Streamlined Complaints And Disciplinary Process Needed

"New Zealanders with complaints against health professionals must be able to make them as easily, speedily and painlessly as possible," Health Minister Annette King said today when releasing a report by Helen Cull QC, commissioned in the wake of publicity about patient concerns in Northland and elsewhere.

"In addition to a more streamlined complaints system, the relevant agencies need better mechanisms for identifying patterns of adverse medical outcomes to ensure a timely response and remedial action.

"To that end I have asked for further advice on the feasibility of a 'one-stop shop' for patient complaints, and propose to consult widely with the health sector and consumer groups on such an approach.

A one-stop shop is the major recommendation in Helen Cull's report.

"For too long patients have had to jump through hoops in order to have their complaints heard," said Mrs King.

"Under current arrangements as many as 14 organisations can each undertake an investigation into the same adverse medical event. And each can take place without reference to the other. Meanwhile the health professional concerned could still be in practice.

"The consequences for patients can be, and often are, confusing, cumbersome and emotionally and financially draining.

"I have said many times that I am committed to quality in the health sector, and we already have a number of initiatives in train to deliver on this."

Helen Cull notes that many of her recommendations will be met by measures such as the Health Professionals Competency Assurance Bill.

"The Ministry of Health has this month released a framework for District Health Boards to credential their senior medical officers and will very soon be making public a set of sector standards to enable a consistent quality of service," Mrs King.

"While most of our emphasis is at the front end - ensuring we have the training, systems and processes in place to ensure quality - we also need good systems for catching and learning from mistakes.

"I am absolutely committed to ensuring that New Zealanders with legitimate complaints against a health professional can pursue them in a more user-friendly way than is now the case," Mrs King said.

Submissions on any of the recommendations in Helen Cull's report should be made by May 4 to:

Deborah Woodley
Ministry of Health
P O Box 5013
Wellington

or by e-mail to
Deborah_Woodley@moh.govt. nz

Copies of the report are available on the Ministry of Health website www.moh.govt.nz

Terms of reference for Helen Cull's inquiry are attached.

Terms of reference

You are required to review the relevant legislation concerning the Health and Disability Commissioner, the Medical Council of New Zealand, the Medical Practitioners Disciplinary Tribunal and the ACC Medical Misadventure Unit.

Following the recent publicity of events in Northland and with reference to other relevant examples which may be brought to your attention, in order to inform the general review outlined below, you are required to examine how the agencies responded to consumer complaints, how they interacted, and whether their actions were co-ordinated and timely. It is anticipated that you will need to interview patients (with their consent) about their personal experience of the complaints system. Your review must not interfere in any way with relevant current or impending proceedings, including those of the Medical Council of New Zealand.

You should report to me by 18 December 2000 on:

(i) What lessons can be learned concerning:

1. the processes and timeliness of investigation(s) of medical practitioners undertaken by the Health and Disability Commissioner, the Medical Council of New Zealand, the Medical Practitioners Disciplinary Tribunal and ACC Medical Misadventure Unit;
2. any regulatory and institutional barriers that may exist which impede the timely identification and investigation of adverse medical outcomes by medical practitioners;
3. any regulatory and institutional barriers to information sharing and co-ordination regarding adverse medical outcomes, between the agencies identified above;
4. any improvements necessary to allow patients better to identify and access patient complaint mechanisms.

(ii) any legislative, regulatory or procedural changes which could ensure that adverse medical outcomes are identified and appropriate, timely remedial action is taken, having regard to the changes proposed in the Medical Practitioners Amendment Bill, the Health Professionals Competency Assurance Bill, and the Mortality Review proposals in the New Zealand Health and Disability Bill.

(iii) any further relevant recommendations.

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