ࡱ> Y\X bjbj e5i 3j j qqq8$,OBt #######AAAAAAA$DeGJAq#A#"c#|##A## B'''#d8#R#A'#A''=O"@#`_nwC$d@lAB0OBp@tG$xG@@&Gq A##'#####AA&f###OB####G#########j s:  19 March, 2010 Mr Mike Bignall, Therapeutic Group Manager, Pharmac PO Box 10 254, Wellington 6143  HYPERLINK "mailto:mike.bignall@pharmac.govt.nz" mike.bignall@pharmac.govt.nz Dear Mr Bignall Re: Proposal for Funding of and Access to Special Foods The Paediatric Society of New Zealand endorses the submissions made by: 1. The Gastroenterology Special Interest Group of the Paediatric Society of New Zealand (attached) 2. The Immunology Special Interest Group of the Paediatric Society of New Zealand 3. The NZ PKU Working Party 4. Dr Callum Wilson and Rhonda Akroyd In addition, the Paediatric Society of New Zealand recommends the following: 1. Malnutrition assessment. We concur that children should be exempt from this requirement for the following reasons 1. The MUST is not appropriate for children as it is an adult assessment tool 2. No tool for assessing malnutrition in children in developed countries exists 2. Ideally children should be assessed by a paediatric dietitian; however at present there is insufficient paediatric dietitian workforce to provide timely assessment of all children who need assessment for supplementary feeds. Adult dietitians assessing children need to demonstrate that they have competence to assess children. This will not be possible until appropriate courses and opportunities for gaining skills to assess children are made available to adult dietitians. 3. Any child enterally fed should be assessed by a dietitian 4. We recommend that special authority applications and first prescription of special foods be extended to registered dietitians, but not to vocationally registered GPs. Renewals could be by vocationally registered GPs, registered dietitians, or appropriate specialists The Paediatric Society of New Zealand notes the following: 1. Increase in use of enteral feeds has been driven by changes in clinical practice including 1. increased use of enteral feeding 2. children with enteral feeding moving to adult formula 3. cessation of use of home-made enteral feeds, i.e. pureed home cooked foods 2. The proposal to extend application for special authorities for Special Foods to vocationally registered GPs is of concern, because our impression is that many GPs are not well informed about nutritional issues in relation to special foods. We are concerned about potential for safety issues e.g. anecdotal report of a GP prescribing De-lact for an infant presumed to be cows milk allergic. There are also significant potential cost issues. 3. GPs may not be able to access DHB funded dietitian services. This would disadvantage children, whose families cannot afford private dietitian consultation. 4. The current problem of adults with disability who require special foods but do not have specialist supervision would be addressed if GPs could prescribe/renew in their own right. Yours sincerely  Rosemary Marks President     THE PAEDIATRIC SOCIETY OF NEW ZEALAND Secretariat: Email:Denise Tringham P O Box 22 234 Wellington 6441 Tel: (04) 938 4827 Fax: (04) 976 4827 psnz@paradise.net.nz  PSNZ Gastro SIG Feedback re Proposal for Funding of and Access to Special Foods Health of our children: Wealth of our nation 45=DdeF G H L     ! wwwwlalalalallahhhNCJ^JhhhwCJ^Jhhhw5CJ\^Jhhhw5CJ\^Jhhhw5CJ^Jhhhw0JCJ^JhhhwB*CJ^Jph&jhhhwB*CJU^Jphhhhl$ d*$a$gdN 0^`0gdNgdwgdw! 1 2 C D    W \ Msx&*9;KLøøííííÞíÞÄÄÄÄÄÞp&jh2CJU^JmHnHtH uhhho@CJ^Jhhho@CJ^JmH sH hhhwCJ^JmH sH hhh7|CJ^JhhhNCJ^JhhhwCJ^Jhhh>lCJ^J"hH.@CJ^JmH nH sH tH (h>lh>l@CJ^JmH nH sH tH (  W s&:;KMN^h 0^`0gdo@gdo@gd7|gdw ?^`?gd7| ?^`?gdNLMN]^ghijlmoprsuvw!"#%(*yk[k[WIWjh$GUmHnHuh$Gh$G5B*CJOJQJphh$GB*CJOJQJphh$G5B*CJ(OJQJphh$G5B*CJ$OJQJphh$G5OJQJ%jh$G5OJQJUmHnHuh%Wjh%WUhhhgCCJ^Jhhhh5CJ^JmH sH hh5CJ^JhwCJ^JhhhwCJ^JhhCJ^Jhiklnoqrtuw  !Sn#$If !Sn#$If$ x$Ifa$  $Ifd 0gdgC "#$%)*z{|xrpecpcc $ !n#a$ !ekd$$If\u+#a  !Sn#$If  $If  $If *z{|hhhgCCJ^Jh$Gh%WhGh''h]5CJaJ|}~ 0gdgC $ !a$ !gdN6&P 1+:pw. 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The Paediatric Society believes all children and youth should, by right, attain optimal physical, mental and social health and wellbeing.  By working as a coordinated national network of health professionals the Society dedicates its efforts and resources to making official submissions to both Government and Non-Government organisations on issues that will impact on the health and wellbeing of children and young people.

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