Funding for youth health services is tenuous and fragmented leading to uncertainty and a hampering of services, research has found.
The evaluation of health services provided by a dozen “Youth One Stop Shops” around the country was carried out for the Ministry of Health and recommends nationally consistent funding to ensure greater certainty and equity for services.
The 200-page report found the centres, including a number run by youth health nurse practitioners or nurse specialists, provided a range of primary health, family planning and mental health services in central, youth-friendly settings at little to no cost to clients.
All district health boards are required to have a youth health plan and while all the youth centres received some DHB funding, the researchers found that funding was generally “tenuous”.
All the centres were reliant on multiple funding streams and the majority of funding decisions were based on “good will and good relationships” between individuals and the funding body and not on policy or legislative requirements. “Funding can be ceased by the funder at any time and on little notice,” says the report.
The impact of short-term funding cycles included “reduced certainty” and “sustainability” and the lack of funding for administrative support and staff development also hindered service growth.
The report said managers described their staff as their greatest strength but all reported difficulty in attracting and retaining staff because of a lack of pay parity with DHB staff, lack of clear career pathways and heavy reliance on staff goodwill.
Also, combining senior clinical and managerial roles often resulted in a “tension” between managing business needs and maintaining clinical services. And clinical staff shortages could lead to staff working beyond their clinical scopes.
The report’s recommendations included nationally consistent funding to provide greater certainty and enable equitable service delivery across the country and strategic development of youth health services.
It also recommended funding a professional network to support and share resources between centres, development of consistent reporting requirements and outcome measures and flexible funding models that recognised youth ‘graze’ across health services.
