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Health And Disability Consumer Advocacy Service tere Submission

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Posted 06 March 2005 - 10:18 PM

Health and Disability Consumer Advocacy Service

Nga Kaitautoko

A service provided and funded under the Health and Disability Commissioner Act 1994
P0 Box 1791, Auckland

23 September 2004

Catherine Parkin
Health Committee Select Committee
Bowen House
Parliament Buildings

Submission on the
Injury Prevention, Rehabilitation, and Compensation Amendment Bill (No 3)

I am aware the Health and Disability Commissioner is commenting on this Bill, but wish to also make a submission in support of the changes promoted in the Bill.

I support the change to a focus on treatment outcomes and remedies for people injured rather than the actions of individual health practitioners and identifying fault. It is appropriate that ACC is required to inform people of the role of the Health and Disability Commissioner when consumers wish to make a complaint about a health service they have received. The Commissioner should also be informed if the ACC notifies another person or authority about matters of public safety or potential of harm to the public.

I also support the removal of what have been unfair rarity and severity criteria. These have not worked in the best interests of consumers and have disadvantaged consumers injured by treatment compared with those suffering personal injury by accident.

The combination of compensation and professional accountability with the medical misadventure provisions of the Injury Prevention, Rehabilitation, and Compensation Act has always been problematic and difficult for all parties. Most significantly, it shifted the focus from compensation and rehabilitation of injured patients to debates around the quality of practice and operated criteria that were unfair to patients. As the provision of documentation and responses to a claim relied on the good will and Co-operation of the practitioner/s involved, delays in obtaining assistance for an injured consumer were the inevitable result of a defensive practitioner unwilling to participate in the process.

As well as this not being the core function for ACC, it is inconsistent with the notion of a no-fault scheme, and has resulted in delays for patients whilst this debate runs its course. The move to a system where ACC has a focus on assisting injured patients, complaints are dealt with through 'a one-stop shop' range of options under the Health and Disability Commissioner Legislation and competency is linked to practising certificates as required by the Health Practitioners Competency Assurance Act 2003 will provide a more effective approach to compensation of injury, dealing with competent practice and complaints and will also be easier for consumers to identify which agency to deal with.

The definition of personal injury by treatment would be clearer and less likely to generate questions of eligibility if it also included the word procedure. Procedures carried out for diagnostic, investigative and -research purposes rather than treatment can also cause adverse events. It is important that adverse events caused by procedures are not excluded from compensation because the use of the term was overlooked.

The collection of medical misadventure information, and what will in the future become treatment injury claims, provides a valuable source of information for quality improvement initiatives within the health system. Regular updates and analysis of this information including trends should he provided to professional bodies as well as being made publicly available on the ACC website.

Yours sincerely
Judi Strid
Director of Advocacy

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