The Cook Islands health system is primarily funded from general taxation. The annual health budget is determined by the Cook Islands Government. The appropriation for the 2020/21 fiscal year is $18.4 million and represents 8.1% of government spending. The health workforce absorbs a majority of that budget ($11.9 million). Te Marae Ora also receives assistance from development partners, the largest being New Zealand ($1.2 million) and World Health Organization (WHO) ($300k).
Of the health budget, 51% is allocated to hospital health settings, 35% to community health settings with the remainder administered through the Planning and Funding Directorate.
Te Marae Ora uses this funding to plan, purchase and provide health services including hospitals, public health services, national services such as screening programmes, child and maternal health, and patient referrals. Most health services in the Cook Islands are free or subsidised.
Detailed information on the funding provided for health in Budget 2020/21 can be found on the Ministry of Finance and Economic Management website
Eligibility for subsidised health services
To be eligible for subsidised health services, you need to be:
- A Cook Islander
- A permanent resident or honorary resident of the Cook Islands
- Married to a Cook Islander or permanent resident, and lived in the Cook Islands for more than six months
- Work permit holder (including spouse and children) who has lived and paid taxes in the Cook Islands for over six months
- Non-Cook Islands woman who is pregnant or has given birth to a child from a Cook Islands partner
All visitors to the Cook Islands including tourists, short-term consultants (less than six months) and anyone who is not included above, will be required to pay for some services.
Information and communication technology (ICT) is essential for promoting access to health services and quality health information.
We are working to lift our ICT infrastructure so it is fit and relevant for the 21st century. This requires a significant investment in new servers, software and hardware. This also requires integrating health information systems, and preparing to move Te Marae Ora onto a new patient information management system. These changes are essential for Te Marae Ora to provide additional services on Rarotonga and the Pa Enua through remote consultations and telehealth initiatives. It will also enable our clinicians in the Cook Islands to liaise with clinicians in New Zealand to review clinical notes on patients and inform quality patient care.