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NZ Herald
April 8, 2002
Dalziel mulls over ACC and medical misadventure
NZPA
The Government is exploring extending Accident
Compensation Corporation's coverage of medical misadventure injuries, but
final policy decisions won't be taken until after the next election.
The area has been highly contentious in recent times because of a number of
cases where injured patients have found it difficult to get ACC compensation
and had problems trying to take doctors to court.
ACC Minister Lianne Dalziel said the existing cover for those injured due to
medical misadventure was "messy" and ran against the founding
principles of ACC.
"It is the only area of the scheme where a claimant has to prove fault
or prove what happened to them was so rare and so severe that it doesn't
generally happen," Ms Dalziel said.
Ms Dalziel said this set the threshold too high and those injured in any
other way received assistance from ACC no matter what the nature of the
accident or who was to blame.
One of the reasons for the tighter rules is to ensure ACC isn't swamped by
claims for medical work where an injury is expected or likely to happen. For
instance, where an operation involves surgery and painful recovery, this is
an injury, but an expected one.
Officials are still working on the options, but Ms Dalziel envisaged ACC
widening its coverage by not making the injured person prove negligence to
have a claim accepted. Instead minor injuries would be excluded and the
claimant would have to show the injury was not a likely outcome of the
medical intervention.
The minister acknowledged if implemented this would lead to an increase in
ACC's expenses and this would have to be met somewhere. Currently any claims
are funded by other levy-payers.
"The question at that point is do we then look at whether registered
medical professionals ... contributed to a fund?"
Doctors have argued that this would lead to defensive medicine being
practised and people being harmed because doctors were scared to intervene in
case something went wrong. This is based on ACC charging higher levies for
those parts of the profession with higher medical misadventure rates.
"I argue if it was a flat low levy across the professionals that
wouldn't be the case," the minister said.
Ms Dalziel said the alternative of a return to the right to sue doctors --
which she does not support -- would create even more defensive medicine and a
huge increase in medical insurance premiums.
ACC statistics show under current rules the number of medical mishap and
medical error claims it accepted rose by more than 100 to 721 in the year
ended June 30, 2001, costing ACC $22 million. The term misadventure covers
both mishap and error. A medical error is where the professional was at
fault.
Over a seven year period ACC accepted 4847 medical mishap and 763 medical
error claims.
The most claims accepted by ACC in the seven-year period for medical mishap
was 629 from general surgery. Gynaecology supplied 516 and orthopaedics 439.
The highest number of medical error claims related to general practitioners,
with 159.
Doctors reacted angrily last year when it was suggested that health
professionals pay an ACC levy to cover the sector. The power to levy the
profession has been in law since 1992, but never used.
A major patient safety study released last year found more than one in eight
public hospital patients would suffer some kind of medical mishap.
Of the 3000 deaths caused by medical failure, about half were preventable,
according to the study.
Preventable errors can be the result of individual negligence or system
problems, such as misread drug prescriptions.
Unavoidable incidents included known complications of operations and drugs.
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