Letter to the Editor

Abstract

26 February 2007 Dear Editor, UPTAKE OF CHILD DISABILITY ALLOWANCE VARIES BY REGION IN NEW ZEALAND Information about services for children with disabilities and their families is not always readily available. I am writing to present data from 2002 on the uptake of the Child Disability Allowance (CDA), a non-means-tested benefit. The allowance is for children who have a physical or mental disability and because of this needs constant care and attention, and will need it for a year or more. To qualify, children also have to need frequent attention in relation to bodily functions or need supervision because of the risk of harm to themselves or others. The total number of children in receipt of the allowance was less than disability data from Statistics New Zealand would tend to lead one to expect, and the geographical variation in uptake was striking. My conclusion is that not all children entitled to the CDA were getting it, and that information on other supports might be similarly patchy. Data relating to all 24 423 children in receipt of the CDA in 2002 were examined in 2003 and are presented here. Each child is plotted geographically depending on the Work and Income New Zealand (WINZ) office processing their allowance, as this was the only readily available localising information. The uptake of the allowance varied greatly from region to region. This was most informative when expressed per 1000 same age population (Fig. 1). Uptake rate of the Child Disability Allowance per 1000 population up to and including those aged 17 years of age. Discussion with the Ministry of Social Development who provided these data explained the high rates in Dunedin City, Invacargill City, Christchurch and Papakura, as all these areas contained WINZ offices that processed the claims from surrounding areas. After combining the high uptake areas with their surrounding low uptake areas, the range of uptake was less extreme, but still varied significantly. Reasons for genuine geographical variation could involve parents moving to be near specialised services, both medical and educational. There may also be a diagnostic bias, with some diagnoses being made more readily in some areas, with consequent consideration of the CDA. Examples of this could include attention deficit hyperactivity disorder or autism. The possibility remains that this benefit is under-used, and that the varying rate of uptake reflects as least in part variations in local awareness of the allowance. Statistics New Zealand estimated in 2001 that 90 000 New Zealand children had a disability.1 While clearly not all of these children would be expected to qualify for the CDA, the uptake appears rather low. If the relatively high but believable rate of the combined Timaru-McKenzie-Waimate Districts (41 per 1000 children aged 0–17) were extrapolated to the whole of New Zealand at that time, then there should have been an estimated 43 474 children in receipt of the CDA rather than the observed 24 423. The CDA is but one aspect of the support available for families of children with a disability or chronic health problem. It may be that the uneven uptake of the CDA reflects variations in a wider awareness of support services. Innovative ways of informing parents directly, such as the Kidshealth website (http://www.kidshealth.org.nz) created jointly by the Paediatric Society of New Zealand and the Starship Foundation, may be a good way of improving information on services, at least among those families and carers (including doctors) who are computer literate. This work was undertaken as part of a research contract for the New Zealand Ministry of Education and I thank them for permission to publish. I would like to thank the Ministry of Social Development for making the data available. Figure 1 was produced by Murray Ellis, Dialogue Consultants Ltd.