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Federation Of Women's Health Councils There Submission

#1 User is offline   doppelganger 

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Posted 26 February 2005 - 10:00 PM

Federation of Women's Health Councils
17 Weenink Rd

Health Committee Secretariat Parliament Buildings, Wellington


Organisation background:
The Federation of Women's Health Councils Aotearoa (FWHC) is a national umbrella organisation of women's health councils, women's health centres arid individual women throughout New Zealand P is a consumer based NGO. The Federation has a commitment to providing a powerful voice for women consumers of health, disability arid social services and to act as an advocate for them. Representing the views of women on matters affecting their well-being is a major junction of the Federation.

This organisation has provided consumer comment on previous versions of the ACC legislation and the medical misadventure provisions and the processes around it.

General Comments
FWHC is especially pleased with the changes that;
  • do not require ACC to make findings of fault
  • looks to build a partnership with the health sector in its focus on reducing impact and incidence of treatment related injuries
FWHC has concerns about how resource allocation decisions are differently applied throughout the country and thereby may place patients at variable risk of adverse outcomes.

Explanatory note

Partnership with the health sector
FWHC is generally supportive of the 4 bullet points

Reporting requirements that capture information for injury prevention purpose of ACC FWHC asks:
  • How will this be done at a provider level? public level?
  • Numbers/categories of treatment injuries; trends; action taken by ACC to reduce, particularly any increasing, trends at a provider and/or national level?
  • The public expects transparency in reporting; action when required.
  • How does ACC intend to interact with the health sector in quality and learning initiatives and how will this be reported?
  • Will ACC make public the number of cases it refers to the appropriate agency because of the risk of harm to the public?

    Amendments to Schedule I of principal Act

    Personal injury caused by treatment or treatment injury
    Clause 13

    "S 32 "(1) - FWHC agrees with this definition

    Personal injury caused by treatment or treatment injury not included
    S 32 "(2)
    These exclusions, while appearing reasonable, have the potential to turn some/many straightforward complaints into difficult ones, depending on the attitude taken by ACC as the insurer/compensating body, the clinical opinions it seeks and the basis on which they are sought.

    "(2)"(b) Anticipated part or consequence exclusion

    FWHC has concerns that this provision, as it stands, could be interpreted a requiring a nil anticipated risk ratio for surgery. Many surgical procedures do have some (not uncommon) degree of risk of adverse outcomes, such as when an adjacent organ is nicked by a scalpel, or a nerve is severed, albeit unintentionally.

    "(2)"© Resource allocation decision
    Under the current Act the related section reads
      Medical error does not exist solely because............. The failure in question consists of
      a delay or failure attributable to the resource allocation decisions of the organisation.
    FWHC has grave concerns around the impacts of issues arising around resource allocation decisions, as referred to earlier. If we use the current example of Christchurch Women's, and their publicly reported statement(1) regarding elective services:
    gynaecology, that only those deemed urgent will be assessed for FSA, women with LSIL smear results who are supposed to be seen within 6 months are not going to be seen.
    • If this is the case, that is an inappropriate decision which must surely fit under s"33"(l)"(h) which includes policies, processes, practices, and administrative systems as treatment.
    • How does ACC plan to deal with the different treatment thresholds around the country?

    • How does this sub-section mesh with "33 "(1 )"(d) - a failure to provide treatment, or failure to provide treatment in a timely manner? Who will decide what is timely - the different and changeable thresholds suggest this is a moveable feast!!

    • what if the assessment (for FSA and/or treatment) fails to consider/incorrectly weights/manipulates key clinical factors because of resource allocation issues?
    S "33"(l)"(a) and"(b)

    FWHC observes this definition doesn't specifically address screening of asymptomatic people - for example, where the screen test may be misread or referral for further assessment or diagnosis does not occur - as screening tests are not diagnosis.

    "(d) needs to be rewritten to read -a failure to provide treatment, or a failure to provide treatment in a timely manner

    "(e) needs to be rewritten to better reflect consent issues as an integral part of treatment. I In tile current Act, Medical error can arise in any of the following....
      Obtaining consent to treatment from
      The person to whom the treatment is being given; or
      The person's parent, legal guardian etc
    FWHC asks if the issue is around failing to obtain consent altogether or failing to provide sufficient information to make a fully informed decision, as well as dealing with the situation where a person does not have legal capacity.

    (f) prophylaxis is not defined in the Bill or the current Act - this possibly needs to be.

    Date of suffering treatment injury
    Clause 14
    S "38"(l) will this section accommodate the screening of asymptomatic people where there has been a failure to read the result accurately?

    Time for making claim
    Clause 16
    (4)(a)(i) the date that the personal injury was diagnosed as being a treatment injury - is diagnosed the right word? what if we have another Gisborne Inquiry?

    Reporting of risk of harm to public
    Clause 38
    New section" 284
    why is "(1 )"© referring to medical misadventure? Is that to take into account the transitional period?

Barbara Beckford & Barbara Robson
Federation of Women's Health Councils
24 September 2004

Federation of Women's Health Councils Aotearoa Ph +64 3 768 7505 Fax +64 3 768 5095 [email protected]

(1) The Press p1, Wednesday August 18, 2004 "Waiting-list ills hurt women

#2 User is offline   hukildaspida 

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Posted 03 December 2012 - 11:12 AM


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