Office of the Health Services Commissioner Annual Report 2008

HRA
HRA - 45 (4) Complaint not confirmed in writing 6 2%
HRA - 51 1(a) Not an interference with the privacy of an individual 5 2%
HRA - 51 1(c) Complaint not made to respondent by complainant 0 0%
HRA - 51 1(f) Complaint is subject to another enactment, court or tribunal 1 0%
HRA - 51 1(h) Respondent dealing/dealt with or hasn’t had opportunity to deal with complaint 5 2%
HRA - 52 (1) Complaint referred to Registration Board 0 0%
HRA - Complaint did not proceed 0 0%
HRA - Outside jurisdiction 6 2%
Total 23 8%
Conciliation Report
Keith Jackson
Chief Conciliator
The conciliation team deals with around 300
new complaints each year. The complaint
files vary in complexity with some major
claims for compensation taking up to two to
three years to conciliate. During the past
year a number of these long-standing
claims have settled, some for amounts in
excess of $600,000. The majority of
complaints are made under the HSCR
while complaints lodged under the HRA,
although less numerous, often involve
unprecedented facts and dilemmas for the
conciliators to work through.
A young woman still living at home attended a
radiology centre for an ultrasound that
confirmed she was pregnant. The woman
elected to have the pregnancy terminated. The
outstanding account was handed by the centre’s
receptionist to the complainant’s mother. The
account stated the service provided to the
daughter and the mother’s access to this
information led to a breakdown of her
relationship with her daughter. The
complainant pursued a complaint under the
HRA claiming that her private health
information was disclosed to her mother
without her consent. The disclosure was
acknowledged by the radiology centre. The
complaint was resolved in conciliation by way of
a monetary settlement for the pain and
suffering experienced by the complainant.
Table 9b
Reason given for Decline in Assessment
Although the types of complaints referred
to conciliation under the HSCR vary widely,
at the most serious end of the scale there
continue to be complaints about major
medical misadventures.
A woman underwent a varicose vein procedure
during which the common peroneal nerve was
mistakenly identified as a vein and severed. The
immediate consequence was a condition known
as foot drop, resulting in numbness and
alteration to the gait. The injury was identified
immediately. The hospital arranged for
assistance to the woman and her family and
referred her claim for compensation to its
insurers. The complaint has been settled in
conciliation.
Conciliation continues to be regarded by
health consumers and providers as a
successful mechanism for the resolution of
complaints, including matters that might
otherwise have been dealt with by litigation
before the courts. The level of co-operation
continues to be high and there is recognition
that the conciliation processes are impartial
and fair. Many health service consumers
express a preference for conciliation even
though they have the option of litigation.
Whilst the changes to The Wrongs Act
1958 have made it more difficult to claim for
general damages (pain and suffering etc.),
in some cases the need for impairment
assessments is waived and settlements can
then be negotiated without undue delay.
A woman underwent removal of her ovaries at
her local rural hospital. Several days later the
woman was found to have had a bowel
perforation, septicaemia and subsequently
suffered a stroke. The settlement of this claim
was assisted by a high level of co-operation
from the hospital, its insurer and solicitors and
resulted in significant quality changes at the
hospital.
Although a collaborative and conciliatory
approach is very much in the spirit of the
HSCR, unfortunately there are examples of
long-standing files closing because of a lack
of co-operation on the part of the health
service provider, their insurer and/or
solicitor even though they had agreed to
participate in the process.
As for the HSCR some people may write to
the Commissioner with complaints under
the HRA but then do not complete and
return the complaint form. This accounts
for approximately 25% of declined HRA
complaints.
A man underwent a laparascopic
cholycystectomy and suffered a major
complication. With the consent of the parties an
independent opinion was obtained in
conciliation. The opinion was critical of the
hospital’s management. Impairment
assessments (both physical and psychiatric)
were also obtained. The impairment
assessments were referred to the Medical
Panels and although the Panels agreed the
injuries satisfied the Wrongs Act 1958
thresholds there was no response from the
respondent’s solicitor in relation to the
complainant’s offer of settlement. The
complainant has sought legal advice.
The appointment of a Senior Medical Officer
has produced immediate benefits for the
whole office, and in particular for the
conciliators. The availability of speedy
advice and informal opinions on medical
matters in conciliation, along with advice as
to the appropriate specialties and
consultants from whom we should seek
opinions has facilitated the handling of
complex complaints.
There were 291 files referred for conciliation
during 2007/08. The outcomes have varied
as demonstrated by Table 10. 80% of
complaints were resolved, 2% referred to
registration boards from conciliation and the
remaining 18% either withdrawn or were
unable to be conciliated.
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Office of the Health Services Commissioner | Annual Report 2008