Eligibility for Publicly Funded Health and Disability Services

Medical Assistance for Pacific Islands

The NZAID agreements recognise that provision of a full spectrum of health care services is a major challenge for many countries in the Pacific, particularly small island states. Two schemes are in place.

Visiting Medical Specialists Scheme (VMS)

Where possible, the Visiting Medical Specialists Scheme (VMS) enables specialists to provide treatment in-country. This is a more cost effective approach, as there is scope for more people to be seen by a specialist.

Medical Treatment Scheme (MTS)

The Medical Treatment Scheme (MTS) has been in existence for almost 30 years. Specific funding is allocated to each country. Individuals referred should be citizens of the referring country and lack access to alternative means of accessing the necessary treatment. Use of MTS funds is only considered if:

• appropriate skills, expertise or facilities to treat the condition are not available in the referring country;
• consideration has been given to whether the condition can be treated in-country by a Visiting Medical Specialist (VMS);
• the referral has been made on appropriate specialist advice and supported from the advice of the local MTS Committee; AND
• there is a good prognosis that the patient will have a healthy life for at least five years after treatment.

Some conditions are excluded for treatment: chronic cardiac failure, chronic renal failure, chronic neurological conditions, conditions requiring heart, renal or bone marrow transplants, and conditions that will incur on-going costs that are unable to be met by partner government health funds (for example, kidney failure, leukaemia and major congenital problems). The MTS also excludes patients who have significant medical conditions other than the one they are being referred for (for example, co-existing advanced cancer).

The partner countries determine annually what proportion of their overall bilateral budget they will allocate to the provision of specialist care.

Each participating country has a national MTS Committee which is responsible for determining which patients should be referred for treatment and for ensuring both equity and medical criteria are met. It is also responsible for developing an annual workplan with the Coordinator from Health Specialists Limited. Workplans are based on identified needs, taking account of specialist visits by other organisations. The Committee provides an important means of pooling expertise to ensure appropriate decisions about treatment are made, which take into account competing priorities and likely treatment and post-treatment costs.

All MTS referrals are completed on the MTS referral form and faxed to the Coordinator for consideration and referral to an appropriate specialist. Once approved, the Coordinator progresses arrangements for treatment in New Zealand (or Fiji), acting as liaison between the treatment hospital and the MTS Committee and patient.

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Page last updated: 29 January 2009