Plans to introduce compulsory immunisation for children of beneficiaries were scrapped after the Ministry of Health said it could actually lower immunisation rates.
The rest of the Government's health-related social obligations went ahead despite concerns they would adversely affect childrens' health.
From July, all beneficiary parents must ensure their children enrol with a general practitioner and compete core Well-Child/Tamariki Ora checks, alongside education requirements.
Documents obtained by the Green Party under the Official Information Act show there were also plans to introduce mandatory immunisation, based on the New Zealand childhood immunisation schedule, for children of beneficiaries. But that was scrapped after the ministry suggested it could create a "perverse incentive" not to immunise.
Parents would be given three warnings for failing to meet the social obligations before facing a cut of up to 50 per cent of their benefit payment.
Ministry officials said many parents would decide it was better not to immunise at all than to risk missing an appointment and not meeting the obligations later on.
"An ‘opt out' clause, to reduce Human Rights concerns, could increase the incentive for some people to ‘opt out' of immunisation as a way to avoid sanctions," a report from the ministry said.
The ministry was also concerned about the wider impacts of the financial sanctions. "The Ministry of Health expects that income sanctions will have a negative impact on the health of sanctioned beneficiaries and their families," it said in an email last May.
"We predict that these people will defer health care and increasingly present at emergency departments rather than primary care."
That would increase the cost to the health system, it said.
The initial proposal had focused on minimising Ministry of Social Development costs, but the net social benefit must also be considered.
Later that month the ministry said it did not want WellChild checks to become mandatory because it risked undermining the relationships and dynamic of the successful programme.
WellChild provides free check-ups and advice until a child is 5 years old. A report prepared for Health Minister Tony Ryall said improving the delivery of WellChild would help it to reach more families.
Green Party co-leader Metiria Turei said Social Development Minister Paula Bennett has ignored strong and persistent warnings from the ministry about the sanctions.
"How can the minister stand here with a straight face and tell the House that these reforms will be better for children, when the advice from the Ministry of Health says that there is no strong evidence that health-related social obligations are needed?"
Mrs Bennett said she received a range of advice, but the reality was sanctions worked; "and the advice I have got says exactly that".
Beneficiaries would have several chances to comply, she said.
EARLY CHILDHOOD IMMUNISATIONS
What is recommended for Kiwi children until age 2
Diphtheria/tetanus/pertussis/polio/hepatitis B/haemophilus influenzae type b and pneumococcal at six weeks, three months and five months.
Haemophilus influenzae type b, measles/mumps/rubella and pneumococcal at 15 months.
- The Dominion Post
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