ANI'S STORY: Another H&D Commissioner Cover-up.
Fri, 29 Oct 2004
ANI'S STORY: Another H&D Commissioner Cover-up.
The following is one of many accounts of complaints made to the H&D Commissioner's office which have been brought to my attention and which offer clear insights into why the 2003 report on the service showed that 51 percent of people using it would not do so again and that 48 percent of users were very dissatisfied with it. Claims that the performance of Ron Paterson's office have improved since that report are clearly refuted when in this and other cases known to me patient dissatisfaction continues to the present time.
In February this year West Coast resident Ani Pirimona made a complaint under the Patients' Code of Rights to the West Coast DHB. It was acknowledged by the DHB in February and received the promise that it would be attended to. Originally Ani had an advocate, Linda Grennell, from the Christchurch provider of advocacy under the Health and Disability Commissioner Ron Paterson, but as nothing of consequence was ever done to Anis' knowledge by Linda she asked me to take over as her advocate and advised both the advocacy service and the DHB of this. She spoke to the H&D Commissioner's office in early August and told them very clearly that she was not happy with what had happened to her. She also told them all communication must go through me. (This had already been advised in a letter to Ron Paterson).
Ani's concerns centre largely on her treatment by Dr. Sullivan at Buller Hospital including that he never had a nurse with him when he checked patients. She found him unsympathetic in the extreme whereas other doctors, including a Dr. Thompson, have been very concerned at her condition as have nurses in Buller Hospital. Ani says she is far from being the only patient who is concerned about Dr. Sullivan.
Throughout this affair Ani has had the close support of a friend who has kept me informed in addition to communication I have had with Ani. The detail supplied by her friend endorses what Ani has said and illustrates the great distress caused by the evasive manner in which her complaint has been handled by the DHB, the H&D office and the Christchurch advocacy service
The following is an outline of my involvement showing the dilatory processes which drive a coach and horses through the Patients' Code of Rights.
10 February DHB wrote to Ani promising a response to her complaint "directly" from Ebel Kremer.
26 February The HDC office wrote to Ani saying she would receive a response from this office "within the next four weeks".
10 March Ani wrote to me enclosing copies of the letters she had received and saying she "can not help thinking that I have been put under the carpet so to speak".
22 March Having been asked to take an interest I faxed the DHB about this. No response received.
15 April I emailed John Luhrs (DHB ceo) about the delay. John Luhrs emailed "This complaint has taken time to investigate fully.... we should be in a position to respond today week". (Under the Code of Rights providers are obliged to inform the consumer within 10 days of the reason for delays and to inform them of progress every month).
17 April I emailed John Luhrs after Ani confirmed she had heard nothing further.
11 May I advised John Luhrs that Ani had still not heard from the DHB.
13 May John Luhrs replied, "I understand well prior to receipt of your email we have had communication from the advocacy service and that we are acting in accordance with that communication. In view of this I am assuming that our communications are now with the advocacy service and thus it is not appropriate for me to correspond further with you on this matter". So three months after the complaint was laid the emphasis changed from slack attention to the Patients' Code of Rights to ignoring the complainant's stated wishes to the authorities regarding who represented them.
10 June I advised John Luhrs that Ani confirms she wishes me to continue advocating for her and pointing out she has advised them in writing of this.
11 June Luhrs advised, "I confirm I have forwarded your email to Mark Bowen, our Quality, Risk and Privacy Manager for consideration and reply in light of the correspondence we have received from the Health and Disability Commissioner's office".
22 June I advised Luhrs that I'd heard nothing from Mark Bowen. He replied saying Mark Bowen is on leave and advised me to talk to the Christchurch advocacy service. He also expressed an objection to "multiple representation".
25 June I asked Luhrs why Mark Bowen didn't respond before he went on holiday and pointed out that he has no right to try to fob me off to the advocacy service when Ani had authorised me to act for her. I again requested an up-date of where the complaint stands. He responded by repeating that Mark Bowen is on leave and that he had "encouraged' me to communicate with the Advocacy Service and that he "will be asking the Service to communicate directly with me"".
26 June I pointed out to Luhrs their repeated failure to comply with the time constraints of the Patients' Code of Rights regarding provider's response to patient complaints and that I take my instructions from Ani, not him.
5 July I emailed Luhrs asking for Mark Bowen's response.
21 July I emailed Annette King's office expressing my concerns about Ani's case. On the same day I emailed John Luhrs pointing out that the complaint had been lodged in February, that Ani re-confirmed that she wished me to be her advocate, and that Mr. Luhrs' suggestion that I talk to the Christchurch advocate Linda Grennell was inappropriate because I had since learned that Christchurch didn't want me involved (I have previously encountered Christchurch advocacy boss Tony Daly while advocating for patients when I found him totally ineffectual). Apart from that, of course, Ani had decided and advised the DHB she wanted me, not Christchurch, to advocate for her.
22 July I received copy of Ani's confirmation to Luhrs that she wished me to continue to be her advocate.
23 July Annette King's office responded to my concerns expressed to her with "Your letter has been received and noted by this office". I sent a sharp reply.
29 July Ron Paterson's office advised that my detailed concerns about Ani's case had been referred to their "complaints assessment team". The following day I received a letter from Paterson saying that Ani was satisfied with what was happening and that Tony Daly (Christchurch advocacy boss) would advise him if this were not the case! So it appears that the Christchurch advocacy service can tell Ron Paterson any story they like - and he accepts that over and above the declared statements of the patient!
He also stated that he did not intend reminding the DHB of their obligations - and this despite the complaint, started in February, still not being resolved.
I received an email from Paterson's office stating my email "had been forwarded for response" (I had advised him that the DHB had broken the Patient's Code of Rights, Annette King wasn't interested and that the Christchurch advocacy service had failed to advance the complaint.)
Anis friend advised that Ani has again told the HDC office that I am her advocate. She also told them about other patients' problems with Dr. Sullivan.
10 August I received from Ron Paterson's office a copy of his letter to Ani apologising for the delays, saying that Mark Bowen, Linda Grennell (Christchurch advocate) and Doctor Sullivan had been on leave and ending, "I have written a letter reminding the West Coast DHB of their obligations ..... have asked that they provide me with a copy of their response to you (Ani) by 24 August 2004".
16 August I emailed Paterson pointing out that his Christchurch advocacy service appeared to be ignoring Ani's expressed instructions to them that I had taken over her advocacy. I said there appeared to be collusion between him and the DHB to avoid complying with the Patients' Code and asked him what steps he was taking to ensure the complaint would be resolved and to get the DHB to comply with the Code and to respond to my enquiries as Ani's advocate.
16 August Paterson's complaints manager emailed me saying I would hear from Paterson when he heard from the DHB.
20 August Ebel Kremer (acting DHB ceo) wrote to Ani saying "your concerns have been investigated", that Dr Sullivan says he "believes that his conduct was professional at all times", and that "I would like to apologise for the distress that you have experienced". Other self-justification of the DHB was included - and that, it seems, was that as far as the DHB are concerned.
27 August I emailed Ron Paterson regarding the DHB having failed to comply with several requirements under the Patient's Code of Rights viz. 10(4) to keep complainants informed at intervals of not more than one month; 10(6)(c) and (d) "all information held by the provider that is and or may be relevant to the complaint" must be supplied to the consumer; 10(7)(ii) - advise the complainant within 20 working days of the reasons for delays in answering the complaint. I also referred to Ebel Kremer's letter to Ani of
20 August and requested that the DHB supply me with all the relevant information as Ani's advocate.
3 Sept. Ron Paterson wrote to John Luhrs, copied to Ani including;
"Ms Pirimona was assisted in this process by Advocacy Services South Island Trust (the Christchurch branch)....a meeting between Ms Pirimona and District health Board staff did not eventuate..... Ms Pirimona's concerns may well have been resolved had this been completed much earlier "(Incredibly, this blithely assumes Ani thinks her concerns HAVE been resolved! They haven't - to this day). He continued, "I do not propose to investigate this matter, nor am I making any findings about the allegations".
In other words another Ron Paterson whitewash. Is it any wonder that the 2003 report on the HDC found 51% of those using the service would not do so again and that 48% were very dissatisfied with the service. (See footnote 1).
At the start of September I tried to get the email address of the DHB chair Gregor Coster but through the board office he declined to give me this. (Auckland-based Professor Coster made much of intending to be a "hands on" chair when he was appointed to replace the previous Wellington-based chair in 2003). Have been given his email address by my contacts I sent him my concerns (email 7 Sept.) but his response was to forward this to the corporate office and block my emails. Subsequently he acknowledged receipt of my email which he had forwarded to the corporate office and which was answered by John Luhrs to the effect that the complaint was closed. If this is a "hands on" DHB chair the mind boggles at what a hands-off chair would do!
Quite simply, the above confirms the HDC office is of little use to Ani as it has been of little use to an incredible half of those using its services.
The important issues arising from the above include;
1. The extent to which such breaking of the Patients' Code occurs. As a campaigner with no "official" standing and using only my own self-funded resources I am aware of many people who feel extremely bitter as a result of their encounters with the "system" headed by Ron Paterson.
2. What is the point of elected DHB boards when a patient's concerns put to the chair of the board are simply handed over to the ceo and the chair blocks further emails from the patient's advocate? Did board members get to see my communications to the chair? Having spent a year as an elected member of that board I greatly doubt it since management kept most of the board in the dark about all sorts of issues.
3. How much suffering on top of existing problems is caused to patients when the complaints process is so tortuous that, in my experience, very few people feel able to sustain a complaint in the face of official whitewashing of their concerns?
4. Regarding that 2003 report showing startling levels of dissatisfaction with the HDC service, claims have been made that things have improved since then. If so, why are cases like Ani's still occurring? And in another case I am involved in why did the then Director of Advocacy Tania Thomas send another patient a letter earlier this year apologising for the standard of the advocacy service she headed? (See footnote 2).
In a nutshell, the H&D Commissioner's Patients' Code of Rights relating to complaints is a total farce. Those supposedly responsible for implementing it obviously believe they can make any statements they like, completely disregard what the complainant says and indulge in a three-way collusion (H&D Commissioner, his advocacy service, DHB) in order to pretend that the complaint has been dealt with according to the legislation. Nothing less than a full public enquiry is essential before further harm is done to vulnerable people by the sort of process described above.
David Tranter Social Issues Researcher, N.Z. Democrat Party.