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The Family Clinic Patient Enrolment Decision
The Family Clinic Patient Enrolment Decision
Waikato District Health Board is not in a position to pursue any criminal legal action relating to alleged patient enrolment practices at The Family Clinic Medical Practice in Vercoe Road, Hamilton.
Chief executive Craig Climo said today while the Ministry of Health's Audit and Compliance Unit found there were a number of enrolment irregularities at The Family Clinic, the exact detail relating to these irregularities was unclear.
A health payments and agreements compliance audit started in October 2007 highlighted these irregularities. As a result of the audit's findings and subsequent action, Waikato DHB recovered more than $156,000 from Toiora Primary Health Organisation (PHO). Deficiencies in various payment enrolment and claiming practices were also highlighted by the audit. The DHB consequently required Toiora PHO to ensure its enrolment procedures at its medical practices now complied with the DHB/PHO agreement for capitation-based funding (The Family Clinic being one of these practices).
"We've accepted legal advice which says there is insufficient evidence to lay criminal charges. The advice did say there were serious impropriety and/or improper practices at The Family Clinic with respect to the alteration of data," said Mr Climo.
"During the investigation we instructed investigators to make a complaint to the Medical Council against Dr Suresh Vatsyayann concerning patients who were enrolled without any legal justification.
That complaint is before the council's Professional Conduct Committee.
In January this year, the Health Practitioners Disciplinary Tribunal found Dr Vatsyayann guilty of professional misconduct following complaints made by patients about the accuracy of his clinical notes. His appeal against that decision and the penalty are set down for hearing at the High Court in Wellington.
"Given that course of events and the fact we've recovered the money that was inappropriately paid by the PHO, we will not take legal action," said Mr Climo.
However while the investigation is now closed, Mr Climo said the DHB reserved the right to reopen it should new information come forward about the identity of the staff person at The Family Clinic who wrongfully enrolled the patients.
Dr Vatsyayann is an elected Waikato DHB board member.
ENDS
Waikato District Health Board
Healthy People. Excellent Care
Waikato District Health Board (DHB) employs over 6500 people and plans, funds and provides hospital and health services to more than 391,770 people in a region covering eight per cent of New Zealand.
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