To provide Cook Islanders with access to specialist services not available the Cook Islands, since 1994, the New Zealand Government has funded and initially managed medical specialist visits to the Cook Islands. Between 2004 and 2008, these visits took place under the Medical Specialists Visits (MSV) scheme and from 2008 to the present, under the Health Specialist Visits (HSV) scheme. Both schemes provided funding under tripartite arrangements between the New Zealand Agency for International Development (now the New Zealand Aid Programme), Ministry of Health Cook Islands (MOH CI) and the Cook Islands Ministry of Finance and Economic Management (MFEM), with management of the schemes now delegated to the MOH CI. The schemes aim to improve the health status of Cook Islanders through access to visiting specialist health services and have objectives relating to: equitable access to specialists; emphasis on women’s health; increasing local capacity; effective follow-up to screening programmes funded by MSV/HSV; and effective local management of scheme funds. New Zealand Government funds approved for the schemes were for $160,000 per annum for the first four years, rising to $175,000 for 2008/09 and to $350,000 for 2009/10. The 2009/10 allocation to the HSV represented just over 3 percent of the total Cook Islands health budget.