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Aust And N Zcollege Of Anaesthetists There submission

#1 User is offline   doppelganger 

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Posted 16 March 2005 - 08:41 PM

A.C~N. OS 042 852


43 Kent Terrace, P0. Box 7451 Wellington South, N.Z. Telephone (04) 385-8556 Facsirnile (04)385-3950 Email [email protected]

Oral Submission presented on the 27 October 2004 to the Select Committee on
Health regarding the Injury Prevention, Rehabilitation, and Compensation
Amendment Bill (No 3)

National Committee of the Australian and New Zealand College of

Dr Peter Cooke FANZCA
Chair, New Zealand National Committee of the 'Australian and New Zealand College of Anaesthetists (ANZCA)
Medical Director, Pacific Health, BOPDHB

Professor Alan Merry FANZCA
Department of Anaesthesiology, Faculty of Medicine and Health Sciences, University of Auckland

Associate Professor Jennifer Weller FANZCA
Honorary Secretary, New Zealand National Committee of ANZCA
Director Faculty Education, Faculty of Medicine and Health Sciences, University of Auckland

The Mission Statement of the Australian and New Zealand College of Anaesthetists is: 'To Serve the Community by Fostering Safety and Quality Patient Care in Anaesthesia, intensive Care and Pain Medicine".

Its objectives are to promote professional standards, patient safety and education and to advance the science and practice of anaesthesia in anaesthesia intensive care and pain management.

The College has a New Zealand membership of approximately 400 anaesthetists. It is principally responsible for training, examination and qualification of anaesthetists, the setting of standards of practice and provides for their continuing professional development in New Zealand.
  • ANZCA supports the Bill because of the likely increased efficiency, the lower barriers to reporting and the opportunities created for improvement of systems

  • ANZCA supports the new process regarding reporting where the Corporation believes that there is risk of harm to the public, provided that the information is given to the person or authority without prejudice in order that the person or authority receiving the information can then conduct the investigation independently
  • ANZCA commends the Government for their efforts to 'build a partnership with the health sector for the reasons stated on page 2 of the explanatory notes of the Amendment Bill

  • ANZCA has some concerns around the issue of causality:
    • ANZCA seeks assurance that the process for determining causality would, whenever possible, include a report from the practitioner who gave or prescribed the treatment and that this should be a statutory requirement

    • Clause 24(2) of the Bill provides that: "Section 134 of the principal Act is amended by repealing subsection (4) (which relates to review applications by registered health professionals or organisations) In other words, the provision of the current Act, which provides specifically for a health practitioner to have to take part in a review (including initiating it), is being repealed. ANZCA submits that this section of the principal Act should not be not repealed, with the effect that there remains an opportunity for a health practitioner to seek review of a decision

    • Clause 25 of the Bill provides that: 'Section 142 of the principal Act is amended by repealing paragraphs (b) and © (which relate to the rights of registered health professionals or organisations at review hearings)". ANZCA submits that this
      section of the principal Act should not be repealed, with the effect that health practitioners have the right to be present during the review.

    • Consistency: If Parliament is to be consistent in removing the whole concept of fault from the Medical Misadventure provisions, then in the interests of ensuring that consistency, any findings, which might imply fault, should be able to be tested. It is an issue of natural justice. A person whose conduct is potentially the subject of criticism, should be able to have a say on that issue. Note also that s.140© of the principal Act requires a reviewer to "comply with the principles of natural justice"
    • Natural Justice: Section 3 of the principal Act states that: "The purpose of this Act is to enhance the public good and reinforce the social contract represented by the first accident compensation scheme by providing for a fair and sustainable scheme for managing personal injury".
    • Fairness to all parties and use of all the available information

    • Making the right decision in a timely fashion.

  • ANZCA submits that for the above reasons, the registered health professional should have the right to be present and to be heard at the review hearing regarding the determination of causality, that is, the link between injury and the treatment.


#2 User is offline   hukildaspida 

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Posted 17 November 2012 - 10:21 PM


Far more research needed into post-surgery deaths

Australian and New Zealand College of Anaesthetists Thursday 15 November 2012, 4:32PM

Media release from Australian and New Zealand College of Anaesthetists

Far more research is needed into why so many patients die after having surgery, about 600 anaesthetists were told in the opening session of a three-day conference in Auckland today.

Explaining his call for more research, keynote speaker Professor Scott Beattie from Canada, an expert in cardiac anaesthesia, says that the World Health Organization has estimated that some 250 million surgical operations are carried out each year, with a post-surgery mortality rate of between two and three per cent. In Europe, the rate is about four per cent dying within 60 days of surgery.

Most of these patients die from causes not related to the reason for having the surgery, with the leading cause being heart attack.

"Millions of people a year are dying as a result of cardiac complications after surgery, and they are less likely to be cardiac surgery patients than other patients.

"While cardiologists recognised the general problem of coronary disease years ago and have made huge progress since in reducing its incidence and effects, there has not been the research into this post-surgical mortality rate. We are 40 years behind in this," Professor Beattie says.

He sees this as a criticial area for anaesthetists because they are usually heavily involved in the pre-operative and post-operative care of patients, as well as providing the anaesthetic care during surgery.

"We can look at what the cardiologists have done but we can't just assume that applying the same techniques and treatments will work. While the patients having post-surgery heart attacks generally will have the same underlying conditions as those with recognised coronary disease, we need more information about why they are having the heart attacks after surgery.

"Surgery itself puts a huge stress test on the body. The anaesthetic will block the stressors during the surgery but afterwards the body is trying to recover from the loss of blood that happens during an operation and the injury to the body that surgery represents. These can trigger responses that are different from those in everyday life.

"So we can't just assume that the same treatment would work. And so far we haven't conducted the large trials to show us what will work.

"We don't have the tools to identify who might have a post-surgery heart attack and if we do identify them, we don't know the best methods of treatment for them.
"While there is some pre-operative assessment, it is hugely variable. There is no standardisation and to introduce comprehensive standardised assessment would be hugely expensive in terms of manpower," he says.

While there is a focus on the first 30 days after surgery, Professor Beattie says that as the objective of nearly all surgery is to return people to a useful lifestyle, research needs to address the longer term as well. And while at 35 per cent heart attacks make up the largest proportion of post-surgical deaths, there is also the other 65 per cent to consider.

Dr Beattie is a professor at the University of Toronto and a specialist anesthesiologist at Toronto General Hospital. He is in Auckland for the 2012 NZ Anaesthesia Annual Scientific Meeting and the 13th International Congress of Cardiothoracic and Vascular Anesthesia. This combined conference is co-hosted by the Australian and New Zealand College of Anaesthetists and the New Zealand Society of Anaethetists in association with the (US) Society of Cardiovascular Anesthesiologists.


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