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Medical Error

#1 Guest_Gone Walkabout_*

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  Posted 17 September 2003 - 01:09 AM

Medical slips highlighted
09.05.2003


One in four New Zealanders with serious health problems has been the victim of medical error, according to a report made public yesterday.

The study, made by the Harvard School of Medicine on behalf of the Commonwealth Fund, surveyed 750 New Zealand patients and compared them with similar groups in Australia, Britain and the United States.

The study revealed "disturbing rates of medical error".

About a third of those surveyed had seen five or more physicians, and it was this group that suffered the most problems, particularly with conflicting advice. Others had been subjected to duplicate tests and poor co-ordination of care.

Some patients taking multiple prescription drugs said their doctors had not reviewed their treatment or even discussed it with them recently.

Ministry of Health spokesman Andrew Greenwood said the ministry was aware of the issues and was taking steps to improve co-ordination of care.

"This report is based on data we supplied," he said.

Health and Disability Commissioner Ron Paterson said the fact that New Zealand had similar error rates to the other countries surveyed (Australia, Britain, the US and Canada) was "no comfort".

http://www.nzherald.co.nz/storydisplay.cfm...on=&reportid=16
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#2 Guest_Gone Walkabout_*

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  Posted 17 September 2003 - 01:24 AM

Software keeps patients safe from doctors' dodgy writing

20.05.2003

By ADAM GIFFORD
The Otago District Health Board is using electronic tools to reduce the number of cases where patients get the wrong medicine.

Project leader John Lucas said there were hundreds of reasons why people were given the wrong drug, ranging from the doctors not knowing enough about the medicine to the prescription being illegible.

Full story: http://www.nzherald.co.nz/business/busines...ion=information
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#3 Guest_Gone Walkabout_*

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  Posted 17 September 2003 - 01:29 AM

July 3, 2002

TIME TO GO BEYOND THE "QUESTIONABLE DOCTORS" REPORTS


By Nicholas Regush

I’d like to salute Public Citizen for its reports on "questionable doctors." The latest issue released yesterday focuses on 1,111 doctors "who have been disciplined by Texas’s state medical board and other agencies for incompetence, misprescribing drugs, sexual misconduct, criminal convictions, ethical lapses and other offences." Public citizen also informs that, "most of the doctors were not required to stop practicing, even temporarily."

The good news is that this information is online and anyone who wants to pay $10 can do some checking. It might be nice to know that your doctor is not a sexual predator or a junkie.

Public Citizen also makes a point of stirring things up about these "questionable doctors." The consumer advocacy group criticized the Texas Board of Medical Examiners for the lame manner in which it discipline Texas doctors. Perhaps lame is too kind a word. "Dangerously lenient," is how Dr. Sidney Wolfe put it. He is director of Public Citizen’s Health Research Group and is known to growl a fair amount when he believes something is terribly unfair. He’s a good man, an old friend and I like him to be on my side.

Having saluted the effort, let me now try to offer good reasons why this regular Public Citizen-led public humiliation of "questionable doctors" should be vastly expanded to include corruption, particularly conflict-of-interest. For my taste, the entire current effort lacks real bite. The medical boards will get into line when hell freezes over. You can criticize them all you want. Their job is to protect the reputations of doctors. So why only target them and a relatively small number of "questionable doctors." I’d go after a greatly expanded list of doctors who have sold out to the drug and medical devices industries.

Let’s tally how much money in the way of special consulting fees, cash incentives, gifts (including trips to Bali), and career sponsorships each doctor acquires over a period of a year. Let’s put that all online, so everyone can see. Frankly, a doctor’s conflicts of interest may be as dangerous to patients as someone who now qualifies for the current "questionable doctor" category.

Corruption is now so wide-spread in medicine that nothing short of extensive public humiliation of offenders will do anything to turn the tide. And we shouldn’t be shy about this. Lives are on the line.
:(
It’s only a matter of time.

http://www.redflagsweekly.com/storm_warnin...002_july03.html
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#4 Guest_Gone Walkabout_*

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  Posted 17 September 2003 - 02:37 AM

'Bad blood' victim angry over compo delays 27 May 2003

A Bay of Plenty "bad blood" victim is angry at the Government over delays to compensation claims haemophiliacs infected with hepatitis C through blood transfusions have made.


He says as legal action drags on, victims are becoming increasingly frustrated at the "bureaucratic brick walls" that keep emerging.

Martyn Ilsley, 30, of Galatea, 82km east of Rotorua, is one of about 150 claimants who are fighting for compensation after being infected with the potentially fatal liver disease in the late-1980s and early 1990s.

The Government has offered $44,000 each to 77 claimants who were infected during surgery between February 1990 and July 1992.

In 1990, advisers told the then government that a blood screening programme should be implemented but that was not done until two years later.

More than half of those eligible for government compensation rejected the offer, arguing it was well short of that which governments in other countries have paid to bad blood victims.

Unlike people who received blood infected with hepatitis C during surgery, haemophiliac claimants received infected blood products.

Because blood products come from several sources, it is harder for haemophiliacs to determine the source of infection.

Mr Ilsley was told he had hepatitis C during a routine blood test in Whakatane seven years ago.

However, he believes the infection occurred several years earlier, around 1990, during a transfusion at Napier Hospital.

Without documents to prove he was given a transfusion then, Mr Ilsley stands no chance of winning his claim for compensation.

He admitted the process was making him increasingly bitter towards the Government and health officials.

"I think the medical records have conveniently disappeared."

Full Article:

http://www.stuff.co.nz/stuff/0,2106,250415...57a7144,00.html
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#5 Guest_Gone Walkabout_*

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  Posted 20 September 2003 - 10:27 AM

Honest doctors can create happier patients :lol:
20 September 2003
By NIKKI MACDONALD

Doctors need to become better communicators to avoid patient complaints, says the national health complaints watchdog.

Health and Disability Commissioner Ron Paterson said ineffective or insensitive doctor-patient communication was a factor in 60 to 70 per cent of the complaints he received.

Commission and Medical Council figures for 2001/2002 showed obstetricians and gynaecologists were the most common target, with about 18 complaints per 100 doctors. Orthopaedic surgeons had 15 complaints and general practitioners 12.

Talking to the national conference of obstetricians and gynaecologists in Auckland yesterday, Mr Paterson said better communication would reduce complaints throughout the medical profession.

Doctors needed to be careful about explaining risks and be more sensitive when talking to patients.

In cases where a mistake was made, honesty was the best policy, Mr Paterson said. Research and his own experience showed patients were less likely to complain if doctors were up front and apologetic.

He believed more communication training was needed at medical school and post-graduate levels. Students learnt to see patients as bits of anatomy, and sometimes lost sight of the bigger picture.

Otago Medical School dean and Medical Council president John Campbell agreed communication was a fundamental issue in the profession but believed the situation was improving. More emphasis was now being placed on communication skills in training.

Doctors were mostly good communicators but workplace stress and time pressures sometimes made it difficult to give full explanations.

Royal College of GPs president Jim Vause said the environment made communication difficult. "It's like trying to explain how the inside of a computer works to someone who has only ever pushed a button on the outside."


http://www.stuff.co.nz/stuff/dominionpost/...89a6479,00.html
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#6 Guest_Gone Walkabout_*

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  Posted 20 September 2003 - 09:52 PM

Frustration over non-urgent surgery



Sep 19, 2003

A Waikato doctor has spoken out in frustration over failed attempts to get surgery for his patients.

The Te Awamutu GP says he is repeatedly referring people to Waikato Hospital for hernia surgery, but the hospital says money is tight and hernias are way down the priority list.

Ross Falconer says despite repeatedly referring patients, the hospital won't add their names to its elective surgery waiting list.

For over a year Owen Emmett has suffered from the pain of a hernia, but despite being referred for surgery to repair the ruptured muscles in his groin nothing has happened.

"If I was working for an employer I would be out the door because some days I can't do much," Emmett says.

"We are instructed by the hospital to treat their pain with Panadol and to refer them back if they suddenly become seriously ill," Doctor Falconer says.

Owen can't afford the $3,000 bill for private surgery and so he must wait.

"My hopes are pretty low at the moment," he says.

Falconer says Owen is not alone.

"Since February last year we have been instructed by the hospital not to refer people with certain conditions - those conditions include hernias," says Falconer.

Ministry of Health guidelines state hospital specialists should see referrals patients within six months, but Falconer says Waikato Hospital is working around the directive and patients referrals are simply being sent back - meaning they can't even get on the waiting list.

Waikato District Health Board says its hands are tied due to financial constraints. Chief Medical Advisor David Geddis says people with those "uncomplicated issues" are unlikely to be seen in the current climate.

"What is the point in leaving them out there in limbo and total uncertainty," says Geddis.

The Health Minister says prioritising elective surgery is a matter for health boards. Annette King says thousands more patients nationwide are getting elective surgery - including those for hernias - under a booking system for operations.

But the opposition disagrees.

"The government is saying to DHBs don't put people on the waiting lists so Annette King can stand in parliament and crow about the waiting list going down - it's dishonest," National's health spokesman Roger Sowry.

Meanwhile, Emmett says he wants surgery so he can keep working and avoid the one place where he doesn't want to be - on the dole.

http://onenews.nzoom.com/onenews_detail/0,...207-1-6,00.html
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#7 Guest_Gone Walkabout_*

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  Posted 23 September 2003 - 10:13 PM

Medical mistakes compo hits $25m
08 September 2003
By MARIANNE BETTS

Mistakes by health professionals have cost taxpayers nearly $26 million in ACC payouts in the past year.


New ACC figures show a record number of medical misadventure claims have been made – 2727 claims were received in the 12 months till the end of June, 300 more than last year.

ACC spokesman Fraser Folster said on average 40 per cent of claims were accepted. A total of $25.6 million was paid out to injured patients and their families during the period, compared with $25.1 million the previous year.

A total of $142 million has been paid out in the past decade.

Mr Folster said the proportion of declined claims might appear higher than expected because in just over a quarter of cases no personal injury could be established.

Many people who lodged a claim failed to pursue it to a decision. A quarter of claims were turned down because the claimant failed to provide ACC with relevant information.

In the past decade most accepted claims came from general surgery patients, followed by gynaecology, then orthopaedics, dental, obstetrics, general practice and drug reactions.

Mr Folster said the right to seek lump-sum payments for permanent impairment from medical misadventure was introduced in April last year but it was still too soon to assess its impact.

The medical misadventure unit continued to receive alot of claims relating to insignificant injuries, such as a small bruise following a blood test, he said. It was difficult to pinpoint the exact reason for the increase in the past financial year as there had been no big incidents that had generated multiple claims.

"However, some individual claimant cases have received extensive media coverage, highlighting the issue of medical misadventure," he said.

Medical Association deputy chairman Ross Boswell said an increase in the number of claims did not necessarily mean there had been a rise in adverse incidents.

There could be a greater public awareness of medical misadventure and the claims process.

Everyone – including doctors – made errors, and medical mishap occurred when everything was done right but the outcome was unfortunate, Dr Boswell said.

Medical misadventure includes medical error and medical mishap. Medical error is the failure of a health professional or an organisation to observe a reasonable standard of care and skill. Medical mishap is an adverse consequence of treatment properly given by, or at the direction of, a health professional.

The Government is reviewing the medical misadventure system.



http://www.stuff.co.nz/stuff/dominionpost/...31a6479,00.html
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#8 Guest_Gone Walkabout_*

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  Posted 23 September 2003 - 10:20 PM

Cancer treatment - why are we waiting?

07 September 2003

Cancer is now the single biggest killer of New Zealanders: 7500 people will die this year and another 16,000 new cases will be diagnosed. The government says early detection can cure a third of the cases - so why are patients waiting so long for treatment? Oskar Alley reports.


HARROWING SAGA SPARKS MOVE TO 'FIX THE SYSTEM'

The patient

Kathryn McIlraith didn't have much to celebrate on her 52nd birthday.

The day started well enough, a luxurious sleep-in on a warm Christchurch January morning. As she stretched and contemplated getting up, her fingertips brushed against an unexpected bump in her left breast.

The next thing she felt was a sinking feeling in her stomach she would come to know and loathe as a New Zealander needing cancer treatment. As a justice of the peace, her personal peace had just been shattered.

McIlraith knew about the importance of breast self-examinations, she'd seen the ads and read the pamphlets - like every other woman in the country she had listened when told early diagnosis and treatment were essential.

A trip to a GP triggered more of that sinking feeling. By the time her surgeon confirmed within weeks that she had breast cancer she was as mentally prepared as could be expected.

"It's a difficult time but I'm a pretty tough cookie, it was pretty clear from the size of the lump, and the location, that it was going to be bad news," she recalls.

In short, McIlraith had done everything right - self-examination, early detection, saw a doctor, early diagnosis. Little did she realise it was our health system that would fail her, as her six-week wait for radiation therapy would stretch to 10 weeks, then 12 weeks, and ultimately 14 weeks. By early February she had undergone surgery at a private hospital - despite having health insurance she paid $1700 of the $6000 operation cost. To go public meant to wait much longer.

A surgeon removed the lump, and affected lymph nodes, leaving McIlraith with heavy scarring and other health problems relating to the lymph nodes' removal.

Before the surgery she had been told to expect a wait of six weeks for follow-up radiation therapy, a process whereby a linear accelerator fires a beam of radiation to destroy tumours.

"You can imagine how dismayed I was to hear that six weeks was completely wrong," McIlraith says. "After the surgery I was told 10 weeks at the earliest, there was no explanation, they just said there was a huge waiting list. And I thought Ofor God's sake'. The system is like a big black hole, where things like patients and their case notes just seem to get lost."

Ten weeks passed but McIlraith's anxiety did not, that sinking feeling got worse with no sign of treatment starting.

A polite inquiring call to Christchurch Hospital met with a "disquieting" response - the oncology unit did not have her details. As far as they were aware she wasn't even on a waiting list, let alone overdue for treatment.

McIlraith embarked on a frantic letter-writing campaign to everyone and anyone who could help, including Health Minister Annette King.

Finally in May– after a 14-week wait - she began radiation treatment, undergoing five sessions a week for 6 weeks.

"What's it like to wait on a waiting list? It's an extremely lonely time of your life," she says. "Some people who have gone through it say it's like water torture. For me, the worst part of it was it doesn't have to be like this, women with breast cancer shouldn't be treated like this. The system can't be that hard to fix."

McIlraith completed her treatment in July and still requires regular check-ups. As her body continues to heal, she is turning her mind to fixing the system.

In five weeks McIlraith, her family and friends, gathered nearly 10,000 signatures on a petition to parliament.

Presented last month, it asks that the house "takes immediate action to ensure that all women who have had breast cancer surgery receive the follow-up treatment including radiation therapy that meets the internationally accepted guidelines".

She is now preparing a submission for the health select committee. "This saga has had a huge impact on my life and for other women who have been through it. Maybe we can help stop it happening to someone else."

'IT'S APPALLING, A NATIONAL DISGRACE'

The doctor

As one of the country's leading cancer physicians, Dr Peter Dady is used to delivering bad news.

But Dady, the Cancer Society's medical director, saves his most frightening diagnosis for the health system responsible for treating cancer patients.

"It is, quite simply, appalling," he says, trying but failing to control his anger.

"The way cancer is treated in this country is a national f–-ing disgrace."

On Tuesday Dady had to tell a young man - with a young family - that the Hodgkins disease he had beaten 12 years ago had returned.

"The reality is he is more than likely to have to undergo radiation therapy, and it is more than likely he will face delays.

"He's looking at an eight-week wait and he is not a happy chappie."

Dady, who heads Wellington Hospital's cancer centre, says doctors and nurses are under-resourced and overwhelmed.

Telling patients they have cancer is traumatic enough, he says. Telling them their treatment will be delayed is perverse.

"The staff hate it. They get flak from distressed patients.

"Cancer is frightening enough, but the wear and tear on patients' psyches on waiting lists is just unacceptable."

The situation one day caused Dady to remark to other specialists that New Zealand's health system was Third World.

"This specialist from India heard me. He came up and told me their waiting lists were shorter than ours."

Dady bridles at top Health Ministry official Colin Feek's claim that up to 12 weeks is an acceptable time to wait for radiation therapy.

"That is bullshit," he spits.

"Four weeks is the maximum time we should take to treat the least urgent cases, faster for the serious ones. If the clinicians are heard, they will say (12 weeks) is absolute garbage. There's plenty of evidence that says that claim is plain wrong."

Dady says the most frustrating aspect is that previous governments knew for years that cancer cases were increasing by 5% annually, and that there were looming problems with staffing levels and the ageing linear accelerators.

Money that the public was told was being poured into cancer centres never seemed to reach the centres themselves, lost in the alphabet soup that typified health sector restructuring, from CHEs to RHAs to DHBs.

Dady says: "There has got to be improved accounting to ensure through the bureaucracy that the money is there, and that it gets there, because my gut feeling is that it isn't."

But he describes the current health minister as "the best we've had in 20 years".

"At least Annette King listens. And she seems prepared to act."

AUSTRALIA PICKING UP THE PIECES

The politicians

Like a bitter pill, Annette King says the idea of having to send cancer patients to Australia sticks in her throat.

Yes, the health minister concedes, it does run the risk of the public thinking New Zealand hospitals do not have the ability to treat its cancer patients.

From December 2001 to April this year, 133 cancer patients have been sent across the Tasman, Health Ministry figures show.

The problem is not one of expertise, she says, but staff shortages.

"I don't want to send people to Australia, but you've got to use every tool you can to help people. I wish we didn't have to, it's not ideal because people are separated from their families.

"But if you're faced with the choice of people waiting too long, and people being prepared to go to Australia, then you have to take that opportunity.

"No one's forced to go, but it had to be included in the mix to try and manage what is a big problem for us."

King says the problem over waiting times is two-fold - public hospitals' ageing and temperamental linear accelerators, and not having enough trained staff to operate them.

She has more than doubled the number of radiation therapists currently training from 16 to 38 (205 people applied for the positions) - the first graduates enter the workforce in November, but they are badly needed now.

Last year the medical professionals won hefty pay rises to address retention problems.

King says: "I will breathe a lot easier when we have that flow-through of new graduates.

"I think cancer is still as scary to people today as it's ever been, 27% of all deaths come from cancer, it's the biggest killer of New Zealanders."

A programme is under way to replace the linear accelerators, which can cost up to $4m each. In some of the country's six cancer centres new bunkers to house the accelerators will have to be built.

Two weeks ago the government launched its cancer control strategy, a national framework years in the making and designed to reduce cancer rates through early prevention.

Its 25 objectives include plans to improve screening programmes, provide better planning for delivering research, diagnosis and treatment, and improving the quality of life for cancer sufferers and their families.

National Party health spokeswoman Dr Lynda Scott, a former geriatrician, says the waiting lists have been, and continue to be, unacceptable.

"If cancer is our biggest killer why the hell is the government not doing more? They've got some cheek telling women early prevention is the cure, when it's the delays they tolerate that put lives at risk."

Scott, who says she frequently had to tell patients they had cancer, said numerous worldwide studies had shown eight weeks was the absolute maximum for beginning radiation treatment.

She believes the government is too set in its own dogma to consider allowing a private health system to share the use, and the cost, of linear accelerators.

"That system works fine overseas, well enough for our government to pay to send New Zealanders to private treatment in Australia. It's a classic victory of ideology over common sense."

King says the argument is a moot point: there aren't enough radiation therapists for the public system let alone private competition. "It would be competition for what is already a scarce resource. Lynda Scott says this all the time. Well my answer is: who's going to run the machines - the cleaners?"

PEOPLE DYING AS BATTLE FOR 'MAGIC BULLET' DRAGS ON

The drugs

The drug is called Mabthera and cancer doctors call it a "magic bullet" for treating non-Hodgkins lymphoma, or cancer of the lymphatic system, which can strike up to 160 New Zealanders a year.

Between a half and a third of those patients will die.

Clinicians have been battling Pharmac for a year to allow Mabthera to be used for aggressive cases of non-Hodgkins lymphoma.

Overseas studies have found the drug can boost survival chances for aggressive cases from 35% to 57%.

Mabthera, which attacks cancer cells but ignores healthy ones, has been approved for use with low-grade cases - but it is up to the six DHBs which host the country's cancer centres to pay.

Mabthera costs about $17,000 for a four to five-week course and is administered in a similar fashion to traditional chemotherapy, which costs $300 to $1000.

Pharmac, the government's drug-buying agency, has to approve cancer drugs for use, but it is up to each DHB to decide if it can afford them. More than 50 drugs are currently in "the basket", or the list of drugs approved for use in the public system.

Cancer Society medical director Dr Peter Dady accuses Pharmac of "rationing by delay" in its approval of cancer drugs, warning: "There are people dying and these people might be saved. This decision is being batted around. I blame Pharmac."

Health Minister Annette King said the new cancer control strategy would consider new drugs to add to the basket as they continued to be recognised.


http://www.stuff.co.nz/stuff/sundaystartim...40a6442,00.html
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#9 Guest_Gone Walkabout_*

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Posted 23 September 2003 - 11:18 PM

Your Health: Rules of engagement
06.09.2003
By MARTIN JOHNSON


Medical students can spend 12 years training to register as a specialist; Bowen therapists' specialist training takes just 12 days. Practising doctors must by law sign up with the Medical Council; Bowen therapists have a voluntary registration body.

Errant doctors can be hauled before council re-education and complaints committees, the Health and Disability Commissioner, a court-like medical tribunal and ACC; Bowen therapists, too, can face the commissioner and Bowen Therapy Inc, but there is no independent prosecution body and patients harmed by the treatment have no medical misadventure recourse to ACC, which covers only those health workers who must be registered by law.

Admittedly, the scalpels and toxic drugs of Western medical science are capable of inflicting far greater harm than Bowen treatment, a form of gentle touch therapy. But the gulf between the two in training, registration and discipline illustrates the extremes of mainstream and alternative medicine.

The Bowen Therapy Inc chairwoman, Gay Jarvis, rejects the tag of fringe therapy for the treatment, which she delivers from a flat at the back of her Palmerston North Home. She prefers "complementary" therapy.

In addition to completing satisfactorily the 12 days' Bowen education, to become a professional member of the Bowen group, practitioners must have passed a basic anatomy and physiology course, hold a current first aid certificate and have the necessary business skills.

Like other representatives of the more than 70 alternative therapies practised in New Zealand - which range from spiritual healing to acupuncture - Jarvis wants to present her method and its practitioners as trustworthy and safe. "Bowen is safe to use on anyone. We are not ACC recognised, but we are striving towards that."

In the absence of statutory regulation of most alternative therapies, some see ACC recognition as a halfway measure. ACC will pay for accident victims to receive acupuncture, chiropractic and osteopathic treatment. But the providers must be registered with the Register of Acupuncturists, the Register of Osteopaths or the Chiropractic Board.

Of these three, only the chiropractic group is required by law to exist. Osteopaths and acupuncturists have been lobbying for a decade for similar status, and many other alternative therapies want it.

The Health Practitioners Competence Assurance Bill, likely to be enacted within weeks, will add osteopathy to chiropractic, medicine, nursing, podiatry, medical radiation technology and 13 other health professions that are now, or will be, regulated by statute.

The bill will be the first to regulate so many health professions under one law. It will also allow unregulated professions to be added if they can satisfy the Health Minister that their health services pose a risk of harming people - doubtless an easy hurdle for needle-based acupuncture at least - and that the practitioners agree on matters like qualifications and standards.

Register of Acupuncturists president Kevin Plaisted said his profession wanted statutory registration because of the risk of harm.

"Acupuncture is intrusive by nature. The public need to be protected, not only because of the risk of applying needles, but also because of the vulnerability of people who come to see people in the healthcare context.

"There's no form of formal discipline. If we suspend someone from the register we can stop their entitlement to claim under ACC, but they can still put a shingle out to say they're an acupuncturist and practise as usual." This has happened.

Also hoping for Government registration are homeopaths, at least one group representing naturopaths and medical herbalists, and the Charter of Health Practitioners, an umbrella group which has 9500 members in affiliate groups, which range from osteopaths and naturopaths to spiritual healers.

"The cost involved in becoming a statutory authority is humungous," said charter chief executive Patrick Fahy, whose organisation was set up a decade ago to protect the public and practitioners.

"A lot of our smaller groups can't do it. That's where the charter has the mass to become a single statutory authority and that's what we've applied for."

But it would seek to bring into this set-up only those signatory groups which wanted it. The rest would remain voluntary-registration bodies and would still enjoy the charter's other benefits.

Homeopathic Society president Bruce Barwell said his group wanted statutory registration partly to eliminate mavericks. Patients were not being harmed by homeopathic medicines, which were safe, but they were at risk of harm from practitioners who tried to treat beyond their competence or who failed to recognise medical conditions.

Health Minister Annette King said acupuncture was the only alternative therapy she knew of that was preparing to seek statutory registration, although the various groups representing Chinese- and Western-oriented practitioners needed to agree on their approach first. She was unsure which others would fit the legislation.

"The idea that you would register somebody who does your colours is something I can't see fitting the test of harm to the public, making a diagnosis, et cetera."

The Government promoted the health practitioners bill as an expansion of the Medical Practitioners Act 1995, which governs doctors. Discipline - now handled by the Medical Practitioners Disciplinary Tribunal, and by other bodies which also control registration, including the Nursing Council and the Medical Radiation Technologists Board - will shift to a new Health Practitioners Disciplinary Tribunal.

At least 19 types of health workers will be able to be charged with malpractice but the list contains just two alternative therapies, chiropractic and osteopathy, and excludes naturopathy, traditional Chinese medicine, colour therapy and the rest as they will not be statutorily regulated.

The prosecutor will be either the Health and Disability Commissioner's director of proceedings or a complaints assessment committee of the accused's registration body.

Alternative therapies not covered by the bill or subsequent Government regulations will escape the attention of the disciplinary tribunal, but not of the Health and Disability Commissioner's office.

Commissioner Ron Paterson said his office received a handful of complaints a year about alternative therapy practitioners. But they were a tiny fraction of the hundreds about mainstream health workers, mainly doctors.

This was partly because many consumers were unaware the commissioner could investigate alternative practitioners. Some who sought fringe healthcare might feel uncomfortable complaining about it because they felt embarrassed at their gullibility.

"Then there are people for whom it [alternative medicine] is a way of life. Even if they don't get the results they want, they aren't willing to lay a complaint. We don't investigate effectiveness of treatment. We investigate the standard we would expect of a reasonable practitioner. In osteopathy, acupuncture and chiropractic there are clear standards. In homeopathy there are some reasonably clear standards.

"Some of the truly fringe practitioners - how does one investigate the quality of care provided by a quantum booster operator [an alternative therapy given to child cancer patient Liam Williams-Holloway, who died in 2000]?"

But his office could investigate complaints on issues like practitioners' sexual misconduct and the adequacy of information they provided on their therapies.

"Reasonable people would want to know about the effectiveness of the treatment. Although practitioners may not able to give scientific evidence, I believe they need to say more than 'I've had a number of people who swear by this treatment'. They've got to be careful not to oversell their therapy."

While chiropractors are the only alternative therapists now liable to disciplinary prosecution by the commissioner's office - the maximum penalty, as for doctors, is to be de-registered - the office can take any accused practitioner, alternative or mainstream, to the Human Rights Review Tribunal, which can award damages.

The commissioner's investigations are limited to recommendations such as refunding a patient's fees, apologising and doing remedial education.

Consumers Institute chief executive David Russell said patients could sue alternative medicine practitioners if their therapies failed to live up to what was promised, but he was unaware of any cases.

"Most people believe they are getting better or that something is happening to them. I know of some desperate cases, one of a woman who died because she believed in a charlatan who was ripping her off for hundreds, if not thousands, of dollars."

Aged in her 40s or 50s, she had a large breast lump which would have been treatable early on, but she trusted in the "mumbo jumbo" of an alternative practitioner and his laying-on of hands.

One purpose of the registration bodies, whether statutory or voluntary, is to ensure registered practitioners' qualifications meet certain standards.

The more-mainstream therapies on the alternative side of the divide, including chiropractic, osteopathy, acupuncture, and homeopathy and others further out like naturopathy, herbal medicine and aromatherapy all have structured degree or diploma programmes.

Many are approved by the Qualifications Authority and in other cases, including naturopathy, acupuncture and chiropractic, the authority has registered trainers, such as the Wellpark College of Natural Therapies, that provide courses in these areas.

Authority spokesman Bill Lennox said, "We've never put ourselves in the position of judging whether something is worthwhile or not. The attitude NZQA has always taken is that if there are nationally recognised experts in their own field and standards can be defined and if we can be assured that there is a demand for a qualification then it's a legitimate thing to develop a qualification in that area."

The Government spends almost $2.2 million a year on alternative therapy training, providing hefty subsidies for many students, just as it does for medical and engineering students.

Auckland-based Wellpark's fees for New Zealanders in the naturopathy programme, its most popular, are $7600 a year, of which the state pays $4000.

It runs courses of between one and three years in aromatherapy, ayurvedic medicine, nutrition, herbal medicine, massage, yoga and a full-time three-year diploma in naturopathy.

Principal Phillip Cottingham said that in addition to tuition in natural therapies, the college's naturopathy and other students received extensive training in medical sciences, including anatomy, physiology, pathology and microbiology. The charter also emphasises anatomy and physiology. Fahy said the charter encouraged practitioners even of "non-tactile" methods such as spiritual channelling to learn at least the basics of these subjects. He accepts some of the practices the charter covers "may seem fringe-y" but asserts they do not weaken the organisation.

"I don't know the first thing about primal healing, but people get results from it and they have standards of how they train people. That's what we're about, making sure these people have standards in place so that they are accountable."

Entry to Wellpark's and other colleges' alternative therapy courses is generally open, without academic prerequisites, although some require sixth form certificate, university entrance, bursary or even more.

Before entering the College of Chiropractic's four-year bachelor of chiropractic course, students must pass eight university or polytech science papers.

To train as a doctor at the Auckland University Medical School, the academic entry requirement is a B+ average in the first year of the bachelor of health sciences course or the bachelor of science (biomedical science) course.

A medical degree requires a six-year course at university and hospitals. After qualifying and spending two more years working in hospitals, doctors can train for five or more further years to become a GP or a specialist, such as an emergency medicine physician or heart surgeon.

Colleges, such as the Royal Australasian College of Surgeons, oversee the hospital-based training and set the exams which culminate in the award of a fellowship. The Auckland and Otago University medical schools are accredited by the Australian Medical Council.

While the orthodox institutions continue to turn out their graduates, the public attraction to alternative medicine seems to be growing. Wellpark College reports rapidly increasing demand for its alternative therapy courses.

Consumer's David Russell urged the Government to give the Commerce Commission more money so it could toughen up on the "out-and-out charlatans" but he doubted new laws could help. "It's difficult to legislate against people's beliefs."

Health Options


The main alternative therapies practised in New Zealand.


Action potential stimulation therapy
Acupuncture
Alexander technique
Anthroposophical medicine
Applied Feng Shui
Applied iridology
Aromatherapy
Aura-soma colour therapy
Ayurveda
Bach flower remedies
Bio energy therapy
Biological medicine
Body electronics
Bowen therapy
Caeteris body/mind energy balancing
Chi Kung Chinese herbal medicine
Chiropractic
Colon hydrotherapy
Colour therapy
Craniosacral therapy
Crystal therapy
Dynamic phytotherapy
Educational kinesiology
Feldenkrais
Flower essence therapy
Gentle therapeutic manipulation therapy
Hellerwork
Herbal medicine
Holistic animal therapy
Holistic pulsing
Homoeobotanical therapy
Homoeopathy
Human potential
Hypnotherapy
Ifas
Intuitive healing Iridology
Isopathy
Jin Shin Jyutsu
Kinesiology
Maharishi's Vedic approach to health (Maharishi Ayur-Veda)
Massage (therapeutic and remedial)
Medical herbalism
Medium channel/intuitive healer/medium
Natural healing sciences
Naturopathy
Neurofeedback (LEG biofeedback)
Neuro-linguistic kinesiology
Neuro-linguistic programming (NLP)
Oriental massage
Ortho-bionomy
Osteopathy
Paramedical aesthetics and aesthetic medicine
Pacific traditional healing methods
Pilates-based body conditioning
Primal healing
Psychotherapy
Rebirthing
Reflexology
Reiki
Rife therapy
Rolfing (structural integration)
Sclerology
Shiatsu
Spiritual healing
Sports therapy
Touch for health test method


* Information from the Ministerial Advisory Committee on Complementary and Alternative Health.


Herald Feature: Health

http://www.nzherald.co.nz/storydisplay.cfm...029&reportID=16
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#10 Guest_Gone Walkabout_*

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  Posted 23 September 2003 - 11:29 PM

Media Beat-Up Of Intensive Care Unit

Monday, 25 August 2003, 4:40 pm
Press Release: Association of Salaried Medical Specialists

MEDIA STATEMENT FOR IMMEDIATE RELEASE,
MONDAY 25 AUGUST 2003
Media Beat-Up Of Intensive Care Unit; Acting As Lobbyist For Private Hospital

“The media has beat-up the story about the cancellation of operations at Wellington Hospital because all its intensive care unit beds were full,” said Mr Ian Powell, Executive Director of the Association of Salaried Medical Specialists, today. Mr Powell was responding to today’s report in the Dominion Post where the private Wakefield Hospital claimed it could have provided intensive care beds.

“There are significant differences between the intensive care units in Wellington, a major tertiary hospital, and Wakefield. Wellington Hospital has a Level 3 intensive care unit that provides full 24 hour cover, including by specialists, for its patients. In contrast, Wakefield Hospital has a Level 1 unit providing a much lower level of support. It is for this reason that most patient transfers between the two hospitals are from Wakefield to Wellington on clinical grounds rather than the other way around.”

“Senior doctors at Wellington Hospital did consider using Wakefield Hospital but decided not to on clinical grounds because of the differences in the level of medical and other support between the two hospitals. The key factor was patient safety and well-being.”

“The Dominion Post would do better in its health reporting if it was to cease acting as an advocate for a private hospital that has had some bad luck in the share market recently,” concluded Mr Powell.


Ian Powell
EXECUTIVE DIRECTOR

http://www.scoop.co....0308/S00073.htm



A wee note: It is also the Wakefield Hospital that was in the media for misleading investment prospectus, which ACC had eventually declined to join others to take legal action, and as we know ACC does have investments in Wakefield Hospital, which is also where some preferred ACC contracted staff also do their work....................
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#11 Guest_Gone Walkabout_*

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Posted 23 September 2003 - 11:56 PM

World cheap drugs go-ahead

Negotiators have overcome last-minute hitches to reach a deal in Geneva on giving some of the world's poorest countries access to cheap drugs.

World Trade Organisation spokesman Keith Rockwell described the agreement, which settles a long-standing dispute, as "one of the most important decisions" ever taken by the organisation's executive.

The deal could see millions of people around the world receiving medicines to treat killer diseases for the first time.

The 146 members of the WTO had reached agreement in principle late on Thursday, but the decision was delayed following a last-minute hitch.

It is understood that the delay has been caused by up to two dozen countries who had been unhappy about the wording of a 'chairman's statement' agreed by the US, Brazil, India, Kenya and South Africa.

The five had previously been at loggerheads over plans to make cheap medicines more widely available.

American opposition

The principle of allowing developing countries access to cheap versions of key drugs had been agreed at WTO talks almost two years ago but talks had dragged since then on implementing the deal.

Many of the drugs at issue are patented, which means they cannot be copied for 20 years. The WTO talks aimed to ease these rules for some medicines, enabling countries in need to import cheaper versions of essential drugs.

Last December, the United States had blocked a deal on cheap drugs - even though it was backed by all other members of the WTO.

US negotiators said it would allow too many drugs patents to be ignored.
They said the proposed deal would mean that illnesses that are not infectious, such as diabetes and asthma, could also be treated with cheap, generic drugs.

But it was understood that the US would lift its opposition to a deal if WTO states pledged not to abuse the system and to only waive patents "in good faith" and not for commercial gain.

They would also be expected to take all reasonable steps to ensure cheap versions of drugs do not make their way onto markets in rich countries.
The issue has been casting a long shadow over global free trade talks since their launch in 2001.

http://networks.org/...c:world:3193625
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  Posted 24 September 2003 - 12:11 AM

Health professionals 'failed meningitis victim'

02 September 2003
By MARIANNE BETTS

It was "extraordinary" that health professionals failed to take a young Wellington woman's temperature before she died of meningococcal disease, an infectious disease expert says.


Auckland doctor Rod Ellis-Pegler told a coroner's inquest into the death of Nileema Sharan that taking her temperature might have indicated her illness was systemic and that she did not just have a pulled neck.

It also appeared there had been a communications failure. Medical intervention, even early on the day of her death, could have saved Ms Sharan, he said.

Ms Sharan, 25, was found dead in her bed about 1pm on June 26 – the day after waiting three hours to see a doctor at Wellington Hospital, before giving up and going to the nearby Accident and Medical Centre. A doctor saw her there and diagnosed a strained neck and sent her home.

Ms Sharan, a hotel receptionist, became ill after she pulled her neck while speaking on the telephone, but her friends and family say that as well as having a sore neck, she was shaking, cold, and had sore legs.

Dr Ellis-Pegler said he was surprised Ms Sharan was not seen by a doctor after three hours and that her temperature, pulse, blood pressure and respiratory rate were not taken. Taking her temperature would have taken 15 seconds and the other procedures would have taken a minute each.

Friends say Ms Sharan was hot, clammy and had a temperature.

"I would have expected having spent that amount of time in an emergency department and not being seen by a doctor that such recordings would have been made whatever the basic illness," Dr Ellis-Pegler said. Recording Ms Sharan's temperature was the only way to be sure of whether she had a fever, which might have indicated she had more than just a pulled neck, he said.

Work colleague Malia Perez told how she had volunteered to accompany Ms Sharan to the hospital in the ambulance.

"She was cold and her legs were feeling numb. She seemed to be in so much pain. She asked me to rub her legs. She was cold and she was shaking," she said.

Ms Perez kept asking how long the wait was going to be and was told half an hour to an hour. Ms Sharan was given Panadol by a nurse for her headache. "She was saying her head was going to explode".

Ms Sharan was moved from second on the list of patients to be seen to sixth. "I was getting annoyed but I didn't want to make a scene . . . I was getting frustrated," Ms Perez said.

They gave up and went to the Accident and Medical Centre where Ms Sharan was seen by Dr Peter Coxhead. Ms Perez said Ms Sharan vomited three times while at the centre and turned away from the light.

Dr Coxhead diagnosed Ms Sharan as having a strained neck and sent her home after she had two injections and was given a neck brace.

Ms Perez said everyone was so relieved she had been seen by a doctor.

"That was the last I saw of her."


http://www.stuff.co.nz/stuff/dominionpost/...02a6479,00.html
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#13 Guest_Gone Walkabout_*

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  Posted 24 September 2003 - 01:32 AM

Bad blood victim vows to fight on
22 August 2003


By MARIANNE BETTS


Haemophiliac and hepatitis C sufferer Steve Waring says he will keep battling on despite police deciding there are no grounds to prosecute anyone over the bad blood scandal.



Mr Waring was one of 45 people to lay a complaint against former health ministers Helen Clark and Simon Upton in 2000, claiming they failed to act quickly enough in introducing hepatitis C screening of blood donations.

Mr Waring, 39, of Lower Hutt, who contracted hepatitis C in the 1980s from contaminated blood products, was disappointed but not surprised at the police decision.

Victims wanted a Government apology, compensation and access to cutting-edge health care, he said. While the criminal prosecution had failed, the civil one would continue.

"People with haemophilia grow up quickly and with determination to succeed, we fight with our lives for things, and this won't go away."

A spokesman for the Prime Minister said Miss Clark would not comment. "It's a police matter and they're handling it."

Haemophiliac recipients of bad blood made allegations of criminal nuisance about delays in introducing comprehensive blood screening.

The government introduced screening in 1992. About 700 New Zealanders contracted the disease through contaminated blood products before screening began. Some have since died.

Hepatitis C is a potentially fatal liver disease caused by a blood-borne virus, spread by contact with the blood of an infected person.

Police were sympathetic to complainants but it had to be established whether there were in fact sound legal grounds for prosecution, acting Police Commissioner Steve Long said.

To successfully prosecute, police would have to prove an unlawful act or an omission to discharge legal duty had taken place.

"The legal advice we have received establishes there has been no unlawful act or breach of legal duty by the ministers, therefore there is no basis for further investigation by police," he said.

Police had conducted extensive consultation with the Health Ministry and sought legal advice from the Crown Law Office before making this decision.

Wellington lawyer Roger Chapman, who is representing 150 people who contracted hepatitis C from bad blood, said the decision did not affect the civil suit. He hoped the case would go to trial next year.

The Government's offer in 2000 of $44,000 to victims who contracted the disease between February 1990 and July 1992 remained open, Health Minister Annette King said.

http://www.stuff.co.nz/stuff/dominionpost/...74a6479,00.html
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Posted 26 September 2003 - 08:54 AM

Doctors failing to act on meningitis
26 September 2003

General practitioners are failing to give patients with suspected meningococcal disease prompt antibiotic treatment, according to a new study.

Public health researchers carried out an audit of all 214 cases of meningococcal disease in Auckland in the year to April 30, 2002.

The study, published in yesterday's New Zealand Medical Journal, found 142 had been referred to hospital by a GP and, of those, 111 were eligible for pre-hospital antibiotics under Health Ministry guidelines.

But just one-third of those eligible for antibiotics were given the potentially life-saving treatment. Early treatment reduces the chances of death from the disease.

The authors suggested there was scope for improvement to the pre-hospital management of suspected cases of meningococcal disease.

Public health doctor Chris Bullen said family doctors were failing to give antibiotics because of diagnostic uncertainty, concern about interference with hospital tests and a belief patients would be treated promptly at hospital.

Dr Bullen said the management of meningococcal disease was time critical.

He said the fear of administering inappropriate antibiotics should not discourage pre-hospital treatment, as minimal harm could be expected if an antibiotic was given before the disease was confirmed.

Early and aggressive treatment of suspected cases of meningococcal disease was essential. Doctors needed to be more suspicious and lower the threshold for treatment.

http://www.stuff.co.nz/stuff/dominionpost/...13a6479,00.html
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#15 Guest_Gone Walkabout_*

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  Posted 27 September 2003 - 12:40 AM

Whistleblower alleges illegal encouragement of off-label use

Scientist David Franklin says he became part of a broad mission at pharmaceutical company Warner-Lambert to deceive, even entice doctors to prescribe drugs to patients whether it was scientifically justified or not.



NBC NEWS

July 11 — The questions began with the confession of an insider at one of the nation’s largest pharmaceutical firms. He says his former company deliberately distorted information about one of its drugs, possibly putting lives at risk, and costing patients and taxpayers millions of dollars. “Dateline” went looking for some answers and has the results of a year-long investigation into what may be one of the biggest medical deceptions in history. NBC’s John Hockenberry reports.

DAVID FRANKLIN: “I was trained to deceive, to lie to doctors.”
John Hockenberry: “So these doctors were completely misled?”
Franklin: “Absolutely.”

Who would train and then pay someone to mislead doctors? Scientist David Franklin says pharmaceutical company Warner-Lambert paid him to do that back in 1996.

Franklin: “It was my responsibility to leverage the trust that physicians had with pharmaceutical companies to corrupt the relationship between the physician and the patient.”

John Hockenberry: “Your job was to find trust, and exploit it, to produce more sales for Warner-Lambert.”
Franklin: “Absolutely.”

Since he was a little boy growing up in Rhode Island, Franklin says, he wanted to be a scientist. But he wanted to use that science to help people, doing medical research to cure disease.

So Franklin got his Ph.D. in biology at the University of Rhode Island and from there became a researcher at the prestigious Dana Farber Cancer Institute. After more than three years as a researcher, Franklin wanted to get out of the lab. He found a job at Parke-Davis, a division of Warner-Lambert. He would be a medical liaison, using his scientific expertise to explain the scientific merits of drugs to doctors.

Franklin: “The medical liaison was supposed to be fair and balanced, where the physician could trust what the medical liaison was telling them.”
Hockenberry: “So, doctors wouldn’t necessarily see you as a company guy, as much as they would see you as a scientist. As as a medical doctor, like them in a way.”

Franklin: “Exactly. A person whose primary responsibility is to care of the patients, making sure that the doctor, to enable the doctor to practice the best possible medicine that science would allow at this point in time.”
Hockenberry: “So, a doctor needs more drugs for their practice. They call the salesman. But if they have questions about the medical use of that drug, they call you.”

Franklin: “Exactly.”

But almost immediately, Franklin says, he became little more than a salesman. The job he thought would be about caring for people turned out to be little more than caring for the company’s bottom line. With his Ph.D. and the title of doctor, Franklin says he became part of a broad mission to deceive, even entice doctors to prescribe drugs to patients whether it was scientifically justified or not.

Franklin: “It was a matter of leveraging, corrupting, if you would, perverting the science, to greatly increase sales and profitability.”

This corporate whistleblower, telling his story to “Dateline” in his first broadcast interview, has rocked the pharmaceutical industry to its core.

Pieced together with confidential documents and taped voicemails, you’ll see a portrait of sales over science.

Read the Full Article:

http://www.msnbc.com...p?0sl=-41&cp1=1
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#16 Guest_Gone Walkabout_*

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  Posted 12 October 2003 - 10:23 PM

Accused doctor to quit
10 October 2003
By GLEN PRENTICE

A doctor plans to quit medicine because of the trauma she has suffered since questions were raised over her treatment of a patient who later died.


The doctor, whose name is suppressed, is defending a charge of professional misconduct brought by the director of proceedings after Noeline Chapman died on August 10, 2001.

It is alleged she failed to properly assess Ms Chapman, failed to adequately investigate the cause of her symptoms, inappropriately prescribed a change of medicine and didn't keep adequate records.

The allegations relate to consultations the doctor had with Ms Chapman on August 8 and 9, 2001.

She told a Medical Practitioners Disciplinary Tribunal hearing in Napier yesterday that the charge had taken a huge toll on her.

"I have never gone through anything like this before. I didn't go into medicine to kill people off . . . this has been a long hard road."

The doctor said she had never experienced the type of anger the Chapman family had shown towards her.

"I am going to be getting out because this is getting to be too much."

She told the tribunal she was familiar with pneumonia and Ms Chapman did not present with any symptoms that indicated she had the illness. She was physically alert, her oxygen levels were good and she was not in distress.

Ms Chapman did not disclose that she was feeling worse on a second visit and she was right to attribute her vomiting as being due to her medication. The doctor said she insisted Ms Chapman came in for a third consultation during a phone call on August 9 when she claimed to be still ill and vomiting. However, Ms Chapman refused, saying she could not afford it, despite reassurances that she would not be charged.

Earlier yesterday, Lower Hutt GP Christopher Wright gave evidence criticising the doctor's treatment of Ms Chapman.

Dr Wright said the doctor should have explored other reasons for Ms Chapman vomiting before attributing it to a reaction to her medication.

He said it was inappropriate to prescribe medicine over the phone.

In cross examination he agreed with the doctor's lawyer that pneumonia in its early stages could be a difficult illness to diagnose.

The hearing finishes today.



http://www.stuff.co.nz/stuff/dominionpost/...27a6012,00.html
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#17 Guest_Gone Walkabout_*

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  Posted 19 October 2003 - 12:48 PM

Hospital infections kill 11, says new report

19 October 2003
By OSKAR ALLEY

At least 11 patients have died from infections contracted in public hospitals, partly due to overcrowding, too few nurses and poor hygiene practices, a critical new report says.

One in 10 patients will get infected during their hospital stay and 340 patients who suffered infections in the lungs, in surgical wounds and the bloodstream have received about $4 million in ACC compensation.

A comprehensive report by the auditor-general's office into the country's 21 district health boards reveal staff at some hospitals do not attend their own meetings to keep hospitals clean and safe.

Hospitals are also urged to improve basic hygiene requirements, such as staff regularly washing their hands. An inspection of hospitals in main centres found that 80% of staff hand basins had minor faults, including no soap, blocked drains and overflowing, used hand towel baskets.

The report makes 39 recommendations to reduce and monitor hospital infections - but the auditor-general is refusing to tell the MPs or the public which hospitals are the worst.

It concludes that hospital-acquired infections pose serious risks to patients, visitors and staff.

"Publicity about outbreaks of hospital-acquired infection reduces the public's confidence in the safety of our hospitals," says the report.

"A significant proportion of hospital-acquired infections can be avoided through effective infection control practices.

"In our view, the reports we examined did not provide sufficient assurance to the public on the management of hospital-acquired infection."

The true costs of infected hospitals is put at $137m, including longer hospital stays which puts stress on bed numbers.

Health Minister Annette King is yet to read the report, presented to the health select committee last week, but a spokesman said she may consider requests to tell the public which hospitals ranked worst.

But Act MP Heather Roy, who has worked in hospitals here and overseas as a physiotherapist and medical researcher, said the public had a right to know.

"Hiding away the results is not going to improve the system and it's now obvious that corners are being cut," she said.

"The DHBs participated in this audit knowing the specific findings would be kept secret but at the end of the day it's usually public pressure that brings about change."

At least 11 patients have died from hospital infections, with ACC approving medical misadventure compensation payments to grieving families.

About 330 other patients who survived infections received compensation of about $4m, an ACC spokesman said.

The report says the elderly, infants and patients receiving treatment that suppresses the immune system, such as chemotherapy, are most at risk.

Infections are most likely to appear in the urinary tract, lungs, surgical wounds and in the bloodstream.

They include the antibiotic-resistant "superbug" MRSA which featured in 1044 public hospital cases in 2001, affecting patients and staff.

Problems managing an outbreak of MRSA included a shortage of hospitals beds and "overcrowding' in wards during winter, requiring patient transfers that spread the infection.

A shortage of regular nurses, requiring the use of casual staff, created extra risk of the infection spreading, the report says.

Melanie Miller, whose 19-month-old daughter Charity died from a staphylococcal infection four days after being admitted to Palmerston North Hospital for burns treatment, welcomed the report's findings.

"We've told people about what happened to us and the danger is that people will be too scared to take their mums, or their aunties to hospital if there's a chance they could get an infection.

"People go to hospital to get better . . . not to get sicker."

Miller said MidCentral Health had never apologised to her and her husband Robert. A coroner's inquest recommended the hospital adopt better treatment for paediatric burns and a new sleep apnoea machine in its children's wing had been named after Charity as a memorial.

Miller, who is pregnant, said there was no way she would return to Palmerston North hospital to give birth.

"I'll go to Wanganui instead."

It was "absolutely wonderful" that the auditor-general's report had specified the 39 recommendations to reduce hospital infections, she said.

She and her husband had "some closure" over their daughter's death but hoped any improvements would mean other families would not have to go through what they had.

Health Ministry spokeswoman Gillian Bohm said patient safety was an essential requirement and the ministry was acting to improve infection control procedures.

Canterbury District Health Board chief medical officer Dr Nigel Millar said patients and family members should remind doctors and nurses to clean their hands.

"We need to get to the stage where hand hygiene is 100% between patients. That's pretty difficult when nurses have got a lot on the minds and are busy."

Nurses Organisation chief executive Geoff Annals said hand washing was important, but it was not appropriate for patients to be telling professionals how to do their jobs.

"What is more important is staffing ratios that enable the appropriate care to be given," he said.

Bay of Plenty District Health Board chief executive Ron Dunham said the report was timely as the region did not have a dedicated isolation facility, which was important to prevent infection spreading.

The DHB was awaiting ministry funding approval to build one.

Wellington's Capital and Coast District Health Board infection control committee chairman Dr Tim Blackmore said it was difficult to measure the number of deaths from hospital-acquired infections.

The organisation was trying to collect data, and was clamping down on problem areas and staff cleaning their hands.

"It's a bit like cars on the roads - if you set the speed limit most people will keep to it. Hand washing is the same. I can't swear for every doctor and nurse."


http://www.stuff.co.nz/stuff/sundaystartim...75a6005,00.html
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#18 Guest_Gone Walkabout_*

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Posted 19 October 2003 - 12:54 PM

Quote

Hospital infections kill 11, says new report

19 October 2003
By OSKAR ALLEY

At least 11 patients have died from infections contracted in public hospitals, partly due to overcrowding, too few nurses and poor hygiene practices, a critical new report says.

One in 10 patients will get infected during their hospital stay and 340 patients who suffered infections in the lungs, in surgical wounds and the bloodstream have received about $4 million in ACC compensation.


ok to do some basic calculation:


$$$4 000 000 / 340 = $ 11764.70

twelve grand for their trouble is not much at all. :unsure:
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#19 Guest_Gone Walkabout_*

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Posted 07 November 2003 - 08:40 AM

Amputee appeals ACC review claiming correct care
06 November 2003
By CATHERINE HUTTON

A Hamilton man whose ulcerated foot was amputated 12 years after he first sought help is appealing an Accident Compensation Corporation review that vindicated his doctor's actions.

Warren Smith, 53, alleges the corporation's review was biased and a conspiracy to cover the facts, after he received treatment from Hamilton plastic surgeon Patrick Beehan.

In his review, an ACC expert adviser found that at all times Dr Beehan had provided Mr Smith with appropriate care and treatment, which was consistent with good practice.

Mr Smith, a self-employed golf club manufacturer, first sought help for a graze to his leg in 1990, which left his tendons exposed. Two years later he was referred to Dr Beehan after the wound failed to heal and he was living on painkillers.

Mr Smith alleges Dr Beehan's failure to tell ACC of the need for surgery and a skin graft, jeopardised his care.

Dr Beehan accepts he did not send the form and has apologised to Mr Smith.

Furthermore Mr Smith alleges the pressure bandages and stockings Dr Beehan recommended, worsened his condition.

In 2002, after exploratory surgery, Mr Smith leg was amputated below the knee.

"Where are my rights as a human being that this can happen - I lose psychologically, physically, emotionally and financially and he can walk away from it?" he asked Judge John Cadenhead in the Hamilton District Court yesterday.

Dr Beehan's lawyer, Hanne Janes, told the court the care Mr Smith received from her client was intermittent and Dr Beehan was by no means the sole health provider.

Because of work commitments Mr Smith had been unable to take bed rest and immobilise his leg, as Dr Beehan initially recommended in 1992, jeopardising his recovery, she said.

But the use of pressure bandages improved his condition, she said.

Judge Cadenhead adjourned the hearing and reserved his decision.

http://www.stuff.co.nz/stuff/waikatotimes/...44a6004,00.html
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#20 Guest_NoRehab_*

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Posted 05 December 2003 - 11:31 AM

Commissioner may reopen files involving surgeon

02.12.2003
9.30pm
Health and Disabilities Commissioner Ron Paterson is considering another look at patient files involving Tauranga general surgeon Ian Breeze.

Mr Paterson said yesterday his office had received six complaints about Mr Breeze since August 1999.

The most serious -- about the 1999 death of Tauranga engineer Lionel Crowley from complications after a botched bowel operation -- resulted in disciplinary action.

On December 16, 1999, Mr Crowley was admitted to Norfolk Southern Cross Hospital for removal of a rectal tumour.

Within hours, he developed a severe infection after a failed operation allowed faeces to leak into his abdomen.

Despite treatment with antibiotics and a further operation at Tauranga Hospital's intensive care unit, Mr Crowley died of multiple organ failure on December 20.

In August this year, the Medical Practitioners Disciplinary Tribunal found Mr Breeze guilty of professional misconduct, fined him $12,500 and ordered him to pay $38,000 in costs.

The tribunal ruled Mr Breeze failed to adequately assess Mr Crowley when he developed symptoms of a life-threatening post-operative infection.

He also failed to transfer his patient's care to an appropriately qualified surgeon in a timely manner, the tribunal said.

In July 2002 -- after a review by the Medical Council revealed deficiencies in Mr Breeze's colo-rectal surgery -- the council ordered he undergo an educational programme before returning to practice.

He is now on restricted duties at Tauranga and Norfolk hospitals.

Mr Paterson said he was "looking closely" at reopening two more cases following pressure from families of other patients who died.

Mr Paterson said cases were revisited as "a matter of procedure" when complainants were unhappy with a decision, or were able to provide relevant new information.

His initial finding had been that no breach of professional standards had occurred in those cases.

However, ACC had found evidence of medical misadventure in both of the cases. The families had been compensated accordingly.

A third, more recent case, was also under investigation.

The families and other interested parties may have come forward at the time of the tribunal hearing if Mr Breeze had not been granted interim name suppression during the disciplinary proceedings, Mr Paterson said.

"This case is a good example of why there should be a presumption of openness (in medico-legal proceedings) and why doctors should not have interim name suppression."


http://www.nzherald.co.nz/storydisplay.cfm...storyID=3537224
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