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B4 school health checks going nationwide

8 February 2008

B4 school health checks going nationwide

Prime Minister Helen Clark and Health Minister David Cunliffe today launched the roll out of B4 School Check, a new nationwide health screening programme designed to ensure that all four and five year old children get the best possible chance to succeed at school.

“Labour’s commitment to B4 School Checks was announced in our 2005 manifesto. The programme is designed to ensure that all New Zealand children, either about to turn five years old, or who have recently turned five, are prepared and supported to learn before they start school,” Helen Clark said from Favona Primary School, one of the schools which took part in the pilot last year.

“Today is the just the second day of school for many five year olds, so this an ideal time to launch the programme nationwide. We want to ensure that all New Zealand children have the opportunity to succeed, and getting these checks done as they start their life at school is a crucial part of their ability to learn,” Helen Clark said.

"The Labour-led Government is committed to providing the best possible educational opportunity for all our children and young people. That is why we introduced 20 Free Hours ECE for three and four year olds, and that’s why we are rolling out these B4 schools checks. These will give our youngest children the best possible start at school, while our policy of having all young people in education, training, or some other form of structured learning until they are eighteen, ensures that they too get the best start to the next phase of their lives, whether it is in the workforce or continued education.”

The B4 School check includes a general health questionnaire, hearing and vision screening, height and weight measurement, behavioural/developmental screening, and an oral health assessment. As part of the programme parents will be able to access health education, advocacy, and support.

“This year the B4 School Checks will see more than 13,500 children - an estimated sixty per cent of the age group being targeted - undergo screening this year. We expect all new entrants will be able to undergo the checks next year,” Helen Clark said.

“The checks are intended to identify health, behavioural, social, or developmental issues which could affect a child's ability to learn, such as hearing problems or communication difficulties.

“People often talk about the basics of education being reading, writing and arithmetic. To succeed in these areas, our children need to be able to see the board and hear their teacher. If they can’t, then we need to pick that up as early as possible so we can address it. We want our children arriving at school ready and able to learn,” Helen Clark said.

Health Minister David Cunliffe said the nationwide roll-out of the programme follows a very successful pilot last year involving 880 children in the Counties Manukau and Whanganui DHBs areas.

“The feedback has been positive from parents and schools. Public health nurses around the country are now undergoing training to conduct the health checks beginning with children in the Waikato, Lakes, MidCentral, and Nelson Marlborough DHB coverage areas. All DHBs will begin delivery of the checks by 31 August this year, with checks offered for all four year olds by the end of 2009,” David Cunliffe said.

The B4 school checks will cost $9.7 million each year when fully operational, plus $1 million for administration of the programme.

B4 School Checks Q & A

B4 School Checks
Frequently asked questions

What is a B4 School Check?

The B4 School check will include a general health questionnaire, hearing and vision screening, height and weight measurements, an oral health assessment and questionnaires about the child’s behaviour/development.

The general health questionnaire will include questions about immunisation, hospital admissions, pre-existing and chronic conditions such as asthma, allergies or disabilities and whether the child has glasses prescribed or grommets inserted.

When will the checks begin?

There will be a three month establishment phase. The first four DHBs implementing the check have begun establishment in February, with the first checks being delivered from 31 May 2008 in Waikato, Lakes, MidCentral and Nelson Marlborough DHBs. The remainder of the DHBs will begin establishment from 1 June 2008 and all DHBs will have begun delivering B4 School Checks from 31 August 2008. It is expected that all DHBs will be offering B4 School Checks for every child turning four by the end of 2009.

The roll-out will be over two phases.

Phase one will involve DHBs in:
Waikato, Lakes, MidCentral and Nelson Marlborough DHBs

Phase two (from August) in:
Counties Manukau, Auckland, Waitemata, Northland, Tairawhiti, West Coast, South Canterbury, Canterbury, Capital and Coast, Hutt Valley, Southland, Otago, Whanganui, Hawke’s Bay, Bay of Plenty, Taranaki, Wairarapa

Where will the checks be done?

Implementation will be different in different regions but the content of the checks will be consistent across the country. The checks will be done in a range of venues based on how the DHBs decide to configure their services. These include early childhood centres, school and community halls, marae, kohanga, general practices, Plunket and Well Child provider clinics etc.

How will the B4 School checks work with early childhood centres?

Some of the Checks may be delivered through early childhood centres and kohanga reo, as was done for 50 per cent of the checks delivered in the Whanganui pilot.

What are areas doing between now and May to get ready for the checks?

DHBs are consulting with potential providers and identifying who will be most appropriate to deliver the checks in their regions. They will be developing their communication strategies and informing their region about when and how the checks will roll out in their region. Relationships and linkages need to be built with other services that will be involved such as early childhood centres and kohanga reo, schools, special education, paediatrics, general practices, hearing and vision specialists, dental services etc.

Training of the staff will need to occur once providers have been identified and staff reallocated to the B4 School Check programme or employed. The Ministry will be providing a train the trainer programme for DHB trainers to attend in April for the first group of DHBs and July for the second group. The DHB trainers will then return to the DHB and train the individual nurses who will be involved in delivery of the B4 School Check in their region.

What can parents expect?

Families with four-year-olds will be contacted to invite them to have a free B4 School check from a registered nurse with training in child health. Informed consent from parents or caregivers will be required for a child to receive the check and for information collected as part of the check to be shared with other agencies, eg, schools. The checks are recommended but will not be compulsory and will be free of charge to the parents.

Parents will be advised of either an appointment time or when the nurse will be visiting their child’s early childhood centre or a local community venue. Parents will be asked to accompany their child to the B4 School Check to complete the general health questionnaire, Strengths and Difficulties Questionnaire and the Parental Evaluation of Developmental Status questionnaire in discussion with the nurse. The nurse will record the results of the B4 School Check in the information system and child health book if available and provide parents with a copy of the results and any follow up information that may be required.

How much does it cost?

The B4 School Checks will be provided to families free of charge.

What happens if a child needs to have an issue picked up during a B4 School Check further investigated?

If any concerns are identified, the nurse delivering the check will discuss the concerns with the parent/caregivers and refer the child to an appropriate service, such as a hearing specialist, family doctor or special education, with the informed consent of the parent/caregivers.

This includes referring children with behaviour issues onto the Incredible Years Training Programme. This is a comprehensive behaviour intervention for children with the most severe behavioural difficulties.

The Programme includes parent, teacher and child-training components for children. The programme emphasises the important role of parents, and promotes parental skills and strategies to work in partnership with schools and early childhood centres.
An additional benefit of Incredible Years is that, as a group programme, participants gain support and knowledge from the other participants.

Parents completing the programme speak of the benefits for their family and children.

Why are the B4 School Checks priority for the Government?

The B4 School checks are part of a much wider plan by the Government to improve the health of New Zealand’s children.

In the last eight years the Government has done much to improve children’s health, including:

- Strengthening child and adolescent oral health services, expanding Well Child checks and creating a universal newborn hearing screening programme – and the cochlear implants when hearing loss is detected.

- 57,000 kids participating in Fruit in Schools – 268 primary schools.

- Undertaken the largest mass-immunisation campaign in New Zealand's history and lowered new cases of meningococcal B by 57 per cent ($200 million) and in Budget 2007 added $68 million to fight pneumococcal meningitis with Prevenar vaccine.

- Invested and additional $2.2 billion dollars into primary healthcare. This investment focuses on disease and illness prevention, health promotion and getting ahead of chronic disease. It provides for free doctors’ visits for under six year olds.


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