09 July 2026 (CKT)
On Tuesday 7 July 2026, the Cook Islands Government (Cabinet) approved the TMO Patient Referral Policy 2026 (2026 Policy) effective from 1 July 2026, authorised under the Ministry of Health Act 2013. This replaces the TMO Patient Referral Policy 2023 (2023 Policy) which was reviewed at the end of 2025 and further refined early this year 2026.
The scope of the 2026 Policy was expanded to accommodate situations and challenges faced by TMO and Government over the last two years when implementing the 2023 Policy.
Some of the significant change includes the eligibility of all permanent returning Cook Islanders with MFAI Passport stamp will no longer be stood down for 12 months to qualify, and contract expatriate workers who have continuously worked for a period of six months will now be covered by the 2026 Policy. Permanent Resident (PR) certificate holders including those who will be awarded their PR Certificate this week will also be covered by the Policy.
Referrals from the Pa Enua to Rarotonga will now be entitled to a $20 accommodation subsidy per day and the eligibility for a family escort has also been revised for the elderly patients, reducing the qualification age from 70 years down to 65 years, and including children who are still attending school up to 18 years from 16 years of age in the 2023 Policy. Parents with a dependent child or twin babies up to 4 years of age may travel with the mother under the 2026 Policy. Infirm, Destitute and Chronic Disability patients have special eligibility for a family escort.
To further support the referral pathway for patients, Te Marae Ora (TMO) signed an Agreement for Service with Oceania Hospital Pte Limited in Fiji on 24 April 2025, and TMO is soon to sign a Partnership Agreement with Health New Zealand. The Partnership Agreement will replace the Memorandum of Understanding signed with the District Health Boards of Auckland which lapsed on 1 July 2021.
The Minister of Health Hon. Vainetutai Rose Toki Brown and Cabinet welcomed the new changes and gave priority considerations to the health and wellbeing of patients requiring secondary care and treatment on Rarotonga from the Pa Enua, and all eligible patients on Rarotonga if referred for tertiary care and treatment in New Zealand, Fiji or other approved countries by the Secretary of Health in consultation with the Referral Committee.
A Fact Sheet is also attached and a copy of the TMO Patient Referral Policy 2026 is available on the TMO Website – https://www.health.gov.ck
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