringDHBtrainerstoupskillstaffandpreparethemfornewroles.

• Stafftraininganddevelopmentcontinuedinmanyotherareas.Anotablesuccesswasthe30nurseswhoachievedAdvancedCardiacLifeSupport.

• 44WairarapaDHBmidwives,registerednursesandenrollednursesarenowregisteredinthenewProfessionalDevelopmentandRecognitionProgramme.

Alignedwithnationalstandards,theprogrammeoffersafinancialincentiveforstafftotakepart,submitportfoliosandattainprofessionalrecognitionatthelevelofpracticetheyareworkingat.

• AvarietyofWDHBeducationprogrammessuchaspain,woundanddiabetesmanagementwereopeneduptootherhealthinterestgroups.

• WDHBandNGOstaffreceiveddiversityawarenesstrainingwithstrongrepresentationfromWairaraparest-homesandhospitals.


Populationserved 39,000

WairarapaDHBStaff 618(manyworkpart-time)

Revenue $82million

Primarycareconsultations 191,000

GPsintheWairarapa 26

Freesexualhealthconsultations 2,818

Fluvaccinations 6,348

Peopleover65receivingsubsidisedresthomecare 247

MealsonWheelsdelivered 7,424

Prescriptionsdispensedbycommunitypharmacies 530,000

LabtestsbyhospitalandcommunityLaboratories 258,351

Communityanddistrictnursevisits 35,327

Childrenenrolledinschooldentalservice 5,716

Visionandhearingappointmentsforchildrenundersix 1,500

Peoplesupportedbyhospitalandcommunitymentalhealthservices 697

PatientsadmittedtoMastertonHospital 6,638

Specialistoutpatientappointments 13,371

Orthopaedicsurgeryoperations 674

EmergencyDepartmentattendances 14,763

RadiologyexaminationsatMastertonHospital 22,516

BirthsatMastertonHospital 438

STATISTICS

Masterton Hospital 51%

Services in other regions 20%

Pharmaceuticals 10%

Services for older people 7%

PHO 4%

Mental Health 3%

Personal Health 2%

DHB Governance 2%

Maori Health 1%

5%MentalHealth

4%DisabilitySupport

PersonalHealthe.g.Emergency,Inpatients,DistrictNursing

42%

WDHB Expenditure


GOVERNANCE

ABoardofelevenmembersrepresentingtheCrownisresponsibleforthegovernanceoftheWairarapaDHBunderSection25oftheCrownEntitiesAct2004.SevenmembersareelectedbytheWairarapacommunityandfourareappointedbytheMinisterofHealth.

TheBoardisresponsibleforoverseeingthedirectionandsupervisionoftheWairarapaDHB’saffairsonbehalfits‘owner’,theCrown.Itsprincipalfunctionsareto:

• delegateresponsibilitytotheChiefExecutive

• setstrategicdirection,goalsandpolicy

• monitorprogresstowardsmeetinggoals

• ensurecompliancewiththeNZPublicHealthandDisabilityAct2000,theCrownEntitiesActandallotherrelevantlegislation

• fostercommunityparticipationinhealthimprovement,includingparticipationbyMaori

• monitortheChiefExecutive’sperformancewithrespecttotheabove.

TheBoardalsohasakeygovernancerelationshipwithWairarapaMaorithroughtheManaWhenuaCaucuswhichmeetsbi-monthly.ThisensuresMaoriparticipationatalllevelsofserviceplanninganddeliveryfortheprotectionandimprovementofthehealthstatusofMaori.

TheAuditandRiskCommitteeoftheBoardensuresthatfinancialstatementsareaccurate,appropriateaccountingpolicies,standardsandpracticesarefollowed,andrisksareidentifiedandappropriatelymanaged.

Role of the Chief ExecutiveTheBoarddelegatesmanagementoftheday-to-dayaffairsandmanagementresponsibilitiesoftheWairarapaDHBtotheChiefExecutive.TheChiefExecutivedeliversthestrategyandgoalsdeterminedbytheBoardwithintheframeworkoftheDistrictStrategicPlan,StatementofIntentandDistrictAnnualPlan.

Advisory CommitteesTheBoardhasthreeadvisorycommittees:CommunityandPublicHealthAdvisoryCommittee;DisabilitySupportAdvisoryCommittee;HospitalAdvisoryCommittee.

AdvisorycommitteesoperateunderstatutorytermsofreferenceandcompriseBoardandcommunitymemberswhoadvisetheBoardonissueswhichhavebeenreferredtothem.

Advisory GroupsSinceitsinceptiontheWairarapaDHBhasinvolvedmanylocalpeopleinarangeofadvisorygroupstoinformitsserviceplanninganddevelopment.Theadvisorygroupsincludethosefor:Maorihealth;mentalhealth;healthofolderpeople;diabetes;respiratorydisease;disabilities;pharmacyservices;pregnancyandparenting;andyouthhealth.Thesegroupsensurethereisgoodstakeholderandconsumerinputintoalldecisionsandthatplansanddevelopmentsarecommunicatedandco-ordinatedacrossthewholerangeofrelevantserviceproviders.

The Board is responsible for overseeing the direction and supervision of the Wairarapa DHB’s affairs on behalf its ‘owner’, the Crown.

�0 | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | ��0 | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | ��

BOARD MEMBER PROFILES

Doug Matheson (MNZM) – ChairmanDougMathesonmovedtotheWairarapainthe1990sandbroughtwithhimawealthofgovernanceexperienceandbusinessknowledge.Doughasalong-terminterestinhelpingshapeorganisationssotheyreachtheirtruepotentialandhasmanycommitmentstoassociationsandbusinessesbothlocallyandinternationally.TheseincludetheroleofBoardChairmanforGoWairarapa,BoardChairmanofBiomedicalServicesNewZealandLtdandimmediatepastNationalChairman(andLifeMember)oftheNZInstituteofManagementInc.In2002DougwasappointedaMemberoftheNewZealandOrderofMerit(MNZM)inrecognitionofhisservicestobusinessandthecommunity.

Doug’senthusiasm,driveandwisdomhavehelpedtheDHBovercomemanychallenges.Heisakeyperformerinstrengtheningrelationships,bringingimprovedcollaborationandconsistencytohealthandhospitalservicesintheWairarapatobetterserveitspopulation.

Janine Vollebregt – Deputy ChairAregisterednurse,JanineVollebregtwaselectedtotheBoardforasecondterminDecember2004.HerexperienceworkingthroughouttheWairarapacommunityhasgivenJaninewideexposuretothemanyissuesthatimpactonpeople’shealthandwell-being,suchasaccesstoservices,healthawarenessandsatisfaction,andservicesappropriatetotheneedsofspecificgroups.Janine’sgoalistoenabletheWairarapatohavehealthfacilitiesandservicesthateveryonecanbeproudofandfeelconfidentinusing.

Cheryl-Ann Broughton-KureiCherylisofNgatiKahungunukiWairarapaandRangitaanedescent,andwasappointedtotheBoardforasecondterm.CherylhasawideinvolvementwiththeWairarapacommunityandastrongassociationwiththeprovisionofhealthservices.ShehasservedastheChairpersonofNgaHapuKaranga(TreatyClaimsCollective)since2000,isTrusteeofNgaKanohiMaraeoWairarapa(collectiveofeightWairarapaMarae),DirectorofAohangaIncorporation(MaoriFarmInc)since2003,BoardmemberofNgatiKahungunuIwiIncsince2004andTrusteeofWhaioraWhanuiTrust(2001–2005).

Perry CameronElectedtotheBoardin2004,PerryCameron(FCISCA)bringsextensiveexperienceinbothpublicandprivatesectorgovernanceandaccountability.HeisaCouncilloroftheNZInstituteofCharteredAccountantsandanappointedmemberoftheNZPsychologistsBoard.PerryisanadvocateforimprovedaccesstohealthservicesthroughouttheWairarapa,withparticularemphasisoncasemanagementforpeoplewithdisabilities,formentalhealthconsumersandsupportforfamilies.

Martin EasthopeAsemi-retiredbusinessman,MartinEasthopehasaprovenbackgroundinstrategiesplanningandbusinessmanagement.Martin’skeyprioritiesforhissecondelectedtermontheBoardaretoprovideintegratedhealthservices,improvedaccessandhealthoutcomesforall,andcompletionofthenewWairarapaHospital.Hesupportsthegrowingrecognitionthattobe“well”requiresmorethanjusthealthservices;itrequiresunitedcommunityactionintermsofbothrelationshipsandworkingproactivelytoreachapositiveoutcome.

Doctor Liz FalknerGeneralPractitionerandMastertondoctorsince1973,LizFalknerwasre-electedtotheBoardforasecondterm.Lizbringsawealthoflife-timeexperienceinthehealthanddisabilitysector,alongwithgovernance,smallbusinessandcommunicationskills.SheisakeyparticipantinBoard/ManaWhenuaCaucusmeetings.LizisalsoMedicalAdvisortothePostPolioSupportSocietyNZ(Inc),andPresidentoftheWairarapaBranchandhasavastrangeofcommunityandcommitteeworkexperience.


BOARD AND COMMITTEE MEMBERSHIP

BoardMembers Community&PublicHealthAdvisoryCommittee

DisabilitySupportAdvisoryCommittee

HospitalAdvisoryCommittee

AuditandRiskCommittee

DougMatheson

JanineVollebregt

PerryCameron

MartinEasthope

PamelaJefferies

CherylBroughton-Kurei

DrLizFalkner

YvetteGrace

VivienNapier

TrishTaylor

DrRobTuckett

N.B. DenotesChair Committeemember TheDisabilitySupportAdvisoryCommitteealsohastwoco-optedmembers;MrsRuthCarterandMrsAnneSavage.

Yvette Hikitapua-GraceYvetteisofRangitaaneoWairarapaandNgatiKahungunudescentandwasappointedtotheBoardinDecember2004.YvettehasabackgroundincommunitysocialservicesstartingwithCameronCommunityHouseandWairarapaRapeCrisisinthe1980s.YvettecurrentlysitsonthegovernanceboardsofRangitaaneoWairarapaIwiAuthorityandtheWairarapaCommunityPrimaryHealthOrganisation(Iwirepresentative).YvettehaspreviouslyservedasChairpersonofTeKuraKaupapaMaorioWairarapa,andonthecollectivesofWairarapaWomen’sRefugeandWairarapaRapeCrisis.

Pamela Jefferies (OBE)Anaccountantandcompanydirector,PamelaJefferieslivesintheSouthWairarapa.Pamela’sexperienceincludesthemanagementofprofessionalpeople,strategicthinking,planning,changemanagementandgoodgovernanceissues.SheisaDirectorofBankofNewZealandandChairmanoftheBankofNewZealandWealthManagementCompanies.InherformercapacityasChiefHumanRightsCommissionershehashadinputintomanyhealthissuesrangingfromtheRighttoHealth,accesstofertilityandrenalservices,rightsforthedisabledandelderlyandCoreHealthServicesCommitteePolicy.

Vivien NapierArelievingprimaryschoolteacherandDeputyMayoroftheSouthWairarapaDistrict,VivienNapierseescontinuedandimprovedaccesstohealthservicesasakeygoalfortheWairarapa.VivienbringsanimportantSouthWairarapaperspectivetotheBoard.Sheenjoysthechallengesandrewardsofdevelopingnewandimprovedhealthservices,particularlywiththeconstructionofthenewWairarapaHospitalandwithakeyemphasisonprimaryhealthinitiatives.

Trish TaylorAregisterednursewithexperienceinpublicandprivatehospitals,districtnursingandmentalhealth,TrishTaylorhasalonginvolvementintheWairarapahealthsector.Shewasrecentlyre-electedtotheBoard,havinghadabreakforseveralterms.Trish’sfirsthandexperienceofworkingatthecoalfaceformanyyearsensurestherealstaffandpatientissuesareheardatBoardlevel.Trishhasapassionforhealth,andensuringhospitalandhealthservicesservethepeopleoftheWairarapa.

Doctor Rob TuckettGPRobTuckett,althoughretired,isstillactivelyinvolvedingeneralpractice,providingmuch-neededholidayandlocumcoverthroughouttheWairarapaonaregularbasis.Robwasre-electedtotheBoardforasecondtermandlooksforwardtocontinuedworktoachievefurthergainsintheprovisionofhealthservices.

DoctorTuckettbringsawealthofGPexperiencetotheWairarapa,havingcometoNewZealandfromtheUKin1974.HehasbeenastrongadvocateforGPinvolvementinhospitalpracticeandhasaspecialinterestinthecareofolderpeopleandpeoplewithdisabilities.

�� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | �� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | ��

STATEMENT OF RESPONSIBILITY

For the year ended 30 June 2005TheBoardandmanagementofWairarapaDHBacceptresponsibilityforthepreparationofthefinancialstatementsandjudgementsusedinthem.

TheBoardandmanagementofWairarapaDHBacceptresponsibilityforestablishingandmaintainingasystemofinternalcontroldesignedtoprovidereasonableassuranceastotheintegrityandreliabilityoffinancialreporting.

IntheopinionoftheBoardandmanagementofWairarapaDHBthefinancialstatementsfortheyearended30June2005fairlyreflectthefinancialpositionandoperationsofWairarapaDHB.

Chairman ChiefExecutive ChiefFinancialOfficerDougMatheson DavidMeates EricSinclair

Dated 25October2005


Reporting EntityWairarapaDHBisastatutoryentityintermsoftheCrownEntitiesAct2004.

ThegroupconsistsofWairarapaDHB,itssubsidiaryBiomedicalServicesNewZealandLimited(100%owned)andjointventuretheCentralRegionTechnicalAdvisoryServiceLimited(TAS)whichisonesixthowned.

ThefinancialstatementsandgroupfinancialstatementsofWairarapaDHBhavebeenpreparedinaccordancewiththerequirementsoftheNewZealandPublicHealthandDisabilityAct2000andthePublicFinanceAct1989.

Inaddition,fundsadministeredonbehalfofpatientshavebeenreportedasanotetothefinancialstatements.

Measurement BaseThefinancialstatementshavebeenpreparedonanhistoricalcostbasis,modifiedbytherevaluationofcertainProperty,PlantandEquipment.

Accounting PoliciesThefollowingparticularaccountingpolicies,whichmateriallyaffectthemeasurementofresultsandfinancialposition,havebeenapplied:

Basis of Consolidation – Purchase MethodTheconsolidatedfinancialstatementsincludetheparentDHBanditssubsidiary.Thesubsidiaryisaccountedforusingthepurchasemethodwhichinvolvesaddingtogethercorrespondingassets,liabilities,revenuesandexpensesonaline-by-linebasis.

Allsignificantinter-entitytransactionsareeliminatedonconsolidation.

Budget FiguresThebudgetfiguresarethoseapprovedbytheBoardandpublishedinitsAnnualPlan.ThebudgetfigureshavebeenpreparedinaccordancewithgenerallyacceptedaccountingpracticeandareconsistentwiththeaccountingpoliciesadoptedbytheBoardforthepreparationofthesefinancialstatements.

Goods and Services TaxAllitemsinthefinancialstatementsareexclusiveofGoodsandServicesTax(GST)withtheexceptionofreceivablesandpayables,whicharestatedwithGSTincluded.WhereGSTisirrecoverableasaninputtaxthenitisrecognisedaspartoftherelatedassetorexpense.

TaxationWairarapaDHBisapublicauthorityundertheNewZealandPublicHealthandDisabilityAct2000andisexemptfromincometaxunderSectionCB3oftheIncomeTaxAct1994.

Thewhollyownedsubsidiarycompany,BiomedicalServicesNewZealandLimited,issubjecttoincometax.Incometaxexpenseischargedinthegroupstatementoffinancialperformanceinrespectofitscurrentyear’searningsafterallowingforpermanentdifferences.Deferredtaxationisdeterminedonacomprehensivebasisusingtheliabilitymethod.Deferredtaxassetsattributabletotimingdifferencesortaxbasesareonlyrecognisedwherethereisvirtualcertaintyofrealisation.

Trust and Bequest FundsDonationsandbequeststoWairarapaDHBarerecognisedasrevenueonreceiptinthestatementoffinancialperformance,exceptwheretherestrictiveconditionsaresuchthattheBoardhasaliabilitytothedonor.

Accounts ReceivableAccountsreceivablearestatedatexpectedrealisablevalueafterprovidingfordoubtfulanduncollectibledebts.

InventoriesInventoriesarevaluedatthelowerofcost,determinedonaweightedaveragebasis,andnetrealisablevalueafterallowingforslowmovingandobsoleteitems.

InvestmentsInvestments,includingthoseinsubsidiaryandassociatedcompanies,arestatedatthelowerofcostandnetrealisablevalue.AnydecreasesarerecognisedintheStatementofFinancialPerformance.

STATEMENT OF ACCOUNTING POLICIES


Property, Plant and EquipmentProperty, Plant and Equipment Vested from the Hospital and Health ServiceUndersection95(3)oftheNewZealandPublicHealthandDisabilityAct2000,theassetsofWairarapaHealthLimited(aHospitalandHealthService)werevestedinWairarapaDHBon1January2001.Accordingly,assetsweretransferredtoWairarapaDHBattheirnetbookvaluesasrecordedinthebooksoftheHospitalandHealthService.Ineffectingthistransfer,theBoardhasrecognisedthecost(orinthecaseoflandandbuildings–thevaluation)andaccumulateddepreciationamountsfromtherecordsoftheHospitalandHealthService.Thevestedassetswillcontinuetobedepreciatedovertheirremainingusefullives.

Property, Plant and Equipment Acquired Since the Establishment of the Wairarapa DHBAssets,otherthanlandandbuildings,acquiredbytheBoardsinceitsestablishment,andotherthanthosevestedfromtheHospitalandHealthService,arerecordedatcostlessaccumulateddepreciation.Costincludesallappropriatecostsofacquisitionandinstallation,includingmaterials,labour,directoverheads,financingandtransportcosts.

Revaluation of Land and BuildingsLandandbuildingsarerevaluedeverythreeyearstotheirfairvalueasdeterminedbyanindependentregisteredvaluerbyreferencetotheirhighestandbestuse.Additionsbetweenrevaluationsarerecordedatcost.Theresultsofrevaluinglandandbuildingsarecreditedordebitedtoanassetrevaluationreserveforthatclassofasset.Wherearevaluationresultsinadebitbalanceintheassetrevaluationreserve,thedebitbalanceisexpensedintheStatementofFinancialPerformance.

Disposal of Property, Plant and EquipmentWhenafixedassetisdisposedof,anygainorlossisrecognisedintheStatementofFinancialPerformanceandiscalculatedasthedifferencebetweenthesalepriceandthecarryingvalueofthefixedasset.

Properties Intended for SalePropertiesintendedforsalearevaluedatthelowerofcostornetrealisablevalue.

DepreciationDepreciationisprovidedonastraightlinebasisonallProperty,PlantandEquipmentotherthanfreeholdland,atratesthatwillwriteoffthecost(orrevaluation)oftheassetstotheirestimatedresidualvaluesovertheirusefullives.

Theusefullivesandassociateddepreciationratesofmajorclassesofassetshavebeenestimatedasfollows:

Buildingsandfitout 2–50years 2–50%

Plantandequipment 2.5–15years 6.5–40%

Motorvehicles 5–12.5years 8–20%

Leasedassets 2.5–15years 6.5–40%

Capitalworkinprogressisnotdepreciated.Thetotalcostofaprojectistransferredtofreeholdbuildings/buildingfit-outand/orplantandequipmentonitscompletionandthendepreciated.

Employee EntitlementsProvisionismadeinrespectoftheWairarapaDHB’sliabilityforannualleave,longserviceleave,retirementgratuities,parentalleaveandconferenceleave.Annualleave,parentalleaveandconferenceleavehavebeencalculatedonanactualentitlementbasisatcurrentratesofpaywhilsttheotherprovisionshavebeencalculatedonanactuarialbasis.

LeasesFinance LeasesLeaseswhicheffectivelytransfertoWairarapaDHBsubstantiallyalltherisksandbenefitsincidenttoownershipoftheleaseditemsareclassifiedasfinanceleases.Thesearecapitalisedatthelowerofthefairvalueoftheassetorthepresentvalueoftheminimumleasepayments.Theleasedassetsandcorrespondingleaseliabilitiesarerecognisedinthestatementoffinancialposition.TheleasedassetsaredepreciatedovertheperiodWairarapaDHBisexpectedtobenefitfromtheiruse.

Operating LeasesLeaseswherethelessoreffectivelyretainssubstantiallyalltherisksandbenefitsofownershipoftheleaseditemsareclassifiedasoperatingleases.Operatingleaseexpensesarerecognisedonasystematicbasisovertheperiodofthelease.


Financial InstrumentsWairarapaDHBseekstominimiseexposurearisingfromitstreasuryactivity.TheWairarapaDHBisnotauthorisedbyitstreasurypolicytoenteranytransactionsthatarespeculativeinnature.

WairarapaDHB(andgroup)ispartytofinancialinstrumentsaspartofitsnormaloperations.Thesefinancialinstrumentsincludebankaccounts,short-termdeposits,investments,debtors,creditorsandloans.AllfinancialinstrumentsarerecognisedintheStatementofFinancialPositionandallrevenueandexpensesinrelationtofinancialinstrumentsarerecognisedintheStatementofFinancialPerformance.

Exceptforloans,whicharerecordedatcost,andthoseitemscoveredbyaseparateaccountingpolicy,allfinancialinstrumentsareshownattheirestimatedfairvalue.

Statement of Cash flowsCashmeanscashbalancesonhand,heldinbankaccounts,bankoverdrafts,demanddepositsandotherhighlyliquidinvestmentsinwhichWairarapaDHBinvestsaspartofitsday-to-daycashmanagement.

Operatingactivitiesincludealltransactionsthatarenotinvestingorfinancingactivities.CashinflowsincludeallreceiptsfromthesaleofgoodsandservicesandothersourcesofrevenuewhichsupportstheWairarapaDHB’soperatingactivities.Cashoutflowsincludepaymentsmadetoemployees,suppliersandfortaxes.

Investingactivitiesarethoseactivitiesrelatingtotheacquisitionanddisposalofcurrentandnon-currentsecuritiesandadvancesandanyothernon-currentassets.

FinancingactivitiescomprisethechangeinequityanddebtcapitalstructureofWairarapaDHB.

Foreign Currency TranslationsTransactionsdenominatedinforeigncurrencies(otherthanforwardexchangecontracts)aretranslatedattherateofexchangerulingatthetransactiondate.Shorttermtransactionscoveredbyforwardexchangecontractsaremeasuredandreportedattheforwardratesspecifiedinthecontracts.

Atbalancedateforeignmonetaryassetsandliabilitiesaretranslatedattheclosingrateandexchangedifferencesarisingfromthetransactionsarerecognisedinthestatementoffinancialperformance.

Cost of Service StatementsThecostofservicestatements,asreportedinthestatementofobjectivesandserviceperformance,reportthenetcostofservicesfortheoutputsofWairarapaDHBandarerepresentedbythecostofprovidingtheoutputlessalltherevenuethatcanbeallocatedtotheseactivities.

Cost AllocationWairarapaDHBhasarrivedatthenetcostofserviceforeachsignificantactivityusingthecostallocationsystemoutlinedbelow.

Cost Allocation PolicyDirectcostsarechargeddirectlytomajorboardactivities.Indirectcostsarechargedtomajorboardactivitiesbasedoncostdriversandrelatedactivity/usageinformation.

Criteria for Direct and Indirect CostsDirectcostsarethosecostsdirectlyattributabletoaspecificWairarapaDHBactivity.

IndirectcostsarethosecostswhichcannotbeidentifiedinaneconomicallyfeasiblemannerwithaspecificWairarapaDHBactivity.

Cost Drivers for Allocation of Indirect CostsThecostofinternalservicesnotdirectlychargedtoboardactivitiesisallocatedasoverheadsusingappropriatecostdriverssuchasactualusage,staffnumbersandfloorarea.Fortheyearended30June2005,indirectcostsaccountedfor14%ofWairarapaDHB’stotalcosts.

Changes in Accounting PoliciesTherehavebeennochangesfromtheaccountingpoliciesadoptedinthelastauditedfinancialstatements.Allpolicieshavebeenadoptedonabasisconsistentwiththepreviousperiod.


Consolidated Statement of Financial PerformanceFor the year ended 30 June 2005

Group Group Parent Budget Actual Actual Note 2005 2005 2004 2005 2004 $000 $000 $000 $000 $000 Revenue 78,426 81,994 75,795 81,072 74,862OperatingExpenses -76,062 -80,132 -74,446 -79,305 -73,644Depreciation -1,393 -1,235 -1,501 -1,163 -1,437InterestExpense -789 -490 -439 -490 -439CapitalCharge 19 -1,171 -387 -1,027 -387 -1,027Operating Surplus/(Deficit) before Taxation 1 -989 -250 -1,618 -273 -1,685Write-downofproperty 7 0 0 -4,071 0 -4,071TaxExpense 2 -18 -8 -22 0 0Net Surplus / (Deficit) after Taxation -1,007 -258 -5,711 -273 -5,756

Consolidated Statement of Movements in EquityFor the year ended 30 June 2005

Group Group Parent Budget Actual Actual 2005 2005 2004 2005 2004 $000 $000 $000 $000 $000 NetSurplus/DeficitfortheYear -1,007 -258 -5,711 -273 -5,756OtherRecognisedRevenueandExpenses (Decrease)/IncreaseinRevaluationReserve 0 0 -3,445 0 -3,445Total Recognised Revenue and Expenses -1,007 -258 -9,156 -273 -9,201ContributionfromOwners 3,893 0 1,620 0 1,620MovementsinEquityfortheYear 2,886 -258 -7,536 -273 -7,581EquityatStartoftheYear 10,218 2,551 10,087 2,361 9,942Equity at End of the Year 13,104 2,293 2,551 2,088 2,361

Equityis$10,811,000lessthanbudgetat30June2005.ThisisbecausetheGroupBudgetintheStatementofIntentwaspreparedbeforethe“greenfields”redevelopmentoptionwasconfirmedleadingtothe$9,300,000writedownofthelandandbuildingsthataretobedisposedatthecompletionoftheproject.Thebudgetalsoassumedtherewouldbeanequitydrawdown(ContributionfromOwners)of$3,893,000tofundtheWairarapaHospitalredevelopmentproject.Thishasnotbeenrequiredaswehavebeenabletodrawdowndebtatalowerinterestratethanthecapitalchargewhichanequitydrawdownwouldattract.Thedeficitfortheyearisalso$749,000lowerthanplanned.

Theaccompanyingaccountingpoliciesandnotesformpartofthesefinancialstatements.


Consolidated Statement of Financial PositionAs at 30 June 2005

Group Group Parent Budget Actual Actual Note 2005 2005 2004 2005 2004 $000 $000 $000 $000 $000

EQUITY GeneralFunds 3a 14,471 10,495 10,495 10,495 10,495RetainedEarnings/(AccumulatedDeficit) 3b -1,367 -8,202 -7,944 -8,407 -8,134Total Equity 13,104 2,293 2,551 2,088 2,361 Represented by: ASSETS Current Assets Cash 231 125 916 0 838ShortTermDeposits 0 69 66 0 0ReceivablesandPrepayments 4 6,540 8,148 6,880 8,008 6,775Inventories 5 575 484 436 484 436PropertiesIntendedforSale 7 0 1,775 79 1,775 79Total Current Assets 7,346 10,601 8,377 10,267 8,128 Non Current Assets TrustFunds 6 230 145 241 145 241Property,PlantandEquipment 7 30,075 17,207 8,640 17,087 8,484PropertiesIntendedforSale 7 0 0 1,775 0 1,775Investments 8&9 0 0 0 103 103Total Non Current Assets 30,305 17,352 10,656 17,335 10,603 Total Assets 37,651 27,953 19,033 27,602 18,731 LIABILITIES Current Liabilities BankOverdraft(secured) 10 7 288 0 288 0PayablesandAccruals 11 7,938 9,944 6,537 9,843 6,468EmployeeEntitlements 12 1,906 3,325 2,762 3,282 2,721FinanceLeaseLiability(current) 14 0 166 343 166 343CurrentPortionofTermLoans(secured) 14 0 6,000 6,000 6,000 6,000Total Current Liabilities 9,851 19,723 15,642 19,579 15,532 Non Current Liabilities EmployeeEntitlements 12 352 380 361 378 359TrustFunds 13 230 145 241 145 241FinanceLeaseLiability(noncurrent) 14 0 72 238 72 238TermLoans(secured) 14 14,114 5,340 0 5,340 0Total Non Current Liabilities 14,696 5,937 840 5,935 838 TOTAL LIABILITIES 24,547 25,660 16,482 25,514 16,370 NET ASSETS 13,104 2,293 2,551 2,088 2,361

For and on behalf of the Board: Board Member Board MemberDated25October2005Theaccompanyingaccountingpoliciesandnotesformpartofthesefinancialstatements.


Consolidated Statement of Cash FlowsFor the year ended 30 June 2005

Group Group Parent Budget Actual Actual Note 2005 2005 2004 2005 2004 $000 $000 $000 $000 $000 CASH FLOWS FROM OPERATING ACTIVITIES ReceiptsfromMinistryofHealthandPatients 79,794 80,460 73,986 79,562 73,052InterestReceived 53 162 76 158 71

PaymentstoSuppliers -37,421 -53,067 -47,703 -52,728 -47,340

PaymentstoEmployees -39,820 -24,522 -24,413 -24,039 -23,978

CapitalCharge -1,133 -775 -1,007 -775 -1,007

InterestPaid -801 -451 -440 -451 -440GoodsandServicesTax(net) 0 157 -26 151 8

Net Cash Inflow/(Outflow) from Operating Activities 15 672 1,964 473 1,878 366 CASH FLOWS FROM INVESTING ACTIVITES

ProceedsfromSaleofProperty,PlantandEquipment 0 224 178 224 175PurchaseofProperty,PlantandEquipment -12,779 -8,238 -1,216 -8,202 -1,112

Net Cash Inflow / (Outflow) from Investment Activities -12,779 -8,014 -1,038 -7,978 -937 CASH FLOWS FROM FINANCING ACTIVIES LoansIntroduced 8,114 11,340 0 11,340 0CapitalIntroduced 3,893 0 1,620 0 1,620Repaymentsofloans 0 -6,343 -32 -6,343 -32RestrictedFundMovement 0 -23 -20 -23 -20Net Cash Inflow/(Outflow) from Financing Activities 12,007 4,974 1,568 4,974 1,568 Net Increase in Cash Held -100 -1,076 1,003 -1,126 997AddOpeningCash 324 982 -21 838 -159CLOSING CASH BALANCE 224 -94 982 -288 838 Madeupof: Cash 231 125 916 0 838ShortTermDeposits 0 69 66 0 0BankOverdraft -7 -288 0 -288 0CLOSING CASH BALANCE 224 -94 982 -288 838

Theaccompanyingaccountingpoliciesandnotesformpartofthesefinancialstatements.


Consolidated Statement of Contingent Liabilities As at 30 June 2005

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 LegalProceedingsandDisputesbyThirdParties 15 190 15 190

Consolidated Statement of CommitmentsAs at 30 June 2005

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 Capital Commitments 18,494 583 18,494 583 Operating Lease Commitments LessthanOneYear 675 779 636 745OnetoTwoYears 212 350 164 306TwotoFiveYears 34 10 33 9OverFiveYears 0 0 0 0Total Operating Lease Commitments 921 1,139 833 1,060 Non-cancellable Contracts for the Provision of Services NotLaterThanOneYear NonFunder 1,133 1,023 1,133 1,023Funder 3,834 2,870 3,834 2,870LaterThanOneYearandNotLaterThanTwoYears NonFunder 461 129 461 129Funder 3,087 890 3,087 890LaterThanTwoYearsandNotLaterThanFiveYears NonFunder 885 145 885 145Funder 2,408 568 2,408 568OverFiveYears NonFunder 0 0 0 0Funder 0 0 0 0Total Non-Cancellable Contracts 11,808 5,625 11,808 5,625 TOTAL COMMITMENTS 31,223 7,347 31,135 7,268

TheCapitalCommitmentsof$18,494,000includesanamountof$18,147,000whichistheremainingcontractsumduefortheconstructionofWairarapaHospital.


Notes to the Consolidated Financial Statements For the year ended 30 June 2005

1. Net Operating Surplus / (Deficit) Before Taxation

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 After Charging: RemunerationofAuditor AuditFees 50 48 42 41OtherServices 0 7 0 7 50 55 42 48Depreciation

Buildings 175 777 175 777PlantandEquipment 611 646 563 592InformationTechnology 378 0 362 0MotorVehicles 71 78 63 68 Total 1,235 1,501 1,163 1,437 NetGainonSaleofProperty,PlantandEquipment -137 -129 -137 -129BoardMembers’Fees 218 247 215 230RentalandOperatingLeaseCosts 1,320 1,411 1,286 1,386BadDebtsWrittenOff 59 15 59 15ChangesinProvisionforBadDebts -22 11 -22 11 After Crediting: Donations 142 43 142 43InterestIncome 162 76 158 71

2. Tax ExpenseInaccordancewiththeNewZealandPublicHealthandDisabilityAct2000,theparent(WairarapaDHB)isapublicauthorityandisexemptfromincometax.ThefollowingtaxationrelatestothesubsidycompanyBiomedicalServicesNewZealandLimited.

Group 2005 2004 $000 $000Operatingsurplus/(deficit)beforeTaxation 23 67PrimaFacieTaxationof33%onSubsidiary 8 22Plus / (Less) Taxation Effect On: PriorPeriodAdjustment 0 0PermanentDifferences 0 0TimingDifferencesNotRecognised 0 0Taxation Expense 8 22

BiomedicalServicesNewZealandLimitedhasnotrecogniseddeferredtaxassetaccumulativetimingdifferencesof$139,556(June2004:$132,548)asthesearenotexpectedtoreverseintheforeseeablefuture.Thetaxeffectofthetimingdifferencesnotrecognisedis$46,053(June2004:$43,741).Atbalancedatetherewereimputationcreditsof$88,154availabletoshareholders.


3. Equity

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000(a) General Funds OpeningBalance 10,495 12,320 10,495 12,320MovementinRevaluationReserve 0 -3,445 0 -3,445IssuedDuringtheYear 0 1,620 0 1,620Balance At 30 June 10,495 10,495 10,495 10,495

(b) Retained Earnings RetainedEarningsat1July -7,944 -2,213 -8,134 -2,358NetSurplus/(Deficit) -258 -5,711 -273 -5,756TransfersfromTrustFunds(note13) 0 0 0 0TransfertoTrustFunds(note13) 0 -20 0 -20RETAINED EARNINGS AT 30 JUNE -8,202 -7,944 -8,407 -8,134

4. Receivables and Prepayments

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000TradeDebtors 1,862 893 1,718 783ProvisionforDoubtfulDebts -76 -98 -76 -98AccruedIncome 5,933 5,848 5,933 5,845Prepayments 427 236 427 236Sundry 2 1 2 1Receivables & prepayments excluding owing by subsidiary 8,148 6,880 8,004 6,767AmountOwingbySubsidiary 0 0 4 8RECEIVABLES & PREPAYMENTS INCLUDING OWING BY SUBSIDIARY 8,148 6,880 8,008 6,775

5. Inventories

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000Pharmaceuticals 73 67 73 67SurgicalandMedicalSupplies 177 135 177 135TheatreSupplies 189 189 189 189OtherSupplies 45 45 45 45TOTAL INVENTORY 484 436 484 436

NoinventoriesarepledgedassecurityforliabilitiesbutsomeinventoriesaresubjecttoRetentionofTitleclausesunderthePersonalPropertySecuritiesAct1999.Thevalueofstockssubjecttosuchclausescannotbequantifiedduetotheinherentdifficultiesinidentifyingthespecificinventoriesaffectedatyearend.


6. Trust Fund Investments

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 MoneyMarketandotherTradingBanks 145 241 145 241

Theseinvestmentsareallheldastrustfunds.

7. Property, Plant and Equipment

Group Parent

2005 2004 2005 2004 $000 $000 $000 $000 Land AtValuation 228 228 228 228Land – Net Current Value 228 228 228 228 Buildings AtValuation 4,520 4,417 4,520 4,417AtCost 0 24 24AccumulatedDepreciation -366 -177 -366 -177Buildings – Net Current Value 4,154 4,264 4,154 4,264

Plant and Equipment AtCost 10,263 9,919 9,725 9,417AccumulatedDepreciation -7,914 -7,459 -7,490 -7,099Plant and Equipment – Net Book Value 2,349 2,460 2,235 2,318 Motor Vehicles AtCost 795 795 753 753AccumulatedDepreciation -616 -545 -580 -517Motor Vehicles – Net Book Value 179 250 173 236 Capital Work in Progress Buildings 9,739 846 9,739 846PlantandEquipment 320 11 320 11Capital Work in Progress 10,059 857 10,059 857 Capitalised Finance Leases InformationTechnology AtValuation 581 581 581 581AccumulatedDepreciation -343 -343 Information Technology – Net Book Value 238 581 238 581 Total Property, Plant and Equipment AtCostandValuation 26,446 16,821 25,866 16,277AccumulatedDepreciation -9,239 -8,181 -8,779 -7,793TOTAL CARRYING AMOUNT OF PROPERTY, PLANT AND EQUIPMENT 17,207 8,640 17,087 8,484


ValuationRevaluedfreeholdlandandbuildingsarestatedatnetcurrentvalueasdeterminedbyCBRichardEllis(RegisteredValuers),asat30June2003underaFinancialReportingStandardNo3(FRS-3)methodologytotheirhighestandbestuse.

Valuation Impact from Hospital Redevelopment Plan and Write-down of PropertyTheBoardrevaluedthebuildingsandassociatedlandunderaStatementofStandardAccountingPracticeNo.17(SSAP-17)methodologytothelowerofcostandnetrealisablevalue.ThevaluationwascompletedbyCBRichardEllis(RegisteredValuer)asat30June2004.

ThisrevaluationreducedthecarryingvalueforProperty,PlantandEquipmentby$9.3millionandrecognisesthebuildingsandassociatedlandasPropertiesIntendedforSalewhichareseparatelyidentifiedontheStatementofFinancialPosition.ThevalueassignedunderSSAP-17is$1.8million.Thisresultedinawrite-downagainsttherevaluationreserveof$3.445millionwhichbroughtthebalanceofthereservetoNil.Theremainingwrite-downbalanceof$4.071millionhasbeenseparatelydisclosedontheStatementofFinancialPerformance.

Capitalised Finance LeasesAt30June2004theBoardreclassifiedleasingarrangementsforInformationTechnologyequipmentasfinanceleases.Theseleaseshavebeenvaluedatthepresentvalueoftheminimumleasepayments.Inpreviousyearstheyhadbeenclassifiedasoperatingleases.

RestrictionsThedisposalofcertainpropertiesmaybesubjecttotheprovisionsofsection40ofthePublicWorksAct1981.ProceedsfromthesaleofWairarapaDHBassetsareusedtopurchasenewassetsasspecifiedunderClause43,Schedule3NewZealandPublicHealthandDisabilityAct2000.

8. Investment in Subsidiary

Parent 2005 2004 $000 $000 Shareinsubsidiary(noncurrent) 103 103Advancestosubsidiary(current) 0 0TOTAL INVESTMENTS 103 103

BiomedicalServicesNewZealandLimitedis100%ownedbyWairarapaDHB(2004:100%).Theprincipalactivityofthesubsidiaryisthetestingandmaintenanceofbiomedicalequipment.Thelatestauditedfinancialstatementswereusedasthebasisforconsolidation.

ThebalancedateofBiomedicalServicesNewZealandLtdis30June.

9. Investment in Joint Venture ShareWairarapaDHBhasa16.7%shareholdinginCentralRegion’sTechnicalAdvisoryServicesLimited(TAS).TASwasincorporatedon6June2001.TAShasatotalsharecapitalof$600ofwhichWairarapaDHB’sshareis$100.At30June2005allsharecapitalremainsuncalled.

ThebalancedateofTASis30June.

10. Bank OverdraftThebankoverdraftissecuredbyanegativepledgewhichrequirestheWairarapaDHBtooperatewithinit’sapprovedoverdraftfacility.Thefacilityavailabletotals$2,500,000.Thecurrentinterestrateonthegroup’sbankoverdraftis10.60%perannum(2004:9.60%).


11. Payables and Accruals

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 TradeCreditorsandAccruals 9,171 5,689 9,067 5,614CapitalChargeDuetotheCrown 156 544 156 544GST/FBTPayable 390 224 383 222IncomeReceivedinAdvance 227 80 227 80AmountOwingtoSubsidiary 0 0 10 8TOTAL PAYABLES AND ACCRUALS 9,944 6,537 9,843 6,468

12. Employee Entitlements

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 AccruedPay 795 651 781 642AnnualLeave 1,872 1,586 1,843 1,554RetirementLeave 312 275 310 273LongServiceLeave 275 265 275 265MaternityGrant 21 38 21 38ConferenceLeave 430 308 430 308TOTAL EMPLOYEE ENTITLEMENTS 3,705 3,123 3,660 3,080 Madeupof: Current 3,325 2,762 3,282 2,721Non-current 380 361 378 359TOTAL EMPLOYEE ENTITLEMENTS 3,705 3,123 3,660 3,080

13. Trust FundsWairarapaDHBreceivesdonationsandbequestsforspecificpurposes.IfforanyreasonWairarapaDHBisnotabletousethefundsasspecified,thenWairarapaDHBisobligatedtoreturnthedonationtothedonor.Fundsareheldinaseparatebankaccountandanyinterestearnedisallocatedtotheindividualtrustbalances.

Group Parent 2005 2004 2005 2004 $000 $000 $000 $000 Opening Balance 241 221 241 221FundsReceived 29 14 29 14InterestReceived 12 9 12 9Total Receipts 41 23 41 23FundsSpent 137 3 137 3BALANCE AT 30 JUNE 2005 145 241 145 241

Trustfundshavebeenclassifiedasnon-currentliabilitieswithintheStatementofIntentandwithinthisreport.Previouslytheyhavebeenclassifiedwithintheequitysectionofthestatementoffinancialposition.Thisreclassificationhasoccurredtorecognisethattherestrictiveconditionsattachedtothesetrustfundsrequirethemtobetreatedasaliability.

ThefollowingfundsareheldasinvestmentsofWairarapaDHB.


2005 2004 $000 $000 BrownetteBequest 21 20CameronBequest 2 2GreytownHospitalPatientComfortFund 9 98MacintoshBequest 3 3MasonBequest 7 6MastertonHospitalPatientComfortFund 10 33RossBequest 19 18ToogoodBequest 5 5TyackeBequest 9 21FundsDonatedtoSpecificDepartments 36 35WairarapaHospitalRedevelopmentLandscapingFund 24 0TOTAL 145 241

TheGreytownHospitalPatientComfortFundandMastertonHospitalPatientComfortFundbalanceshavebeenutilisedduringtheyearforthepurchaseof25newelectricbedsforuseaccessinghospitalserviceswithintheWairarapa.

TheWairarapaHospitalRedevelopmentLandscapingFundwasestablishedduringthefinancialyear.ThistrustfundcontainsallcashdonationsreceivedbyWairarapaDHBforthepurposesoflandscapingwithinthenewhospitaldevelopment.

14. Term Loans and Finance Lease Liability

Group Parent

2005 2004 2005 2004 $000 $000 $000 $000 CrownHealthFinancingAgency 11,340 6,000 11,340 6,000FinanceLeases 238 581 238 581TOTAL 11,578 6,581 11,578 6,581 Made up of: CurrentPortion 6,166 6,343 6,166 6,343Non-currentPortion 5,412 238 5,412 238 Repayable as follows: LessThanOneYear 6,166 6,343 6,166 6,343OneToTwoYears 72 166 72 166TwotoFiveYears 5,340 72 5,340 72Total 11,578 6,581 11,578 6,581 Interest Rates Summary: CrownHealthFinancingAgency 6.60% 7.09% 6.60% 7.09%

A$6milliontermloanwasraisedwiththeCrownHealthFinancingAgencyon12April2005.Thedebtissecuredbyanegativepledge.WithouttheCrownHealthFinancingAgency’spriorwrittenconsentWairarapaDistrictHealthBoardcannotperformthefollowingactionsinthefollowingareas:

Securityinterest:Createanysecurityinterestoveritsassetsexceptincertaindefinedcircumstances.

LoansandGuarantees:Lendmoneytoanotherpersonorgiveaguarantee.

ChangeofBusiness:Makeasubstantialchangeinthenatureofbusiness.

Disposals:Disposeofallorsubstantialpartofitsassetsexceptincertaindefinedcircumstances.

ProvideServices:Provideservicestooracceptservicesfromapersonotherthanforpropervalueandonreasonablecommercialterms.

TermloansarenotguaranteedbytheGovernmentofNewZealand


Analysis of Finance Lease Liabilities

Group Parent

2005 2004 2005 2004 $000 $000 $000 $000 PayablenoLaterthanOneYear 191 359 191 359LaterthanOne,notLaterThanTwoYears 90 191 90 191Laterthantwo,notlaterthanfiveyears 0 91 0 91Laterthanfiveyears 0 0 0 0 281 641 281 641Futurefinancecharges -43 -60 -43 -60Recognised as a liability 238 581 238 581

Representing lease liabilities: Current 166 343 166 343Non-current 72 238 72 238 238 581 238 581

At30June2004theBoardreclassifiedleasingarrangementsforInformationTechnologyequipmentasfinanceleases.Inpreviousyearstheyhadbeenclassifiedasoperatingleases.InaccordancewiththePublicFinanceAct1989andtheCrownEntitiesAct2004theapprovaloftheMinisterofFinancehasbeenobtainedforthefinancingleasearrangements.Theleasearrangementshadbeenaccountedforasoperatingleasesforthe2003/04financialyearandanydifferenceintreatmentforthecalculationofthenetdeficitisnotconsideredmaterialforthe2003/04financialyear.

15. Reconciliation of Net Surplus/(Deficit) After Taxation with Cash Flow from Operating Activities

Group Parent

2005 2004 2005 2004 $000 $000 $000 $000 Net Surplus/(Deficit) After Tax -258 -5,711 -273 -5,756

Add/(less)Non-CashItems Depreciation 1,235 1,501 1,163 1,436Write-downonpropertyvaluation 0 4,071 0 4,071Increase/(Decrease)EmployeeEntitlements 580 248 580 248Total Non-Cash Items 1,815 5,820 1,743 5,755 Add/(less)ItemsclassifiedasInvestmentActivity NetLoss/(Gain)onSaleofProperty,PlantandEquipment -137 -128 -137 -129Total Investing Activity Items -137 -128 -137 -129 Add/(less)MovementsinWorkingCapitalItems (Increase)/DecreaseinReceivablesandPrepayments -1,270 -1,809 -1,233 -1,793(Increase)/DecreaseinInventories -48 63 -48 63Increase/(Decrease)inPayablesandAccruals 1,862 2,238 1,826 2,226Increase/(Decrease)inTaxation 0 0 0 0Working Capital Movement – Net 544 492 545 496 Net cash (Outflow)/Inflow from Operating Activities 1,964 473 1,878 366


16. Related Party DisclosureWairarapaDHBisawhollyownedentityoftheCrown.TheGovernmentsignificantlyinfluencestheroleoftheWairarapaDHBaswellasbeingitsmajorsourceofrevenue.

ThegroupentersintonumeroustransactionswithgovernmentdepartmentsandotherCrownagenciesonanarm’slengthbasis.Wherethosepartiesareactinginthecourseoftheirnormaldealingswiththegroup,thesetransactionsarenotconsideredtoberelatedpartytransactions.

Related Party Transactions and BalancesFunding and Capital Charge PaymentsWairarapaDHBreceived$75millionfromtheMinistryofHealthtoprovidehealthservicestotheWairarapaareaintheyearended30June2005.WairarapaDHBpaid$387,000totheMinistryofHealthforCapitalCharge(seeNote19).

Theamountreceivableatyearendwas$5.04million.Theamountpayableatyearendwas$52,000.

Inter-group Transactions and BalancesWairarapaDHBpurchasedfromBiomedicalServicesNewZealandLimitedbiomedicalservicingofpatientrelatedequipment.Thepurchasesaccountforlessthan1%oftotalpurchasesbyWairarapaDHB.

ThesetransactionswerecarriedoutunderthetermsoftheLetterofAgreementbetweenWairarapaDHBandBiomedicalServicesNewZealandLimiteddated24June1996,effectivefrom1February1996.

2005 2004

$000 $000 Purchases 107 89ManagementFee 15 30InsuranceCover 4 4TaxationAdvice 0 1

Thefollowingbalancesasat30June2005resultedfromtheabovetransactionsandarepayableonnormaltradingterms:

2005 2004 $000 $000 AccountsPayable 10 8AccountsReceivable 4 8

DougMatheson(Chairperson,WairarapaDHB)andDavidMeates(ChiefExecutive,WairarapaDHB)areDirectorsofBiomedicalServicesNewZealandLtd.

Inter District FlowsWairarapaDHBpurchasesservicesfromotherDHBsforitscommunity.Theprocessforthispurchasingarrangementisinterdistrictflows.Fortheyearended30June2005thefollowingtransactionswereincurredbytheDHB:

2005 2004 $000 $000 Revenue 2,132 2,061Expenditure 16,213 16,289Debtorat30June 283 57Creditorat30June 1,186 1,328


Key Management and Board MembersTherewerenotransactionsbetweentheBoardmembersandseniormanagementwithWairarapaDHBinanycapacityotherthanthatforwhichtheyareemployed,exceptforthoseBoardmemberslistedbelow:

MartinEasthope ExecutiveCommitteeMember,CancerSociety(WairarapaBranch);AnnEasthope(marriedtoMartin)hasbeencontractedtoprovidevariousDHBprojectmanagementservices

DoctorLizFalkner GeneralPractitioner,TheDoctors(Masterton)

YvetteGrace Trustee,WairarapaCommunityPHOTrustBoard;Member,WairarapaCommunityPHOServicesCommittee;Member,RangitaaneoWairarapa;Representative,TeMauriAIwi(FamilyStart)

DoctorRobTuckett GeneralPractitioner(part-time),Carterton,GreytownandMartinboroughMedicalCentresandMastertonMedical.

JanineVollebregt Trustee,WairarapaCommunityPHOInterimTrustBoard(untilJuly2004);Chairperson,WairarapaCommunityPHOServices;ParttimeemployeeWairarapaDHB(ProjectManagerofPrimaryNursingInnovationsProject)

Alltransactionswerecarriedoutonanarm’slengthbasisandamountedto$4,070,000(2004$2,943,000).ThecurrentyearincludesallpaymentstotheWairarapaCommunityPHOTrust.

Other Related PartiesPaymentstotheCentralRegionTechnicalAdvisoryServiceLimitedintheyearending30June2005totalled$73,950.

Theamountsoutstandingatyearendarepayableonnormaltradingterms.

Norelatedpartydebtshavebeenwrittenofforforgivenduringtheyear.

17. Financial InstrumentsThegrouphasaseriesofpoliciesprovidingriskmanagementforinterestrates,operatingandcapitalexpendituresdenominatedinaforeigncurrency.WairarapaDHBisapartytofinancialinstrumentsaspartofitseverydayoperations.Theseincludeinstrumentssuchasbankbalances,investments,accountsreceivable,tradecreditorsandloans.

Thegroupisriskaverseandseekstominimiseexposurefromitstreasuryactivities.Itspoliciesdonotallowanytransactionsthatarespeculativeinnaturetobeenteredinto.

Interest Rate RiskInterestrateriskistheriskthatthevalueofafinancialinstrumentwillfluctuateduetochangesinmarketinterestrates.Thiscouldparticularlyimpactonthecostofborrowingorthereturnfrominvestments.TheBoardmembersdonotconsiderthereisanysignificantexposuretointerestrateriskonitsinvestments.

Theinterestratesonthegroup’sborrowingsaredisclosedinNotes10and14.Therewasnointerestrateswapagreementinplaceasat30June2005.(TherewasnointerestrateswapinplaceatJune2004).Interestratesoninvestmentsandcreditfundsrangefrom6.20%to6.75%.

Currency RiskCurrencyriskistheriskthatthevalueofafinancialinstrumentwillfluctuateduetochangesinforeignexchangerates.Foreigncurrencyforwardexchangecontracts(andoptionagreements)canbeusedtomanageforeigncurrencyexposure.Therewerenoforeigncurrencyforwardexchangecontractsinplaceasat30June2005(June2004nil).

Credit RiskCreditriskistheriskthatathirdpartywilldefaultonitsobligationstoWairarapaDHBorthegroup,causingtheWairarapaDHBorgrouptoincuraloss.

FinancialinstrumentsthatpotentiallysubjectWairarapaDHBtoriskconsistprincipallyofcashandshort-terminvestments,tradereceivablesandvariousoff-balancesheetinstruments.

WairarapaDHBinvestsinshort-terminvestmentswithhighcreditqualityfinancialinstitutionsandsovereignbodiesandlimitstheamountofcreditexposuretoanyonefinancialinstitution.AccordinglyWairarapaDHBdoesnotrequireanycollateralorsecuritytosupportfinancialinstrumentswithorganisationsitdealswith.

TheWairarapaDHBreceives93%(June200493%)ofitsrevenuefromtheCrownthroughtheMinistryofHealth.Accordingly,theWairarapaDHBdoesnotconsiderthereisanyriskarisingfromtheconcentrationofcreditwithrespecttoaccountsreceivable.


Fair ValueThefairvalueoffinancialinstrumentsisapproximatedbythecarryingamountdisclosedintheStatementofFinancialPosition.

18. Patient FundsWairarapaDHBadministerscertainfundsonbehalfofpatientswithavalueof$695(June2004$682).ThesefundsareheldinaseparatebankaccountandanyInterestearnedisallocatedtotheindividualpatientbalances.Therefore,thetransactionsduringtheyearandthebalanceat30JunearenotrecognisedintheStatementsofFinancialPerformance,FinancialPositionorCashFlowsofWairarapaDHB.

19. Capital ChargeWairarapaDHBpaysacapitalchargequarterlytotheCrownbasedonthegreaterofitsactualorbudgetedclosingequitybalanceforthemonth.Thecapitalchargeratefortheyearended30June2005was11%(200411%).

20. Board Members’ RemunerationBoardmembers’remunerationreceivedorreceivablefortheyearended30June2005.InadditionBoardmembersareabletoclaimreimbursementforoutofpocketexpenses.

2005 2004 $000 $000 DougMatheson–Chairman4 36 37JanineVollebregt–DeputyChair2 22 20Cheryl-AnnBroughton-Kurei4 17 19PerryCameron1 10 0MartinEasthope2 22 26PamelaJefferies3 10 0LizFalkner2 18 19YvetteGrace3 10 0VivienneNapier2 18 20TrishTaylor1 10 0RobTuckett2 18 20RobynDaglish5 8 20LindaNelson5 9 19JaniceWenn5 7 19LynPatterson(resigned10January2004) 0 11TOTAL 215 230

1Newlyelectedmemberfrom6December2004

2Re-electedmember

3Newlyappointedmemberfrom6December2004

4Re-appointedmember

5Termfinished5December2004

MartinEasthopewastheDeputyChairfortheperiod1July2004to5December2004.JanineVollebregtwasappointedtheDeputyChairfrom6December2004.


21. Employee RemunerationThenumberofemployeesandformeremployeeswhoreceivedremunerationandotherbenefitsof$100,000ormoreperannumduringtheyear.

Total Annual Remuneration and Other Benefits Number of Employees

Number of Employees

$ 2005 2004100,000–110,000 1 2110,001–120,000 3 0120,001–130,000 3 0130,001–140,000 0 2140,001–150,000 1 0150,001–160,000 2 3160,001–170,000 0 2170,001–180,000 3 0180,001–190,000 2 1190,001–200,000 2 6200,001–210,000 1 1210,001–220,000 1 0220,001–230,000 2 2230,001–240,000 0 0240,001–250,000 1 0

Thechiefexecutive’stotalannualremunerationandotherbenefitsfallsinthe$210,001to$220,000bracket.

Ofthe22employeesshownabove,19areorweremedicalemployees.

Iftheremunerationofpart-timeemployeesweregrossed-uptoafulltimeequivalent(FTE)basis,thetotalnumberofemployeeswithFTEsalariesof$100,000ormorewouldbe24,comparedwiththeactualtotalnumberofemployeesof22.

Termination Payments DuringtheyeartheBoardmadethefollowingpaymentstoformeremployeesinrespectoftheterminationoftheemploymentwiththeBoard.

Number of Employees Amount $1 2,9901 6,7221 6,7341 7,7431 17,2161 20,6251 28,8892 34,2741 39,415


22. Post Balance Date EventsOn5July2005WairarapaDHBrepaidasumof$6,000,000totheCrownHealthFinancingAgency.Thisamounthasbeenclassifiedasacurrentliabilityonthestatementoffinancialposition.

Otherthanthoseitemsnotedabovetherehavebeennoothersignificanteventsbetweentheyearendandthesigningofthefinancialstatements.

23. Explanation of Major VariationsThebudgetfiguresinthisreportaretakenfromourStatementofIntentforthefinancialyearended30June2005.Thebudgetwhichdidnotassumewewouldbeadoptinga“Greenfields”approachtothesiteredevelopment.

Revenuewas$3,568,000higherthanplannedduetoincreasesinCrownFundingadvisedafterthebudgetwascompleted.Thisincluded$1,147,000fortheHealthofOlderPeopleRiskPool,$831,000forPrimaryHealthOrganisationTop-Upfunding,$518,000fortheNursesPaySettlementand$470,000forHolidaysActfunding.

Operatingexpenditurewas$4,070,000higherthanplannedduetoexpensesrelatingtotheincreasedCrownFundingoutlinedabove,adverseInterDistrictFlowsandhigheroutsourcedservicesandclinicalsuppliescosts.Thesewereoffsetbyfavourablevariancesininfrastructureandnon-clinicalsuppliescostsandalsofinancingcosts.

Property,PlantandEquipmentwas$12,868,000belowbudgetastheStatementofIntentwaspreparedpriortothe$9,300,000write-downofthecurrenthospitalcampusbuildingsat30June2004.Theremainingbalanceisduetotheinitialdelayinthesitedevelopmentexpenditurewhilethe“Greenfields”optionwasexploredandsubsequentlyapproved.Thisalsoresultedinalowerlevelofdebtdrawndowntofundtheproject.

24. Management CommentaryHospital RedevelopmentSubjecttotheapprovalfortheGreenfielddevelopment,theBoardresolvedon4June2004todisposeofanysurplusbuildingsandassociatedlandatthecompletionoftheproject.SubsequentlytheBoardrevaluedthebuildingsandassociatedlandunderaStatementofStandardAccountingPracticeNo.17(SSAP-17)methodologytothelowerofcostandnetrealisablevalue.ThevaluationwascompletedbyCBRichardEllis(RegisteredValuer)asat30June2004.

ItistheBoard’sintention,thatonthecompletionofthesiteredevelopment,surplusbuildingsandassociatedlandwillbesoldtotheCrownHealthFinancingAgency.

ThetotalfundingapprovedbytheMinistersofHealthandFinanceforthehospitalredevelopmentprojectis$29,500,000madeupof$7,600,000Equity,$19,750,000DebtfromtheCrownHealthFinancingAgency,$1,900,000fromWairarapaDHBfreecashflowsand$250,000borrowedfromtheWairarapaCommunityHealthTrust.At30June2005,$5,340,000offundinghadbeendrawndown,allofwhichwasDebtfromtheCrownHealthFinancingAgencywhichappearsintheStatementofFinancialPositionasTermLoans(secured)withinNon-CurrentLiabilities.Thusat30June2005,$24,160,000offundingremainstobedrawndownforthehospitalredevelopmentproject.


Improvement of Health & Disability Services• ProgressHospitalRedevelopmentwhilemaintainingserviceprovision

• ImprovingChild,Family&YouthHealth

• BetterMentalHealth

• ReducingtheIncidence&ImpactofDiabetes

• ReducingtheIncidence&ImpactofRespiratoryDisease

• ElectiveServices

• PrimaryCare

Inclusion of People with Disabilities• NZDisabilityStrategy

Maori Health & Reducing Inequalities• ImplementingHeKorowaiOrangaandWhakatataka

• ReducingInequalities

Community Participation• Communityengagement

Quality of Services• AchievingAccreditationandCertification

• WorkforceDevelopment

• IndustrialRelations

Financial Responsibilities• Keepinginfrastructurecostsaslowaspossible

• Managingwithinbudget

STATEMENT OF OBJECTIVES AND SERVICE PERFORMANCE

Improvement of Health & Disability ServicesProgress Hospital Redevelopment while maintaining service provision

Deliverables/Targets Performance/Achievement

CompletionoffinalMasterplananddevelopeddesign

• DevelopeddesignagreedwithMinistryofHealthandTreasurybyDecember2004.

Achieved:FinalmasterplananddevelopeddesignwassubmittedtotheMOHandTreasuryinDecember2004.

Completeinitialconstructionwork

• Construction/re-constructioncommencedby31January2005,andfurthermilestonesachievedontimethereafter.

Achieved:Siteclearancecommencedon5January2005andconstructionstartedinJanuary2005.

Deliveryofallservicesmaintainedatlevelsachievedin2003/04orbetter

• Actualversusexpectedserviceoutputsspecifiedintheprice-volumeschedule.

Achieved:TheProviderarmexceededthecontractedvolumetargetsspecifiedwithintheprice-volumescheduleforthefirsttime.Thetotalcontractdeliveredindollartermsexceededthetargetby$258,686.

For the year ended June 2005

ThissectionofthereportdescribestheachievementagainsteachobjectivetodemonstratetheWairarapaDHB’sperformancefortheyearandshowhowtheoverarchinggoalsaremet.

TheStatementofIntentfor2004/05comprised16programmesofworkthathavebeengroupedintosixmajorcategories.Theseare:


Improvement of Health & Disability ServicesImproving Child, Family & Youth Health


Increasedaccesstopaediatricservices

• CommunityPaediatricianemployedbyOctober2004

Achieved:PaediatriciancommencedemploymentinAugust2004foraoneyearterm.Anappointmenthasbeenmadeforareplacement.Thenewcontractisforathreeyeartermtofurtherprogressthework.CurrentlyaPaediatricClinicalNurseSpecialistisadvertisedtoworkbothintheinpatientsettingandinthecommunity.TheClinicalNurseSpecialistwillworkwiththePaediatriciantoensureasmoothtransitionfromhospitaltocommunityanddevelopsystemstoreduceavoidablehospitaladmissionsandimprovepaediatriccarewithinthecommunity.

SuccessfulimplementationoftheNationalImmunisationRegister(NIR)

• NIRimplementationprogressagainstplanat30June2005

Achieved:NIRgolivedateachievedforMeningococcalVaccineeventinformation.NIRbirthcohortgoliveisontargettocommenceon24October2005.

Successfulimplementationofmeningococcalvaccinestrategy

• CoverageanduptakeachievedforMaoriandnon-Maori,agedunder5years,5-16years,and17-20years.Target:95%coverageoverallagegroups

Partiallyachieved:Implementationplancompletedandvaccinationcommencedontimeon23May2005.Theprogrammeconsistsof3dosesovera20weekperiod.Thefirstdosescoveragewas75.5%afterweek9andtheDHBisontracktoachievethetargetfortheunder5yearsandthe5-16yearsgroup.However,consistentwiththenationaltrendthetargetisnotlikelytobeachievedforthe17-20yeargroup.

Reducedhospitaladmissionsofchildrenandyoungpeople

• Numbersofambulatorysensitivehospitalsadmissionsofchildrenandyoungpeople

• Dischargeratesper1000population

Age 2003Actual

2004/05Target

< 5yrs 112.4 105

5-14yrs 26.4 20

15-24yrs 15.9 13.5

Partiallyachieved:Thetargetforreducingambulatorysensitivehospitaladmissionsofchildrenunderfivehasbeensurpassed.Forthoseaged5-14yearsthetargethasnotbeenachieved,buttherehasbeensomeimprovementoverpreviousyears’data.Forthoseaged15-24yearsperformancehasdeteriorated.

Age 2004/05Target

Actualforyearto30April2005

< 5yrs 105 69.2

5-14yrs 20 24.8

15-24yrs 13.5 21

continuednextpage>


Improving Child, Family & Youth Health


Improvedoralhealthinchildrenandadolescents

• Numbersofenrolmentsandcompletionsindentalservicesforadolescents

• Percentagesofadolescentpopulationutilisingservices:

2003/04Actual 2004/05Target

93%enrolment 95%enrolment

68%completions(estimated)

75%completions

Partiallyachieved:Enrolmentsforadolescentshasexceededthetargetwitharesultof98.5%achieved.Thecompletionsdataisnotcapturedandthereforenoresultcanbeprovidedagainstthetarget.

• ReviewofschooldentalservicescompletedbyDecember2004

Achieved:ThereviewofschooldentalserviceswascompletedbyDecember2004,andbuildingonfromthereview,anOralHealthStrategicServicePlanwascompletedbyJune2005.

Increasedaccesstoante-natalandparentingeducation

• Increaseinnumberofprogrammesfunded,andnumbersofattendees:


10programmes 15programmes

120attendees 150attendees

Achieved:Newpostnatalparentingeducationprogrammescommencedin2004/05.Theresponsetoteenspecificeducation,fromteenparents,waspoorandthisresultedinfewerthanplannedprogrammesbeingdelivered,butoverallattendancewasaboveexpectations.

Atotalof13programmeswereundertakenwithatotalof156attendees.

Morehealthpromotingschools(HPS)

• NumberofschoolsactivelysupportedtowardsHPS:


1 3

Achieved:Therearenow8schoolsinWairarapabeingsupportedtobecomeHealthPromotingSchools.

IncreasedaccesstoservicesforYouth

• ReviewofserviceprovisionforYouthcompletedbyJune2005

Achieved:ReviewincorporatedindraftYouthHealthStrategywhichwascompletedby30June2005.

Lessfamilyviolence

• ImplementpartnerabuseinterventionprogrammeforallhospitalstaffbyJuly2004

• Formal,regulartraininginchildprotectioninplaceforallhospitalstaffbyJune2005

Partiallyachieved:Policiesandprocedureshavebeendeveloped.Familyviolencetrainingheldmonthlyforallstaff.Frontlinestaffhavebeentargetedinitially.


Improvement of Health & Disability ServicesBetter Mental Health


Accesstoarangeoflocalmentalhealthservicesthatarerecoveryoriented,clinicallysustainable,andaffordable

• ImplementationpathwayfornewmentalhealthservicesplancompletedbyNovember2004

• ReconfigurationofservicescompletebyJune2005

• ClinicalpathwaysestablishedforallDHBprovidedmentalhealthservices,byOctober2004

Achieved:Implementationpathway,includingregistrationofinterestandproviderselectionprocesseswascompletedbeforeNovember2004,andnewprovidersselectedandadvisedbyDecember.ServicechangestookplaceintheperiodJanuary-March2005.Thereconfiguredserviceswereimplementedfullyfrom1April2005.

ClinicalpathwayswereestablishedforallDHBservicesduringthefinancialyear.

MentalHealthServicesthatdemonstrablymakeapositivedifferencetoconsumers

• OutcomesmeasurementinuseinallDHBprovidedmentalhealthservices,byMay2005

Notachieved:OutcomemeasurementsarepartoftheMH-Smartproject.TheMH-SMARTprojectisaninformationsystemthatcollects,collatesandreportsoutcomebasedmeasurementsformentalhealthservices.Theproject,runbytheMOH,hasbeendeferred1yearwithanimplementationof1July2006nowplanned.Thisdelaywasnecessarytoallowforamorerobustsystemselectionprocessandtoallowgreatertimeforimplementation.ThetrainingofstaffonMH-SMARTbeginsinNovember2005.

ServicesthataremoreresponsivetoculturalneedsofMaori

• MentalhealthservicesculturaladviseremployedbyJuly2005

Achieved:A0.5FTEMaorimentalhealthculturaladviserroleestablishedandappointed(advisingonbutnotdoingclinicalwork),plusa1.0FTEMaorisupportperson(notclinicallyqualified)hasbeenemployedtosupporttangatawhaiorawhoaccessthemainstreamservices.

Increasedaccesstomentalhealthservicesforyouth

• IncreasefundingforalcoholanddrugservicesforyouthfromJuly2004

• PlanforfuturedevelopmentofmentalhealthservicesforyouthcompletedbyJune2005

Achieved:The2004/05fundingincreased,overthatprovidedfor2003/04,foralcoholanddrugservicesforyouthby$65,000.

Theplanforthefuturedevelopmentofmentalhealthservicesforyouthwassubsumedintotwootherprojects–TheWairarapaYouthHealthStrategy,andtheregionalstocktakeandreviewofChildAdolescentMentalHealthServicesacrossthecentralregion.Bothoftheseprojectsaredueforcompletionduringthe2005/06financialyear.


Improvement of Health & Disability ServicesReducing the Incidence & Impact of Diabetes


IncreaseinnumberofMaoriandPacificpeoplewithdiabeteswhohavefreeAnnualchecks

Improveaccesstoeyescreeningforpeopleaffectedbydiabetes

• NumberofMaoriandPacificpeopleaccessingAnnualfreechecksincreasesbyatleast10%during2004

Achieved:Diabeteschecksforthecalendaryearfor2004wereincreasedoverallby10.4%.Theywereincreasedby15.6%forMaoriand23.1%forPacificIslandpeople.

Oneclinicalpathwayfordiabetestreatmentandmanagement,usedbyallserviceprovidersacrossWairarapa

• Flow-chartpathwaysdevelopedforchildrenandadultsbyJune2005

Partiallyachieved:PaediatricclinicalpathwayhasbeenagreedfortheWairaraparegionandwillbeimplementedinthe2005/06financialyear.Thepathwayforadultsisbeingdevelopedduring2005/06.

2002Actual

2003Actual

2004Target

AnnualchecksdoneTotal–allethnicities 408 682 828•Maori 70 90 119•Pacific 8 13 16•Others 457 579 692EstimatedtotalnumberwithDiabetes

1,145 1,189 1,263

Peoplewhohavehadtheireyesscreenedinthepast2years.

359 600 745

•Maori 45 77 107•Pacific 4 11 14•Others 310 512 624

2004Actual

AnnualchecksdoneTotal–allethnicities 753•Maori 104•Pacific 16•Others 633EstimatedtotalnumberwithDiabetes

1,263

Peoplewhohavehadtheireyesscreenedinthepast2years

563

•Maori 78•Pacific 11•Others 474


Improvement of Health & Disability ServicesReducing the Incidence & Impact of Respiratory Disease


Increasingnumbersofpeoplehavehealthylifestylesandenvironments

• 100homesofpeopleaffectedbyrespiratorydiseaseinsulatedbyJune2005

Achieved:271homeswereinsulated.

• Influenzavaccinationsales Partiallyachieved:thedefinitionappliedtothecategorieswaschangedsincethetargetswereestablishedandtheactualachievementsarenotabletobemeasuredonaconsistentbasiswiththetargets.Anoverallincreaseof2%wasachieved.

Commonclinicalpathwaysfortreatmentandmanagementofrespiratoryillness,usedbyallserviceprovidersacrossWairarapa

• Clinicalpathwayforchronicobstructivepulmonarydisease(COPD)agreedbyJune2005

Achieved:ACOPDcommunitypathwaywasagreedinFebruary2005.

Improvement of Health & Disability ServicesElective Services


Noonewaitsmorethansixmonthsforaninitialoutpatientassessment

• 100%ofallreferralsareseenwithin6monthsby30June2005

Substantiallyachieved:ThisperformancetargetwasmetacrossallreferralsforsomemonthsoftheyearandformostoftheyearforGeneralSurgery,Gynaecology,andUrology.

AplanhasbeenputinplacetobringperformancewithinthelevelrequiredforElectiveServicesPerformanceIndicatorbyDecember2005.Elementsofthisplaninclude:

• additionalclinics• efficienciesinclinicscheduling• useofspecialistnurseforfollowupclinics

Allthoseassessedaseligibleforsurgeryareoperatedonwithinsixmonthsoftheirfirstspecialistassessment

• 100%areoperatedonwithin6monthsofassessmentbyJune2005

Notachieved:AtJune200587people(or9.3%)hadbeenwaitingover6monthsforsurgery.50%ofthesepatientswerewaitingforENTorophthalmologyprocedures.Botharereliantonavailabilityofvisitingspecialists.Investigationsintomanagingservicedeliveryinotherways(e.g.surgicalbus)areongoing.

Moreintegratedprimary-secondarymanagementoftheelectivesurgicalservicesworkprogramme

• EstablishaWairarapaElectiveServicesSteeringCommitteeandworkprogrammebySeptember2004

Achieved:AsteeringcommitteewasestablishedinSeptember2004.Membershipincludessecondaryandprimaryservicespersonnel.

2002Actual

2003Actual

2004Actual(To18/06/04)

2005

UnitsofVaccineSold

6,130 6,720 7,300 8,111

Increasednumber

590 539 811

%increase 9.6% 7.97% 10%


Improvement of Health & Disability ServicesPrimary Care


EffectivedeliveryofnewPHOservices

• Increasedaccesstoandutilisationofprimaryhealthservices–baselinedatatobeestablishedduring2004/05

Achieved:Baselinedatahasbeenobtainedandtherehasbeengrowthinutilisationofprimaryhealthservicesacrossallpatientgroups.

2004/05 Qtr1 Qtr2 Qtr3 Qtr4Nurseconsults 8,624 9,437 8,765 10,593GPconsults 38,029 36,387 35,250 44,353-Maori 4,333 3,921 3,701 5,152-Pacific 427 342 298 457-Under5s 3,245 2,997 2,116 4,431-Over64s 11,252 11,585 11,483 14,538-Quintile5 5,438 4,738 4,508 6,111-CarePlus – 758 1,162 2,192%Fully-vaccinated 56% 69% 78% 82%children

IncreasingaccesstoservicesforMaoriandPacificpeople

• Numberofpeopletransportedto,andsupportedat,primaryand/orsecondaryhealthservices,byMaoriproviders.Target:35permonthduring2004/05(thisisanewservice)

Achieved:WhaioraWhanuiandTeHauorabothoffertransportandsupporttoMaoriandPacificclientsaccessingprimarycare.Actualaveragenumbersofpatientstransportedpermonthin2004/05were:

• Maori 127transports/month• Pacific 20transports/month

Expenditureinpharmaceuticalsismanagedwithinbudget

• JointPHO/DHBworkinggroupdevelopsreferredservicesmanagementstrategybyMay2005

Partiallyachieved:TheexpenditureonPharmaceuticalswasmanagedwithintheDHBspharmaceuticalbudgetforthe2004/05year(includingPHARMACrebates).TheDHBdidnotdevelopaworkinggroupwiththePHOtodevelopareferredservicesmanagement(RSM)strategy.ThiswasbecausethelocalworkonRSMwasovertakenbytheregionalRSMProjectledbyTASwhichwasinitiatedearlyin2004/05.ThisprojectprovidedandcontinuestoprovideawiderangeofdataonRSM,trends,prescribingtrends,informationbyserviceprovideretc.TheDHBusesthisinformationtoassistwithfinancialmanagement,influencingprescribingpatterns,contractmanagementandarangeofotherserviceplanningandmonitoringactivities.TherearelinkageswiththePHOwithPharmaceuticals,withthePHO’sPharmacyFacilitatorregularlyreviewingTASRSMdataandusingthistoinformdiscussingforexamplewithGPsonprescribingactivityandmedicinemanagement.

TheDHBalsohadarangeofRSMinitiativesrunningthroughouttheyearandincluded:

• Pharmacyworkingpartytoimprovepatientcareandtreatmentthroughmedicinesmanagementprojects.

• AlocalcontractwasimplementedwithWairarapapharmacistsasafirststeptomovingawayfromafeeforserviceframework.

• DUMPcampaign–awastemedicinescampaignwaslauchedduringtheyearandwillberepeatedin2005/06.

• Wai-Arolaboratoryenteredthelocalmarketcompetingforcommunity-referredlaboratorytestvolumes.ThiswillwithtimereducetheDHB’sexpenditureonlaboratorytestaslevelsofInterDistrictFlowsreduceasaresultofWai-Aroactivity.


Inclusion of People with DisabilitiesNZ Disability Strategy


ContinuetoimplementWairarapaDHBDisabilityStrategyActionPlan

• Progressreportonactionscompletedat30June2005

Achieved:Thefollowingwasachievedduringtheyear:

• Asplansforthenewhospitalfacilityandservicedevelopmenthaveprogressed,variousdisabilityinterestshavebeenrepresentedandprovidedvaluableadviceforthestructuralandserviceplanning.Thebuildingcatersforavarietyofaccessmodesandsignagewillaccommodatetheneedsofthevisuallyimpaired.

• Duringthepastyear,theDHBhasworkedwithlocalandregionalgovernment,thePHO,RedCrossandtheDisabledPeoplesAssemblytoaddresstransportissuesandaccommodatetheneedsofdisabledpeople.ThishasincludedestablishmentoftheWairarapaCommunityTransportserviceandrelevantsubmissionsforpublictransportservices.

• “DiversityAwareness”workshopshavebeenheldforstaff.

• ContractshavebeenreconfiguredtomorespecificallyaddressdisabilityneedsforMaori.

• DisabilityneedsforolderpeoplehavebeenaddressedthroughimplementationoftheWairarapaElderLocalLinks(W.E.L.L.)plan.Forexample,introducingasinglepointofentryforaccessingdisabilitysupport.

• Asurveyofcarersidentifieduseofallocatedsupport,perceivedinformalsupportsystemsandtheneedsofcarers(includingtrainingneeds).Thissurveyhasprovideddirectionfordevelopmentofacarersupportservice.

• NGOprovidersofdisabilityserviceshavegivenpresentationstoDSACtoenableaclearerunderstandingofservicesandsupportthatareprovidedandrelevantissues

PeoplehaveaccesstoacomprehensiverangeofAssessment,Treatment&Rehabilitation(AT&R)servicesthatdemonstratebestpractice

• Re-designdeliveryofAT&RservicesandimplementnewservicemodelbyMay2005

Achieved:SinglepointofentryestablishedforAT&RbyMay2005.AnAT&RUserGroupwasestablishedin2004toreviewandprovideinputintotheAT&Rfacilitiesinthenewhospitalandtodesignanddeveloptheservicetofurtherclarifyco-ordinationofAT&Rservices.


Maori Health & Reducing InequalitiesImplementing He Korowai Oranga and Whakatataka


Stronger,moreeffectiveMaoriproviders

• Growthinservices‘byMaoriforMaori’,measuredbyfundingandstaffemployed

Achieved:TherehasbeengrowthinfundingforMaoriproviderserviceswithtotalfundingincreasingby3%in2004/05.

WhaioraWhanuihaveincreasedstaffnumbers,andtheservicesprovidedwiththeadditionoftheFamilyStartprogram,MeNZBCampaignandgrowthinTamarikiOra,enablingWhaioratoemploytworegisterednursesandacommunityhealthworker.TheyhavealsobeensuccessfulinrecruitingaregisterednurseintotheMeNZBcampaign,aswellasaPaediatricspecialistnurseandRegisteredNurseintoTamarikiOra.AMobilediseasestatemanagementnurseworksfromWhaiorasupportingotherprovidersincludingworkingcollaborativelywiththeDHB.Duetotheincreaseinservicesandstaff,Whaioraareplanningtomovetoanewfacilitylaterthisyear.

TeHauoraRunangahasbeensupportedtofocusonprovidingKaupapaMaoriMentalHealthservicesinthecommunity.TeHauorahasachievednationalrecognitionwiththequalificationachievedbyastaffmember.TeHauoracontinuestobuildtheirrelationshipandsupporttheMentalHealthStrategytoprovidequalityKaupapaMaoriMentalHealthprograms.Theyarecurrentlyrecruitingtobringmorequalityandqualifiedstafftotheirservice.

• MaoriworkforcedevelopmentstrategycompletedbyMarch2005

Achieved:TheDHBMaoriWorkforcedevelopmentstrategyinnowinit’s2ndyear,andisundergoingreviewalongwithallotherstaffingstrategiesbeingundertakenduring2005,duetotheWairarapaHospitalRedevelopment.

TheUCOLnurses’programmeisinitssecondyearwith10MaoristudentscurrentlycontinuingYear2studies.

MaoriareenteringtheUCOLnursestrainingingreaternumbers,with12Maoristudentsinthe2005Year1programme.

TheDHBandtheMaoriProvidersCollectivehavesignedaMemorandumofUnderstanding,supportingintersectorialcollaboration.BothMaoriandtheDHBhaveprovidedopportunitiesforjointtraining,consultationondischargeplanning,andsupportingcommunitybasedhealthprograms.TheDHBisalsoparticipatingintheCentralRegionMaoriworkforcedevelopmentstrategy.


Implementing He Korowai Oranga and Whakatataka


IncreasingpartnershipandparticipationbyMaoriinDHBdecisions

• ManaWhenua-DHBrelationshipagreementreviewedandrenewedbySeptember2004

Achieved:ManaWhenuaCaucusoWairarapaismadeupofrepresentativesoflocalIwi,RangitaaneandNgatiKahungunu.

Therelationshipagreementcontinuestobeadvancedwithareviewcompletedearly2005.TheDHB,viatheMaoriHealthUnithassupportedManaWhenuawiththehostingofconsultationhuiinourcommunity,andprovidesadministrationsupportforallhui.

TheDHBandManaWhenuacontinuetomeetregularlyonatwo-monthlybasis.

MainstreamservicesareincreasinglyresponsivetoMaori

• AllDHBstaffcompleteTiritioWaitangitrainingbyJune2005

Achieved:AspartofongoingtrainingopportunitiesaroundTeTiritioWaitangi,theDHBoffered‘TreatyofWaitangi’workshopsduring2005.Theseworkshopswereattendedbyatotalof131managementandstaffandthreefurtherworkshopsplannedforNovember2005.Theresponsefromstaffwhoattendedwasverypositive.

ToprovidecontinuedsupporttowardsunderstandingMaorihealth,theDHBlaunchedthe‘TikangaBestPractice’guidelines,whichisavailabletoallstaffintheareasthattheyworkthroughouttheDHB.TheseguidelinesofferpracticeadvicetostaffonactionstoconsiderwhendealingwithMaori.NaidaGlavishofAucklandDHB,andtheauthoroftheTikangaBestPractice,wasinvitedtoWairarapatolaunchtheguidelines.

• ReviewsofpathwaysofcareforMaoriinmaternity,andmentalhealthservicescompletedbyJune2005

Achieved:AreviewofmentalhealthpathwayshasbeencompletedinconsultationwithMaori.TeHauoraRunangahasbeenamajorpartofthisstrategy,supportingtheKaupapaMaoriMentalHealthStrategy.MentalHealthwillcontinuetoreceivepriorityconsiderationinthereconfigurationofservicesduringtransitionintothenewhospitalfacility.AMaoriMentalhealthadvisorandsupportworker,(nonclinical)havebeenengagedbytheDHBMentalhealthservices.

AreviewoftheMaternitypathwayscontinueswiththereviewtakingintoaccountthecomprehensivereviewandredesignofMaternityservicesduringtheWairarapaHospitalRedevelopmentProject.TheDHBhaveincludedMaoriatallaspectsofthisreview,drawingontheknowledgeandexpertiseoftheMaoriProvidersworkinginourcommunity.


Maori Health & Reducing InequalitiesReducing Inequalities


Improveknowledgeandmeasurementofinequalities

• Increasedreportingofethnicitybyserviceproviders

• NewhealthneedsassessmentreportcompletedbyMarch2005

Partiallyachieved:DHBstaffattendedMoH“trainthetrainers”trainingduringNovember2004.Hospitaladmissionandreferralformshavebeenrevisedtoalignwithnewethnicitydatarequirements.Trainingsessionshavebeenestablishedforstaff.Mostcommunityservicesarenowcollectingethnicitydatatothenewrequirements.TheschooldentalserviceisplanningtoimplementethnicitydatacollectionfromJuly2005.

TheHealthStatusReportwhichidentifiesandassessesthehealthneedsoftheWairarapacommunitywascompletedinMarch2005andcanbeobtainedfromtheDHBwebsite.

NewprimaryhealthservicesincreaseaccessforMaoriandPacificpeople,andothersinlowsocio-economicgroups

• PHOreportsonServicetoIncreaseAccessinitiatives

Achieved:ThePHOhavestartedmanyinitiativestoincreaseopportunitiestoaccessservices,withtheKuraClinic,operatingfromTeKuraKaupapaMaorioWairarapa.ThisclinicishighlyprizedandwellutilisedbyallwhanauassociatedwiththeKura.AnotherclinichasbeenopenedintheCameronCommunityCentre,supportedbyChoiceHealth,theNurseInnovation,andthePHOwhichhasastrongclientbaseamongstourPacificpeople.

WhaioraWhanui,andTeHauoraalsoworkwithTheDoctorswithavoucherprogramthatenableshighriskclientstheabilitytoaccessDoctors.Whaioraalsoprovidetransportandsupporttoassesshighrisk,needclients.

Increaseaccesstoprimaryhealthservicesforyouth

• Quarterlyreportsfromnurseledclinicforyouthindicateincreasingusage.Target:40clientspermonthbyJune2005

Achieved:TheGreytownclinicforYouthachieved42clientspermonthbyJune2005whichshowstheincreasingusage.


Community ParticipationCommunity Engagement


Allstakeholdergroupshaveopportunitytoprovideinputtodevelopmentofthenewhealthneedsassessmentreport

• Threeormorestakeholderforumsareheldtoconsiderhealthneedsinformation,andprovidecommentforthedevelopingreport,by30November2004.

Achieved:AwiderangeofmeetingswereheldbyNovember2004andanumberofadditionalmeetingsheldthroughoutthefinancialyearwithmanystakeholdergroups,including:Maori,GeneralPractitioners,mentalhealth,youth,pharmacists,diabetes,respiratoryandolderpeople’sadvisorygroups.

Newhealthneedsinformationiswidelyavailableandpromoted

• Copiesofthecompletedreportaremadeavailabletoallgroups,anddistributedwidelyinbothelectronicandpaperformats

Achieved:ThecompletedHealthStatusreportisontheDHB’swebsite.InadditioncopiesonCDhavebeenprovidedtoallWairarapapubliclibraries,localauthorities,serviceprovidersandotherinterestgroups.Papercopiesarealsoavailableonrequest.

ThereiswidepublicengagementindevelopmentoftheDHB’snextstrategicplan

• Fourormorepublicmeetings/huiareheldtopresentanddiscussthedraftstrategicplan

Achieved:Fourpublicmeetingshavebeenheld.InadditionasummaryoutlineofthedraftplanandfeedbackformhasbeendeliveredtoallhouseholdsinWairarapa.Thishasresultedinmuchgreaterpublicresponseandengagementthanhasbeenachievedpreviously.

Copiesofplansandproposalsaremadewidelyavailable

• CopiesoftheDHB’sHealthNeedsAssessmentreports,StrategicandAnnualplans,StatementofIntent,AnnualReport,hospitalre-developmentproposals,andservicestrategies,includingconsultationdrafts,areavailableinallpubliclibrariesandontheDHBwebsite.

Achieved:TheHealthNeedsAssessment,DistrictStrategicPlan,DistrictAnnualPlan,StatementofIntentandAnnualReportareavailableatpubliclibrariesandontheDHB’swebsite.

TheDHB’sdecisionsareopenandtransparent

• BoardandStatutoryCommitteeagendasandpaperscontinuetobeaccessibleonWairarapaDHBwebsite

Substantiallyachieved:AllmeetingsoftheBoardandStatutoryCommitteesarepublicmeetingsandopentothepublic.AlldecisionsmadeinaconfidentialsectionofameetingoroftheStatutoryCommitteesarereportedtotheBoardmeetingwithinthepublicsectionofthemeeting.

ThepapersforeachmeetingareavailablefromtheDHBandarepostedinpubliclibraries.

Theagendaandminutesofthemeetingsareavailableonthewebsite.


Quality of ServicesAchieving Accreditation and Certification


AllservicesfundedbytheDHBmeetrequirementsoftheHealthandDisabilityServices(Safety)Act

• DHBprovidermeetscertificationrequirementsbyOctober2004

• AllDSSproviders,andmentalhealthresidentialserviceprovidersmeetcertificationbyOctober2004

Achieved:TheDHBproviderachievedaccreditationandcertificationinSeptember2004.Accreditationwasawardedforathree-yearperiodendinginDecember2007.InlinewithcertificationprovidedtootherDHBs,WairarapaDHBachievedcertificationforatwo-yearperiodendinginSeptember2006.

AllDSSandmentalhealthresidentialserviceproviderswerecertifiedbyOctober2004.

Servicesarepreparedtorespondtoemergenciesanddisasters

• DistrictCivilDefenceandPandemicplansarecompletedbyDecember2004

Partiallyachieved:Abusinesscontinuanceplanmeetingcivildefencerequirementshasbeencompleted.

Thepandemicplanisunderreviewat30June2005.Thisplanwillbecompletedby31December2005.

Servicesdemonstrateclinicalgovernanceandaccountability

• Aclinicalmeasurementprogramme,includingclinicalindicators,auditsystemsandactionplandevelopedbySeptember2005

Partiallyachieved:ProgresstowardtheSeptember2005deadlineisprogressingwell.At30June2005areviewofClinicalIndicatorprogrammewasbeingundertakentodeterminethemostappropriateindicatorstomeasure,andthedatarequirements.TheClinicalBoardoverseesthisprogramme.Clinicalauditisinplaceandisongoing.


Quality of ServicesWorkforce Development


Aconstructiveorganisationalculture

• CompleteplanfororganisationalculturechangebySeptember2004andreportprogressquarterly

Achieved:SurveycompetedJune2004andplanimplementedtoworktowardsbuildingaconstructiveculture.AreportonprogressisprovidedeachmonthtotheHospitalAdvisoryCommitteewithinthereportonorganisationaldevelopment.

CompliancewithrequirementsoftheHealthPractitionersCompetencyAssuranceAct(HPCA)

• HumanResourcessysteminplacebySeptember2004,tosupportHPCAActrequirementstoensurescopesofpracticeandcompetenceforhealthprofessionalscanbedemonstrated.

Achieved:HumanResourcesprocesseshavebeenalteredtoaccommodatetherequirementsofHPCAActinlinewiththeguidelinesestablishedbyDHBNZ.

AhealthanddisabilityworkforcedevelopmentstrategyforWairarapa

• CompletionofWairarapaHealthandDisabilityworkforceactionplanbyMarch2005

Partiallyachieved:AplanonworkforcedevelopmentwasprovidedtotheSeniorManagementTeaminSeptember2005whichincludedtheplansfordisabledemployees.Furtherworkonthisplanwillbeundertakenoverthe2005/06year.

TwoworkshopswererunforstaffinMarchandJune2005ondiversityandencompasseddisabilityissues.


Quality of ServicesIndustrial Relations


Fairandaffordableremunerationarrangements

• ReviewallindividualemploymentagreementsbyJune2005

• OutcomesofregionalandnationalcollectivebargainingareaffordablewithintheDHB’sfinancialplan

Partiallyachieved:Areviewofindividualemploymentagreementshasnotbeenundertakenduetocompletionofthenationalmulti-employercollectiveagreements(MECA)undertakenduringtheyear.

AllcollectivebargainingagreementshavebeencompletedwithintheparameterssetbytheDHBsfinancialplan.ItisnotedthatadditionalfundingwasprovidedtotheDHBtocovertheadditionalcostsoftheDHB-NZNursingOrganisationcollectiveagreementthroughthepayequityfundingpoolestablishedbytheGovernment.

Asafeandfairworkingenvironment

• AmanagementdevelopmentprogrammeinplacebyJune2005toensuretrainingisavailableinallaspectsofmanagement,includingemployeerelationspractices.

Achieved:TheDHBhadfivestaffinvolvedintheLeadership&ManagementProgramme(LAMP)runbyDHBNZduringtheyear.

WehavecompletedanOrganisationalCultureInventory(OCI).Theresultsweredebriefedwithstaffandastrategydevelopedtosupportdevelopmentofamoreconstructiveculture.Strategiesincluded:

• Competencyframeworkdevelopedandapproved

• Culturecoachesmeetingregularly

• Managementdevelopmentprogrammedesignedandawaitingimplementation

• Teamsactivelyworkingonactiontodevelopmoreconstructiveculture(e.g.LeadershipStylesInventory).


Financial ResponsibilitiesKeeping infrastructure costs as low as possible


Achieveefficienciesinradiologyservices

• Implementnewsystemstoachievelowerunitcosts,byJune2005

Partiallyachieved:TheRadiologyprojectforPictureArchivingandCommunicationSystem(PACS)hasbeendelayedbecausetheDHBjoinedwithotherDHBsintheCentralRegiontoselectandimplementasingleprovidersystemforPACS.

AselectionhasbeenmadeandPACSwillbefullyimplementedinWairarapaDHBinDecember2005.

Achieveefficienciesinoperationoflaboratoryservices

• Implementnewsystemstoachievelowerunitcosts,byJune2005

Achieved:Wai-Arolaboratoryservices,thehospitallaboratory,hasenteredthelocalmarketandhassecuredthecontracttocompletelabtestsfortheGreytownGPpractice.

IncompetingforthelocalmarketWai-Arohasimplementedthesystemsnecessarytolowertheoverallunitcosts.

Financial ResponsibilitiesManaging within budget


Managekeydemanddrivenexpenditurerisks–DisabilitySupportServices(DSS)andpharmaceuticalswithinbudget

• Reducepharmaceuticalexpendituregrowthtothenationalaverage

• MatchDSSexpendituretoassuredfunding

Achieved:TheDHB’stotalexpenditureonpharmaceuticalsfor2004/05waslessthanbudgeted.In2004/05theDHB’sexpenditureonpharmaceuticalswas$7,841,000againstabudgetof$8,007,000.TheDHB’sgrowthratefrom2003/04to2004/05was2.8%howeverthenationalaverageexpendituregrowthisnotavailablefromPharmacatthetimethisreportwascompleted.

TheDSSexpenditurewas$9,336,000andtotalfundingprovidedwas$9,469,000.

Maintainproviderarmexpenditurewithinbudget

• Financialtargetsachievedat30June2005 Achieved:TheDHBProviderarm(comprisingMastertonHospitalandthepublicandcommunityhealthservices)achievedasurplusof$115,000comparedtotheplanneddeficitof$1,042,000.

�� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | ��

AUDIT REPORTAUDIT REPORT TO THE READERS OF WAIRARAPA DISTRICT HEALTH BOARD AND GROUPS FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2005

TheAuditor-GeneralistheauditorofWairarapaDistrictHealthBoard(theHealthBoard)andgroup.TheAuditor-Generalhasappointedme,StephenLucy,usingthestaffandresourcesofAuditNewZealand,tocarryouttheauditofthefinancialstatementsoftheHealthBoardandgroup,onhisbehalf,fortheyearended30June2005.

Unqualified opinionInouropinionthefinancialstatementsoftheHealthBoardandgrouponpages13to47:

• ComplywithgenerallyacceptedpracticeinNewZealand;and

• Fairlyreflect:

– theHealthBoardandgroup’sfinancialpositionasat30June2005;

– theresultsofoperationsandcashflowsfortheyearendedonthatdate:and

– theserviceperformanceachievementsmeasuredagainsttheperformancetargetsadoptedfortheyearendedonthatdate.

Theauditwascompletedon25October2005,andisthedateatwhichouropinionisexpressed.

Thebasisofouropinionisexplainedbelow.Inaddition,weoutlinetheresponsibilitiesoftheBoardandtheAuditor,andexplainourindependence.

Basis of Opinion WecarriedouttheauditinaccordancewiththeAuditor-General’sAuditingStandards,whichincorporatetheNewZealandAuditingStandards.

Weplannedandperformedtheaudittoobtainalltheinformationandexplanationsweconsiderednecessaryinordertoobtainreasonableassurancethatthefinancialstatementsdidnothavematerialmisstatements,whethercausedbyfraudorerror.

Materialmisstatementsaredifferencesoromissionsofamountsanddisclosuresthatwouldaffectareader’soverallunderstandingofthefinancialstatements.Ifwehadfoundmaterialmisstatementsthatwerenotcorrected,wewouldhavereferredtotheminouropinion.

Theauditinvolvedperformingprocedurestotesttheinformationpresentedinthefinancialstatements.Weassessedtheresultsofthoseproceduresinformingouropinion.

Auditproceduresgenerallyinclude:

• determiningwhethersignificantfinancialandmanagementcontrolsareworkingandcanbereliedontoproducecompleteandaccuratedata;

• verifyingsamplesoftransactionsandaccountbalances;

• performinganalysestoidentifyanomaliesinthereporteddata;

• reviewingsignificantestimatesandjudgementsmadebytheBoard;

• confirmingyear-endbalances;

• determiningwhetheraccountingpoliciesareappropriateandconsistentlyapplied;and

• determiningwhetherallfinancialstatementdisclosuresareadequate.

Wedidnotexamineeverytransaction;nordoweguaranteecompleteaccuracyofthefinancialstatements.

Weevaluatedtheoveralladequacyofthepresentationofinformationinthefinancialstatements.Weobtainedalltheinformationandexplanationswerequiredtosupportouropinionabove.

Responsibilities of the Board and the AuditorTheBoardisresponsibleforpreparingfinancialstatementsinaccordancewithgenerallyacceptedaccountingpracticeinNewZealand.ThosefinancialstatementsmustfairlyreflectthefinancialpositionoftheHealthBoardandgroupasat30June2005.Theymustalsofairlyreflecttheresultsofoperationsandcashflowsandserviceperformanceachievementsfortheyearendedonthatdate.TheBoard’sresponsibilitiesarisefromtheNewZealandPublicHealthandDisabilityAct2000andthePublicFinanceAct1989.

Weareresponsibleforexpressinganindependentopiniononthefinancialstatementsandreportingthatopiniontoyou.Thisresponsibilityarisesfromsection15ofthePublicAuditAct2001,section43oftheNewZealandPublicHealthandDisabilityAct2000andthePublicFinanceAct1989.

IndependenceWhencarryingouttheauditwefollowedtheindependencerequirementsoftheAuditor-General,whichincorporatetheindependencerequirementsoftheInstituteofCharteredAccountantsinNewZealand.

Otherthantheaudit,wehavenorelationshipwithorinterestsintheHealthBoardoritssubsidiary.

SBLucyAuditNewZealandOnbehalfoftheAuditor-GeneralPalmerstonNorth,NewZealand

�� | Wairarapa Distr ict Health Board Wairarapa Distr ict Health Board | ��

DIRECTORY Board Office WairarapaDHB POBox96 Masterton Telephone:069469880 Fax:069469881 Website:www.wairarapa.dhb.org.nz Board Members DougMathesonChairman JanineVollebregtDeputyChairman Cheryl-AnnBroughton-Kurei PerryCameron MartinEasthope DoctorLizFalkner YvetteHikitapua-Grace PamelaJefferies VivienNapier TrishTaylor DoctorRobTuckett Chief Executive DavidMeates

Executive Managers EricSinclairChiefFinancialOfficer/GeneralManagerCorporateServices JoyCooperDirector,ServicePlanningandFunding AnneMcLeanGeneralManager,HospitalServices HelenPocknallDirectorofNursing AlanShirleyChiefMedicalAdvisor MaggieMorganCommunityandPublicHealthServicesManager JennyPrenticeGeneralManager,OrganisationalDevelopment PiriTeTauDirectorofMaoriHealth Auditor AuditNewZealandonbehalfoftheOfficeoftheControllerand Auditor-General

Bankers ANZBankingGroup(NewZealand)Ltd CrownHealthFinancingAgency

Solicitors ImpactLegal

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